There is an initiative afoot in Latin America and the Caribbean to tackle the problem of parasitic infectious diseases such as Dengue Fever. The International Development Bank (IDB) has teamed up with the PAHO (Pan American Health Organization) and the Global Network to, as IDB president Luis Alberto Morena stated, “to put an end to…preventable and controllable diseases” in our region.  The funds for this initiative have come from the Bill and Melinda Gates Foundation.

US2.5M of these monies will be turned over to the IDB by the Global Network and the Sabin Vaccine Institute by signed co-financing agreement.  The Sabin Institute will design a special lending mechanism to facilitate the disbursement of sub-grants to deserving beneficiaries at the governmental and non-governmental levels to help them develop integrated plans targeting Dengue, lymphatic filariasis (elephantiasis), plague and other neglected infectious diseases (NIDs).

Source: stabroeknews.com

6

The Belize Flag

Belize

Yet another head of state from the wider Caribbean has been smitten by Dengue Fever.  First there was DR Vice President Rafael Albuquerque who was hospitalized on Sunday, August 17 2008 with Dengue Fever, one day after his swearing-in ceremony.  In September of that year, Trinidad Minister of Health Jerry Narace suffered the same fate, although he would not admit it.  Now, guess whose turn it is? Prime Minister of Belize Dean Barrow.

PM Barrows office confirmed this in a brief statement issued on Tuesday, September 29  2009. Barrow was absent from work for the rest of that week.

Source: caribarena.com

Puerto Rico

updated on October 12  2009

The AH1N1 (Swine Flu) has, in the past year, been receiving a considerable amount of attention from Caribbean health authorities, seemingly to the detriment of the more longstanding Dengue problem in the region.  Puerto Rico based blogger Adrianna has taken note of this.  She made the following comment to that effect on September 5, 2009 on her blog Observations from the ‘Island of Enchantment’:

We are currently in the peak of the hurricane season…and this is also a period in which more cases of dengue fever are reported.  However, now with all the attention on the swine flu, it seems as though the dangers of dengue fever have been pushed to the (back burner).  When visiting Puerto Rico’s Department of Health Website, the first thing you’ll see are the statistics on the swine flu…

Every year though, thousands of people on the island become infected with dengue fever and hundreds have died from it throughout the world.  As one of the local newspapers interestingly pointed out, dengue fever is more likely to be a greater threat in Puerto Rico than the swine flu.

PR Senator Luis Daniel Muniz took notice of this discrepancy too when reviewing the Dengue statistics up to the end of August.  For him, 150 new Suspected Dengue Cases and 3,256 total, demanded action. Muniz, therefore, instructed secretary of the Department of Health Lorenzo Gonzalez to promote an island-wide fogging campaign to regain control of the situation.

Muniz was reported in pontealdia.com as saying ”We cannot focus solely on addressing the transmission of the virus AH1N1 while Dengue cases continue to rise in Puerto Rico.

The Centers for Disease Control (CDC) in Atlanta, Georgia, confirmed one Dengue death in April, an eight-year old girl from central Puerto Rico.

There was also an unconfirmed press report of the death of a nine-year old from the same general area.

One month on, the incidence of Dengue continues to soar so much so that at October 10, the total number for the year was 94 higher than for the same time last year.

To date, Puerto Rico has recorded no less than 155 Dengue Cases.  And to quote Dr. Martha Patricia Cano, Director of Dengue Prevention, there were also 42 Dengue Hemorrhagic Fever cases.  Dr. Cano maintained that there has been only one case due to the disease, thereby discounting earlier media reports of a second.  (Source: flutrackers.com)

Version 1.1, originally published on May 7, 2008

ALERT! Version 1.2, reflecting the Dengue data for 2008, is here…

Dengue Fever is Dangerous slideshow

 

Slide through Dengue Fever is Dangerous – v.1.1, covering up to 2007. 

 

Dangerous Dengue is on the Increase

Or jump ahead to Dengue Fever is Dangerous – v.1.2 for a current perspective, to May 2009.

 

(Brought to you courtesy of the Environmental Health Division, British Virgin Islands)

 

 

Related Posts:

Guyana atop Dengue for Carifesta XDengue pummels VenezuelaDengue Totals Rising…

Dengue outbreaks have now been reported in Argentina, Bolivia and in Bahai, Brazil, Paraguay and Mexico.

