Virologist prescribes caution, transparency

Amidst concerns by parents over a confirmed case of a pupil contracting the virus that causes scarlet fever at Hillaby/Turner’s Hall Primary School, virologist Dr Camille Lange is calling for caution, transparency and vigilance.

She also says it is still too early to determine whether Barbados is facing a wider outbreak.

“Based on the publicly reported information alone, I would be cautious about calling this a wider outbreak,” she said. “What has been reported appears more consistent with a small cluster or a situation under investigation. However, I cannot rule out wider transmission without access to surveillance data, laboratory results, clinical reports and school absenteeism trends.”

Her comments come as parents have been demanding answers about the handling of the situation and whether enough information has been shared by health and education officials with families whose children attend the Farmers, St Thomas school.

Last Wednesday, health and education officials held a meeting with some parents in a bid to assure them they were not withholding information of the health issues being experienced by some pupils. However, a number of frustrated parents refused to go into that meeting and instead held a small protest outside the school gates.

Lange, who has extensive international experience responding to major infectious disease threats, including during the 2014 Ebola outbreak in Sierra Leone, said while she could not determine whether official statements fully reflected what health officials were seeing on the ground as she had not reviewed the underlying clinical or public health data, public confidence often depends as much on communication as it does on medical facts.

“What I can say is that parents appear to feel that their lived experience has not always matched the tone or completeness of the public messaging. That gap matters. Even when officials are medically correct, public confidence can be weakened if people feel their concerns are being minimised,” she told the Sunday Sun.

The virologist stressed that transparency was essential whenever public health concerns arose, particularly when children were involved. “People need to understand what is known, what is not known, what is being investigated and when they can expect updates.”

While individual medical details must remain confidential, she added, authorities should provide regular aggregate information such as the number of reported cases, the number tested, confirmed, ruled out or still under investigation.

However, Lange made it clear she was not suggesting officials had failed to act.

Communication concern

“Based on public reports, there were investigations, testing, meetings and follow-up. My concern is whether communication has been consistent, timely and sufficiently parent-centred. Parents do not need only conclusions, they need explanations.”

The public health specialist pointed out that it was especially important for parents to understand why schools remained open while investigations continued, as she cautioned against assuming that every child presenting with symptoms necessarily had scarlet fever.

“Scarlet fever; hand, foot and mouth disease, viral rashes, impetigo, allergic reactions and even dengue can overlap in some symptoms. Fever, rash, sore throat and fatigue can appear in many conditions.

“What is important is whether there is a system actively looking for patterns, following up symptomatic children and updating the public as the picture becomes clearer.”

While investigations continue, she is encouraging schools and parents to focus on prevention.

Among the recommendations are ensuring sick children remain at home, seeking prompt medical attention for children with symptoms, frequent handwashing, regular cleaning of high-touch surfaces, close monitoring of cough and sneezing etiquette, and maintaining accurate attendance and illness records.

She also called for stronger communication between principals, school nurses, public health officials and parents whose children are diagnosed with scarlet fever.

According to Lange, internationally accepted guidance generally states that children diagnosed with scarlet fever are no longer considered contagious about 24 hours after beginning appropriate antibiotic treatment, provided they are clinically well enough to return to school.

Scarlet fever is caused by Group A Streptococcus bacteria and spreads primarily through respiratory droplets and close personal contact. Schools can be particularly vulnerable because children spend long periods together in classrooms and shared spaces.

However, Lange emphasised that the presence of several cases does not automatically mean Barbados is facing a major outbreak. “It means schools need good hygiene, prompt recognition, appropriate treatment and clear exclusion guidance.”

Her advice to parents: “Keep calm but keep asking questions . . . . Ask your doctor what diagnosis is suspected, whether a test was done, what the result means, whether antibiotics are needed, when your child can return to school and what symptoms should prompt urgent medical attention.” (NS)

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