Dengue Fever 2006: New Year, New Outbreaks
Dengue fever can produce widespread epidemics characterized by high morbidity rates, but the vector-borne flavivirus generally causes much lower mortality rates unless shock and hemorrhage occur. Four different dengue virus serotypes exist. All four cause febrile illness in humans, which can lead to dengue hemorrhagic fever in more severe cases. The CDC stated recently: “In 2005, dengue is the most important mosquito-borne viral disease affecting humans; its global distribution is comparable to that of malaria and an estimated 2.5 billion people live in areas at risk for epidemic transmission” .
Reported outbreaks of dengue fever, precautionary measures against the virus, and other dengue news occurred in the following countries last month:
: Health Ministry Director Ismail Merican announced an outbreak of dengue fever in the Tanah Merah district of Kelantan . Officials recently learned that the two 13-year-old girls who died in the district last month tested positive for dengue, not Japanese encephalitis. In addition, 11 other dengue cases were reported in Tanah Merah last month. According to AsiaNews.it, Ismail stated, “We have beefed up our control measures. Whether it is dengue or JE, the root cause is mosquitoes, so we have taken measures to ensure cleanliness” . MALAYSIA : According to El Comercio, Health Minister Ivan Zambrano acknowledged a second death in ECUADOR from the current outbreak of dengue fever . Like the first fatality that occurred on January 13th, the 65-year-old woman who recently past away suffered from dengue hemorrhagic fever. Zambrano reports efforts between the Crisis Committee, province directors, the Malaria Program, and local epidemiologists to control and prevent future cases. Approximately 4,000 cases of classic dengue fever occurred in 2005 along with 75 cases of hemorrhagic dengue, as reported by El Diario . Ecuador : To prevent a potential outbreak of dengue fever, Public Health Ministry officials have recommended that community members in PARAGUAY eliminate mosquito-breeding sites that form after rainfall . Because areas within Asuncion average a 4.1 percent larval infestation index, the ministry aims to reduce the index to less than one percent, which decreases the odds of virus transmission. ABC Digital reports that prevention success also depends on increased vector surveillance and participation by the entire community to implement corrective measures . Asuncion
Comments: The proposed “Prevention of Mosquito Breeding Act” in
may prove beneficial, while recognizing that containers made from other materials like glass and aluminum can also serve as breeding grounds for mosquitoes. As noted in reports from Sri Lanka , prevention success greatly depends on cooperation among all members of the entire community. Everyone in dengue-afflicted areas must therefore work together to eliminate mosquito breeding sites by properly disposing of trash, covering buckets of water, and removing other outdoor items that collect rain. Surveillance also plays a pivotal role in the battle against infectious disease. Transparency remains essential to control disease outbreaks and prevent future cases; early notification enables health officials and the public to adopt precautionary measures in a timely fashion. Paraguay
1. CDC. Division of Vector-Borne Infectious Diseases. Dengue Fever, Current Trends. Available at: http://www.cdc.gov/ncidod/dvbid/dengue/. Accessed on
8 February 2006.
2. Reuters. At least two dead in
Riodengue fever outbreak. Available at: http://www.alertnet.org/thenews/newsdesk/N26376317.htm. Accessed on 12 February 2006.
3. Agencia Brasil. Rio Physicians' Syndicate issues international dengue alert. Available at: http://internacional.radiobras.gov.br/ingles/materia_i_2004.php?materia=254853&q=1&editoria=. Accessed on
12 February 2006.
4. South Asian Media Net. Plastic containers and bags to be banned. Available at: http://www.southasianmedia.net/Archive_full.cfm?nid=268239. Accessed on
6 February 2006.
5. Daily News. New act on “Prevention of mosquito breeding” soon. Available at: http://www.dailynews.lk/2006/02/06/. Accessed on
6 February 2006.
scrambles to contain dengue outbreak. Available at: http://www.asianews.it/view.php?l=en&art=5287. Accessed on Malaysia 6 February 2006.
7. El Comercio. Otra persona falleció por el dengue hemorrágico. Available at: http://www.elcomercio.com/noticia.asp?seccion=2&id=23571. Accessed on
6 February 2006.
8. El Diario. Manabí ya supera los 20 casos de dengue. Available at: http://www.eldiario.com.ec/?module=displaystory&story_id=59446&format=html. Accessed on
6 February 2006.
9. ABC Digital. Story available at: http://www.abc.com.py/articulos.php?fec=2006-01-30&pid=231372&sec=3.
Deepu Alex, Carlene Gong, Chelsea Johnson, Cheryl King, Anthony Ho, Katarro Rountree, and Lisa Sani
Graduate Students, Master of Science Program in Biohazardous Threat Agents and Emerging Infectious Diseases, MICB-524 “Emerging Diseases: Past as Prologue”
Department of Microbiology and Immunology
of Medicine Georgetown University School