Brazil continues to top the Clinical infections list with a tally of  226,513 Suspected Dengue Cases at Week 15, up from 126,139 Suspected Cases at last count.  To date, 1,416 persons have suffered from the complications of Dengue Hemorrhagic Fever/Dengue Shock Syndrome.  87 DHF/DSS Cases resulted in death.

Although Bolivia submitted five more weeks’ worth of Dengue records to the Pan American Health Organization (PAHO) than Brazil, the number of Clinical infections at 59,937 Cases, was still well back from Brazil’s, but with a much lower death toll.  Bolivia has not admitted to any more than 25 deaths (a figure that has remained unchanged over several weeks) from the 188 DHF/DSS Cases up to Week 20.

All things considered, this is undoubtedly Bolivia’s worst outbreak in decades, one that has spread to Argentina where the size of the event in terms of the number of  Clinically Confirmed Cases (24,720) and geographic spread is at a ten-year high.

Nevertheless, in spite of the fact that the DHF/DSS complications (6) and deaths (5) were minimal in Argentina, in  late May, when compared to what obtained in Bolivia, this event has still eclipsed the 1998 Argentina epidemic in magnitude. Most of those deaths have occurred in the northern provinces of Chaco and Catarmaca.

A spokesperson for the international humanitarian group Doctors of the World said the number of cases may be three times higher than what the government puts out.  That though might still be a modest calculation since the rule of thumb is a factor of 10. (Source: Wall Street Journal)

For countries in the Americas that, for one reason or the other, had not declared Dengue Outbreaks, the situation may be no less serious.  Take for instance Venezuela, on the tip of the South American mainland.  It could well be an issue of semantics that an Outbreak Alert was not posted there.  Venezuela has reported 14,167 Clinical Cases through Week 17.

Columbia, on the other hand, had not conducted any Laboratory Confirmations, preferring to go with Clinical Confirmations only.  So as it stood at Week 17, Columbia had 14,151 Clinical Cases, 16 less than Venezuela ’s 1,167 for the same period.  For what it was worth, Venezuela and Columbia were at the top of the DHF/DSS list at the end of March.

At the beginning of May,  DHF/DSS in Columbia numbered 2,o06 with 1,230 in Venezuela.  And to top that off, Columbia buried 17 (seventeen) persons to Venezuela’s 0 (nought).

Paraguay and Mexico, two countries which were once in the second tier of nations with Dengue along with Honduras, El Salvador and Peru, now have an elevated profile as Dengue Cases there keep rising.

Paraguay may have had more Confirmed Cases of Classic Dengue back in April.  But for what it was worth, Mexico was in a cloudier state at the time due to a higher percentage of DHF/DSS Cases, 534 from 2,624 Clinical/Confirmed Cases to Paraguay’s 1 out of 2,963.  On Week 16, Mexico’s figures had climbed to 723 DHF/DSS Cases out of 3,784 Cases.   In the interim, Paraguay’s Cases had more than doubled to 4,912  by Week 20 while the death toll was stuck on 1.  (The rationale for this is simple: DHF/DSS statistics indicate the degree of susceptibility of the given population based on the circulation of multiple virus types, one or more of which would have previously infected the resident generation within that population.)

Honduras and El Salvador had 2 deaths between them up to March month-end.  Oddly enough the incidence rate for the former was ten times higher than for the latter because of the number of DHF/DSS Cases, 171 in Honduras, 7 in El Salvador.  Nothing changed in regards to Honduras in the ensuing months be no further reporting of Dengue was forthcoming from that Central American country.  El Salvador has added a few more weeks of data to their pool to derive 1,638 Clinical Cases and 6 DHF/DSS Cases on Week 19.

Closer home in the Caribbean basin, Aruba was way out front with 2,652 Clinical Cases, followed by French Guiana (807), Suriname (241) and Guyana (492) for countries with more than one hundred Clinical Cases. Of those four countries, only Guyana was diligent enough to update the PAHO database since the last go around. Also, Guyana kept its perfect record of confirming all Clinical Cases. Not so Aruba, which does not have such a policy, a position I would not support unless the numbers would overwhelm the countries’ laboratories.

