Update of Plague outbreak in Madagascar and revision of restrictions

29th November 2017 – The World Health Organization (WHO) has officially reported the plague outbreak in Madagascar to be contained in an update dated 27th November 2017. The 27th November marked 14 days after the last case of plague was reported.

In light of this development, the Public Health Authority is lifting the imposed travel restriction and wishes to inform others that there are no trade restrictions. Surveillance at the ports of entry, in laboratory and the health facilities are maintained. Isolation facilities at the military training academy are to be returned to the academy with immediate effect. Ships can enter port for normal activity without having to spend the 7 days outside Madagascar first.

The PHA takes the opportunity to thank the public for their support and understanding during this outbreak. The PHA will provide periodic update as and when required.

Overview of outbreak

Since the onset of the plague outbreak in Madagascar in August 2017, 2348 cases have been reported with 206 deaths (case fatality rate of about 9%).

The Ministry of Health in Madagascar officially announced the containment of the acute urban pneumonic plague outbreak on 25th November 2017. However, because plague is endemic in Madagascar and as the plague season lasts from September to April, more cases of bubonic and sporadic pneumonic plague are expected to be reported until April 2018.

It is therefore important that certain surveillance measures continue through to the end of the plague season. Based on its guidelines, WHO has reported that due to concerted national and international response the current and unprecedented outbreak of plague in Madagascar, which started on 1 August 2017, has been contained. International risk of spread of the plague was assessed to be low during the outbreak and now with the absence of new cases, that risk is even lower.

 

Health Care Agency to receive new batch of medical equipment

27th November 2017 – The Health Care Agency will sign an agreement for the purchase of medical equipment under the 36.5 million Seychelles Rupees received from the Government of Indian on Tuesday 28th November 2017 at 1.30pm.

Equipment purchased under this grant will be from an enterprise of the Indian Government, HLL Infra Tech Services Ltd.

The CEO of HCA, Dr Danny Louange and the CEO of HLL Infra Tech Services Ltd, Mr S.N Sathu will sign the agreement to facilitate purchase of specific equipment, in the presence of the Minister for Health, Mr Jean Paul Adam in a short ceremony, in the Minister’s Conference Room at the Red Roof Building.

The agreement caters to 17typesof medical equipment, totalling to 378 items specified by HCA. These include anaesthesia units, neonatal ventilators, patient monitors, ultrasound scanners, dental chairs and equipment and many other useful life saving equipment.

This partnership marks the second phase of the purchase of medical equipment from the Indian Government following the presentation of a large consignment of similar equipment from the Indian Government in early November 2017.

 

Update on Plague Alert

22nd November 2017 – The WHO update of 20th November has declared that the epidemic phase of the plague outbreak in Madagascar is ending but is not over. WHO will usually declare an outbreak to be over after two maximum incubation periods has passed (2×7=14 days).

However, given the endemic status of plague in Madagascar and given that the usual season ends in April, they may not do that just yet. Therefore, all measures in place in Seychelles continue. These include the temporary suspension of Air Seychelles flights to Madagascar, active isolation, measures at the ports of entry, and surveillance at all levels.

In view of the greatly decreased risk of human to human transmission, disease circulation exit screening in Madagascar, entry screening in Seychelles, easy treatment of cases, no antibiotic resistance detected and confirmatory tests being done locally, completed preparedness and response plan including a communication plan, make the chance of a plague case entering Seychelles and spreading very low at this stage.

Since the onset of the outbreak in Madagascar in August 2017, 2267 cases have been reported with 195 deaths. 76% of the total number of cases were pneumonic. During the outbreak 82 healthcare workers got infected but none died.

Only two foreigners contracted the plague while in Madagascar; the late Mr Alix Alisop (Seychellois) and a South African coach who was one of his contacts when he was ill. The latter recovered.

The number of cases in Madagascar has steadily declined since mid-October. The last confirmed bubonic plague case was reported on 7th November 2017, and the last confirmed pneumonic plague case was reported on 14th November 2017.

Since plague is endemic to parts of Madagascar, WHO expects more cases to be reported until the typical plague season ends in April 2018. It is therefore important that control measures continue through to the end of the plague season. With all the measures in place it is expected that any new cases would be managed more promptly.

Seychelles hosts Rehabilitation International Secretary General

14th November 2017 – The Ministry of Health will host the Secretary General of Rehabilitation International (RI), Ms Venus M Ilagan at the Red Roof Building on Friday 17th November 2017at 11am.

Ms M Ilagan will pay a courtesy call the Minister for Health, Mr Jean Paul Adam at 11 am to discuss new partnerships and areas of cooperation.

This visit follows the Rehabilitation International Global Annual General Assembly being held in Ethiopia from the 12th to 15th November 2017. Seychelles who is a member of Rehabilitation International will be participating in this meeting.

Rehabilitation is the action of restoring someone to health or normal life after training and therapy after an ailment. In Seychelles rehabilitation services are mainly offered at the North East Point Hospital and the Rehabilitation Centre in North East Point.

Ms Ilagan will be in Seychelles from the 16th to 19th November. She will also visit the Ministry of Family Affairs, the School for the Exceptional Child, Rehabilitation Centre, and the Vocational Centre for Persons with Disabilities.