GUYANA DENGUE UPDATE at April 20: The Dengue count rose to 424, almost 300% higher than for the same period last year when 108 Cases were recorded.  This, in spite of a drop in the number of cases coming out of Georgetown and Lethem, attributed to the fogging that was done there   And still, there were unreported cases, according to Health Minister, Dr. Leslie Ramsammy.

Health Minister Ramsammy was convinced that there will be an outbreak of Dengue in Guyana unless people keep their environment clean, get rid of the abundance of discarded tires they have on their premises and prevent mosquitoes from breeding in their water tanks.

Minister Ramsammy revealed too that fogging would be done in Georgetown every three months. (Source: Dengue on the rise, Stabroek News)

The other Caribbean countries with in-country Dengue were French St. Martin (68), St. Barths (46), Barbados (25), Martinique (15), Guadeloupe (13), Jamaica (12), Trinidad and Tobago (10), Grenada (7), St. Lucia (6), St. Vincent and the Grenadines (5), British Virgin Islands (3) and St. Kitts and Nevis (1).

DHF/DSS in the Caribbean number 61, Suriname (57), Aruba (2), French Guiana and Guyana (1 each).  The two DHF/DSS Cases in French Guiana and Guyana expired.

(The Non-Hispanic Caribbean includes Anguilla, Antigua and Barbuda, Aruba, Bahamas, Barbados, Bermuda, British Virgin Islands, Cayman Islands, Curacao, Dominica, French Guiana, Grenada, Guadeloupe, Guyana, Haiti, Jamaica, Martinique, Montserrat, Netherlands Antilles, St. Bartholomew, St. Kitts and Nevis, St. Lucia, St. Martin, St. Vincent and the Grenadines, Suriname, Trinidad and Tobago, Turks and Caicos Islands, and US Virgin Islands.)

See full size image

British Virgin Islands

by Freeman Rogers, Editor, The BVI Beacon

Well, okay, the mosquitoes never really went away.  But they’ve been particularly awful recently, at least in my Road Town apartment.

So I’ve decided to fight back.

Freeman Rogers

Freeman Rogers

Every morning I get out of bed and grab one of those electric tennis rackets.  Then I sit in my living room and cackle with glee as I take revenge on the insects whose buzzing tormented me throughout night.

But that ritual is a little sick.  And, anyway, I’ve swung my electric tennis racket so often I’ve developed tennis elbow.

So I thought very hard and developed an ingenious plan. Or so I thought.

During the days after I came to the Virgin Islands, I remembered, I seemed to lose several pints of blood to mosquitoes every night.  Then, after a couple weeks, I noticed fewer and fewer bites.

When I explained this to other residents, they said, “Oh, yeah, the mosquitoes here like fresh meat. They like to bite new people.” I’ve heard this theory several times since.

If it were true, I realised, I could offer my living room couch to tourists for free.  Then, all the mosquitoes would bite them and leave me alone.

Since this seemed like a pretty big commitment — you can’t always trust a freeloading tourist — I decided to be sure.

‘Fresh meat’ theory

So I called Dr. Dave Chadee, a senior lecturer at the University of the West Indies, who has been studying mosquitoes for more than 27 years.

When I asked him about the “fresh meat” theory, he laughed.  The Trinidad-based scientist had another explanation.

“I think foreigners that arrive to the islands generally do not take much precaution,” he said.

After they’ve been here for a few days, though, they begin to exhibit “learnt behaviour,” such as wearing long pants, applying insect repellent and staying indoors, the scientist said.

Dr. Chadee also had another theory to explain the “fresh meat” phenomenon: Over time, people react less to the histamine that mosquitoes inject to keep human blood from clotting.

“As the tourists stay on longer and longer, they become less sensitive to the bites,” he said.  “It’s not that you have immunity, it’s that you become less sensitive.”

Failed plan

In other words, mosquitoes don’t give a hoot about “fresh meat.”

My plan to use tourists as mosquito bait was starting to look like a waste of time.

But then Dr. Chadee briefly restored my hope.  Some people, he said, seem to naturally attract mosquitoes. Even science doesn’t know why.

“Whether it is human odour, whether it is the type of clothing,…or that they’re in the wrong place at the wrong time,” he said.

This fact briefly made me reconsider my original plan.