 

Self-management practices promoted on World Diabetes Day

13th November 2017 – To commemorate the world wide occurrence of Diabetes Day 2017, on Tuesday 14th November 2017, the Ministry of Health is hosting a half day forum between 8.30 am and 12.30p, at the Sheikh Kalifah Diagnostic Centre.

The aim of the activity is to explore appropriate diabetes self-management skills and practices amongst people living with diabetes. Both patients and doctors will discuss their views in a shared panel discussion, to inform many of the various materials being developed for self-management in diabetes.

Additionally, two new tools for people living with diabetes will be introduced and discussed. These include a booklet titled ‘Mon Dyabet, Mon Responsibility’, outlining self-care practices that can be employed at home and a trial of a ‘passport’ for patients to record each and every aspect of managing their disease.

World Diabetes Day is commemorated annually on 14th November. Although, this year’s theme ‘Women and diabetes – Our Right to a health future’ places a special focus on women’s experience with the disease, the Ministry of Health aims to educate everyone on adequate self-management skills in line with previous campaigns started throughout the year.

Seychelles Family Hospital inaugurated by President Faure

13th November 2017 – Mr Danny Faure, President of the Republic of Seychelles will unveil the plaque of the Seychelles Family Hospital in Perseverance 1, officially opening the facility to the public, on Thursday 16th November 2017.

This will take place in a ceremony at the hospital at 3pm.

In attendance will be the Vice President, Speaker of the National Assembly, President of Appeal, Chief Justice of the Supreme Court, Two Leader in the National Assembly, Minister and High Official in the Government and several other management staff from the Ministry.

The Family Hospital was sponsored by the Sheikh Kalifah Bin Zayed Al Nayan Foundation and was officially handed over to the Ministry of Health on 9th August 2017. Operations have already begun at the facility, since the final patients moved at the end of October.

Ministry of Health hosts discussion on new scheme of service with NARS

13th November 2017 – The Minister for Health met with the Nurses Association Republic of Seychelles (NARS) on Thursday 9th November 2017, to further discuss terms of the proposed scheme of service for nurses and midwives.

Opening the meeting, Minister Adam expressed appreciation of the Association for working with the Ministry of Health to give appropriate recognition to the nurses and midwives who are the bedrock of the health system through their submissions in July 2017.

“There are several advantages that are already planned in the budget 2018,” Minister Adam said. “We want to continue to discuss with the nurses association and take them forward in future.”

This feeling of partnership was also affirmed by the Chairperson of the association, Mrs Rosie Bistoquet who thanked the Ministry for taking the discussion further by inviting them to once more discuss the proposals. “We get to discuss the scheme and the weakness that we’ve picked out, in the common interest of advancing the nursing profession,” Mrs Bistoquet said.

The new scheme of service for nurses is part of an already proposed revision for all health workers. This is being phased over the next two years. In 2018, the first phase for Nurses, Midwives and Health care assistants will be rolled out. For nurses, the main improvements for 2018, include a SCR 3,000 retention allowance.

Minister Adam clarified that the intention is to have the allowance incorporated within the basic pay for nurses. “This step is to be done as an allowance until the assessment of nurses’ responsibilities and duties have been completed in line with work being undertaken with WHO,” Minister Adam stated.

“Providing the allowance in 2018 however means that nurses won’t have to wait until the review is complete to get an increment.”

However, the view from the opposite side of discussion insisted that this be included as part of the basic pay immediately. Though this is not yet possible according to standard human resources practices, NARS have been reassured that it will be done once the review is complete. This will be towards the end of 2018.

Other points of concern was the difficulty to get loans with a lower basic pay. Minister Adam clarified that when giving loans, banks take into consideration the whole package of nurses, including allowances which are regular and not variable in nature. The whole package include the basic salary, marketable skills allowance, inducement allowance and retention allowance.

Improvements planned for 1st January 2018, will give nurses a starting package of SCR 13,000 when their regular allowances are calculated together. Minister Adam also confirmed that nurses’ pension will also be calculated on the total of the regular pay and regular allowances.

Another advantage within the new scheme meant to take effect in 2018, is a revised gratuity system whereby nurses will receive 10% of their total salary over 5 years.

Minister Adam also highlighted several of the changes brought up in nurses meeting held over the past few weeks. These include improvements in the rates payable for un-rostered overtime and the development of a performance incentive based system to better reward good performance and ensure also a higher quality of service to the public.

Following the meeting, it was agreed that further discussions on outstanding issues relating to inducement allowances, risk allowances, and marketable skills allowances will be addressed with NARS in an agreed quarterly meeting.

 

Update on Plague Alert

31st October 2017 – The Plague outbreak in Madagascar persists but is reported to be slowing down. The capital Antananarivo is the most affected area with predominantly pneumonic type. All countries in the region are on heightened surveillance and alert, and have issued travel advisory. Many other countries outside the Indian Ocean have also issued travel advisories.