But then I wondered how I would advertise my couch: “Free accommodation for someone who is particularly prone to mosquito bites”?

I didn’t think I would have many takers.

Other plans

With my tourist-bait plan out the window, I asked Dr. Chadee about some other wisdom I’d heard.

“It is true that eating bananas will keep mosquitoes away?” I said.

Again, Dr. Chadee laughed.

“I’ve heard people talking about garlic and other things,” he said.  “I don’t know of any foods that can be eaten to really give off the odour that will deter mosquitoes from biting you.  A lot of people have gone and taken Vitamin C, and some have taken garlic and stuff like that, but I don’t think there is much scientific evidence to support the use of that.”

Another plan ruined by science.

Then Dr. Chadee’s tone became very serious and he started explaining the real danger of mosquitoes: Namely, they can transmit nasty diseases.

Here, as most residents know, dengue is the most common threat from the insects.  But Caribbean countries also have to be wary of other diseases they might have forgotten about, the lecturer said.

Malaria, for example, was eradicated from most of the region in the 1960s and 1970s, but, since then, many health officials have relaxed their vigilance.

As a result, the disease has returned to some countries, including Jamaica.

I hung up the phone feeling afraid, with the realisation that my mosquito problem was worse than I had feared.

VI fight

So I called Minchington Israel, the programme manager for the Virgin Islands’ Vector Control Programme.

To my relief, Mr. Israel assured me that his department’s 10 inspectors are on top of the situation.  They spend their time collecting data on where the next mosquito outbreak might occur and trying to pre-empt it.

Now, for example, they’re anticipating a problem between Beef Island and Paraquita Bay, and they’re planning to fog the area soon.¹

Currently, most of the programme’s resources are put toward fighting the Aedes aegypti mosquito, which carries dengue, Mr. Israel said.  And, though the VI doesn’t have a history of malaria, officials could institute a similar programme to fight mosquitoes that carry that disease, too, if necessary, he added.

But the real soldiers in the mosquito war, according to the programme manager, are you and me.

Laying eggs

Because Aedes mosquitoes like to lay their eggs in clean water, most of them reproduce in or around homes — in cisterns or in pools that collect around buildings and yards.

This means that residents need to clean up any potential breeding areas around their homes.  And, if their cisterns are infested, they can get free guppies from the programme: The tiny fish eat mosquito larvae without fouling drinking water, Mr. Israel said.

“There’s no question that only householders can win the battle against Aedes aegypti,” he added, making me feel truly noble in my own quest.

After listening carefully to Mr. Israel, I’ve patrolled my apartment for standing water, and I’m considering ordering some free guppies. I feel like a true soldier in the war against mosquitoes.

But I’m not sure if that’s enough.

So, if you have any friends who happen to be particularly attractive to mosquitoes, please give them my name: I think I know of a great place for them to vacation.

¹The Beef Island to Paraquita Bay areas were fogged ending Thursday, November 05, 2009 with more work still to be done.

Last Updated by Freeman Rogers (Wednesday, 28 October 2009)

Sanofi Pasteur has taken yet another step forward in the development of its investigational, novel tetravalent Dengue vaccine candidate with advanced clinical studies among children and adults in Singapore and Vietnam.  Part of a global clinical study programme being undertaken in endemic regions in Asia and Latin America, these studies mark the expansion of  sanofi-aventis Group’s Asia-Pacific Dengue vaccine programme from Thailand and the Philippines.

Clinical trials have been completed in a mix of non-endemic and endemic countries, namely the United States of America, Mexico and the Philippines.  However, clinical studies of Asian adults and child subjects are ongoing in the Philippines and Thailand as well as in Peru and Mexico in Latin America.  With specific reference to Thailand’s children, the goal of the studies is to determine vaccine efficacy against asymptomatic Dengue.

The initial results show that three doses of the vaccine are sufficient to elicit a balanced immunological response against the four Dengue serotypes.  Additionally, tolerance and safety appear to be good.

Sanofi Pasteur is working jointly with Singapore’s Communicable Disease Centre and Vietnam’s Pasteur Institute. Sanofi Pasteur is the vaccines arm of sanofi-aventis Group.  Their tetravalent Dengue vaccine, the first to get this far along, targets all four Dengue virus strains simultaneously.