Local update
  • As of Saturday 28thOctober2017, the last two people who had visited Madagascar and were under active surveillance in isolation at the military academy completed their 7 days. They were discharged home. There are currently no further persons under isolation or any form of surveillance.
  • Cruise ship season has started and between late October2017 and April 2018, there will be 68 cruise ships that will call at port Victoria. The PHA has the schedule for the season and is not only monitoring the movements of the cruise ships, but also analysing the passenger mobility.
  • Cruise ship agents have been directed to inform the cruise ship operators that no passengers or crew from Madagascar should join the ship less than seven days prior to arriving in Seychelles.
  • No ship should enter Seychelles less than 7 days after leaving Madagascar. Should this happen, the ship will be placed under quarantine in outer harbor until the 7 days have elapsed. During that time no passengers, crew or cargo may leave the ship. The PHA officers will be monitoring closely.
  • Temperature checks and medical declaration form are continued to be applied at the airport for arriving passengers to maintain vigilance.
  • The Public Health Authority (PHA) continues to emphasise the advisory to discourage people from travelling to Madagascar for the time being.
  • However, individuals from Madagascar who have spent at least 7 days outside Madagascar and have remained well may enter Seychelles and will not be placed under active surveillance at Ile Perseverance military training academy. Any person who has been in Madagascar in the last seven days will be placed in isolation as per the established procedure.
  • Hotline 141is active and people can call for information and advice.

 

Regional Influenza Alert

31st October 2017 – The island of Reunion has been registering an increase in influenza activity since August 2017. The peak of the epidemic was around mid to late September and has been on the decline ever since. Up to week 41, 2017, there were 42 admissions of which 33% tested positive for A(H1N1)pdm09, 44% for Influenza B and 24% A(H3N2)/A non H1N1 unfortunately, 8 influenza related deaths reported since beginning of 2017.

This however has not been registered by WHO as a regional threat as the number of cases has quickly subsided. The Seychelles authorities have been monitoring the situation nonetheless through the exchange of information through the SEGANET Indian Ocean Commission network, and the risk has been assessed as curtailed for Seychelles.

For the past two years, the influenza activity in Seychelles has been at its lowest with no significant number of cases reported and no outbreaks. For the greater part of 2017, few cases of influenza were notified and was significantly below the number of cases expected for the particular time of the year. Sentinel influenza surveillance has been at its minimal due to the few cases but has managed to identify a low circulation of Influenza B in the population. To date there is no influenza associated deaths reported.

Influenza is a viral illness which normally spread by the coughs and sneezes of an infected person. Although unpleasant, flu is rarely life-threatening. You can also catch flu by touching an infected person, for instance, shaking hands or surfaces contaminated by the virus. A person is contagious 1-2 days before getting symptoms and up to 7 days after becoming ill. This means that you can spread the influenza virus before you even know you are infected. Incubation period is from 1 to 4 days. Influenza presents with fever, a temperature of 38 degress celcius or higher and cough with or without other symptoms such as aches and pains, nasal congestion, tiredness, headache, sore throat and chest discomfort. Influenza needs to be distinguished from common cold.

Treatment of Flu is mostly symptomatic.

Individuals with flu should:

  • stay at home
  • avoid contact with other people where possible
  • keep warm and rest
  • consume plenty of liquids
  • avoid alcohol
  • stop smoking
  • make an effort to eat even if appetite is low
  • take painkillers and anti pyretics to lower temperature. Antibiotics is not recommended unless the person develops secondary bacterial infection. This usually happens in people with depressed immune system such as elderly, very young children or if the person is on medications that lowers immunity.

In view of the now diminished flu activity to below epidemic threshold in Reunion, no particular travel restriction to or from Reunion is indicated. Europe is also entering the influenza season. Anyone travelling in these areas are at increased risk of catching influenza. Therefore, take universal precaution of frequent hand washing, avoiding crowd and poorly ventilated rooms. If you do catch influenza, stay at home and refrain from mixing in crowd to prevent spread. You only need to consult a doctor if the symptoms are severe or you develop breathing difficulties and / or severe chest pain.

 

Operations commence at Family Hospital as patients move in

31st October 2017 – On Tuesday 31st October 2017, patients and staff from the Female Medical Ward of the Seychelles Hospital will relocate to the newly built Family Hospital situated on the peripheries of Perseverance.

Moving the entire ward is necessary to kick start the redevelopment plan of the Seychelles Hospital. It will include renovations, in phases, on the emptied ward as well as the others.

A total of 19 patients accompanied by their attending physicians and nurses will have moved by the end of the day.

Several provisions have been made for the patients. This ensures that there will be no interruptions to the services they are currently receiving. The Hospital will only be providing in-patient care for now and the staff will not be able to accommodate walk-in and emergency services. Management staff of the Health Care Agency has extended a reminder for members of the public to continue utilising these services from their regional health centres.

Personal visits will be from 2pm to 7pm during weekdays and 10 to 6pm during weekends. The Seychelles Public Transport Corporation (SPTC) will provide daily buses services.

The Family Hospital was officially handed over to the Ministry of Health by the Sheikh Kalifah Bin Zayed Al Nayan Foundation on Wednesday 9th August 2017 and the opening of the facility is scheduled for later.