(Source: intellasia.net)

5

http://wwp.greenwichmeantime.com/images/flags/trinidad-flag.gif

Trinidad

The National Surveillance Unit of the Trinidad Health Ministry revealed in an official press release recently that there was a “steady decline” in Suspected Dengue Cases by month in Trinidad and Tobago between February and July.

The NSU release, late August, stated that February 2009 saw 266 Suspected Cases making it the heaviest month to date.  Since then, the number of Dengue diagnoses have fallen to the extent that only 42 Cases were counted between July 01 and July 25  2009.   This brings to 1, 204 the total of Cases tallied by the Surveillance Unit for the first seven months of the year.

The low level of Dengue activity has not dulled Trinidad’s Insect Vector Control, the country’s regional corporations and the ministry led inter-sectoral committee’s “Source Reduction” mantra.  They continue to urge Trinidadians to eliminate mosquito breeding places even as they maintain spraying  programmes, undertake clean-up campaigns and mount aggressive public awareness initiatives.

And of course, the authorities could not stress more how important it is for persons showing the classic signs and symptoms (intense headaches, sudden onset high fever, backache, muscle and joint pains, pain behind the eyes or retro-orbital pain, vomiting, and occasionally skin rash and diarrhoea) of Dengue to visit a physician without delay. (Source: Govt: Dengue cases on decline)

22

https://sws9americas08.wikispaces.com/Cuba

Cuba

Two Cuban epidemiologists were in Sri Lanka in mid-August to lend a helping hand to the Health Ministry there in its ongoing tug-o-war with a Dengue outbreak, which had claimed 232 lives.

The Cuban experts first toured the country to assess the situation and presented the Sri Lanka Public Health Director, Palitha Maheepala, with a detailed report of how to tackle the Dengue outbreak using the bacteria, BTI (Bacillus thuringiensis israelensis), that the Cubans have been researching as part of their own bio-insecticide programme. BTI bacteria kill the larvae in Aedes aegypti infested waters.

Colombo has pledged to study the Cuban report before implementing its findings.

Source: prokerala.com

15

http://www.mapsofworld.com/flags/guatemala-flag.html

Guatemala

The confirmation by health authorities in early August of the death of two people from Dengue Hemorrhagic Fever in the Caribbean Sea province of Izabal, brings to at least 10 the number of deaths to Dengue this year.  This figure is derived partly from a report by an opposition party Congressman, representing Izabal, that eight children from his district had died from DHF.

The Congressman’s numbers are, however, somewhat at odds with those  of the Health Minister Celso Cerezo. Cerezo says that he is aware of the two most recent deaths and another 16 DHF cases – all of whom were recovering – in Izabal.  But he puts the total Classic Dengue infections in the district at 115 while Congressman Byron Chacon’s tally is well below that at 69.

Source: Latin American Herald Tribune

14

See full size image

Cayman Islands

There seems to be some truth to the story that spending cuts initiated by the Cayman Islands’ government have affected the operations of the Mosquito Research and Control Unit (MRCU), the agency responsible for mosquito control in the British Dependent Territory.

The first programme to be grounded by the cuts in overtime pay is the MRCU’s fleet of airplanes that have made such a big difference in the success of the mosquito control programme in Cayman.  The Cayman Islands remains one of the few Caribbean countries where there is no continuous, local Dengue transmission.  Only on the very rare occasion has the Aedes aegypti mosquito ever enjoyed a short-lived resurgence in that country.  The real threat to the Cayman Islands is actually when travellers return home with Dengue.

With the hands of the MRCU having been somewhat tied by what a Cayman News Service report referred to as insolvency in the Cayman economy, MRCU Research Manager Fraser Allen is calling on residents, especially those in the Capital Georgetown and West Bay, to take up the slack by exercising greater control over Aedes aegypti breeding in and around their premises.  This the Research Manager explained would save resources and keep the spread of mosquito-borne diseases like Dengue Fever in check.

The fact that these mosquitoes breed mostly in domestic environments…as a result of human activity gives residents a major role to play in eliminating the insect.  By taking simple actions such as emptying water vessels regularly and punching holes in old household items prior to disposal, residents can prevent breeding and reduce the chance of a dengue fever outbreak in the Cayman Islands,” was Allen’s advise to the Cayman public, published in the CMN, September 4, 2009.

7

Next Page »