BVI Government acts to control the spread of Dengue

from Government Information Service

edited by Israel

Virgin Islands (Br.)

The Ministry of Health and Social Development is acting to control the spread of Dengue Fever following an increase of new cases in the Territory during the last five weeks.

Dr. Irad Potter (CMO)

Chief Medical Officer Dr. Irad Potter said eight (8) positive cases were diagnosed between June 1 and July 7, six (6) females and tw0 (2) males between the ages of 7 and 35.  “The public is advised to take protective measures to prevent themselves or family members from contracting the disease,” Dr. Potter said. 

The Chief Medical Officer noted that it is important for medical attention to be sought as soon as signs and symptoms of Dengue Fever are evident.  General symptoms include fever, frontal headache, pain behind the eyes (also known as retro-orbital pain), and muscle and joint pain.  Some persons may develop a rash.

Dr. Potter is encouraging residents to take basic measures to help limit the breeding of Aedes aegypti mosquitoes, which spread the Dengue virus.

Residents are reminded that mosquitoes breed in stagnant water.  The Chief Medical Officer also advised that the water in flower pots should be replaced with dirt or that containers should be cleaned and scrubbed regularly.

Cisterns should also be covered and outlets screened, while downspouts should be covered with mosquito netting or other suitable covering.

The Chief Medical Officer has also called on residents to ensure the proper disposal of items such as old tires or receptacles that can gather water that can create the ideal environment for the Aedes aegypti mosquito to multiply.

Dengue fever and Dengue Hemorrhagic Feverare acute febrile diseases, found in the tropics, and caused by four closely related virus serotypes.  The World Health Organisation (WHO) estimates that two fifths of the world’s population is now at risk from Dengue.  The WHO also estimates that there may be 50 million cases of Dengue infection worldwide every year.

 

Original BVIGIS release: bvinewsonline 

 

 

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Dengue epidemic in Guyana; Malaria uncontrollable

Guyana

Minister of Health, Leslie Ramsammy, citing official data finalized up to the end of May, 2009, declared in mid-June that Dengue in Guyana was at epidemic levels. In regards to Malaria, the Minister revealed that health workers, including Vector Control, was struggling to keep the number of infections of both diseases down. He was not hopeful either of success in controlling either Dengue or Malaria.

Speaking at a Vector Control workshop for government and city council health workers on June 17, Ramsammy underlined the strides his country has made in the war on Malaria between the 1990s and the present. The country recorded 94,000 Malaria cases in the ’90s; only 11,000 cases in 2008.

But in the same breath as Ramsammy was lauding his country’s successes in regards to Malaria, he expressed grave pessimism that these gains could be consolidated, let alone improved upon.

“Despite the things that we have done,” he intimated, “like introducing better medication, better trained people, and distributing mosquito nets, we are not going to win the battle.“

The Minister laid the blame for this squarely at the feet of the municipalities, which he said have not “maintained any capacity for Vector Control.” Not a single one, he emphasized – not even the city of Georgetown.

Source: Kaieteur News

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Predicting Dengue

A new method of predicting DF and DHF epidemics

A new method of predicting Dengue Fever and Dengue Hemorrhagic Fever epidemics has been placed in the public domain for discussion and analysis.  The research that has produced this innovation, one based on climate variations and vegetation greenness, comes out of the Universities of Miami and Costa Rica, with further modelling done for Trinidad in the West Indies.

For this project, lead researcher, Doug Fuller, and his colleagues looked narrowly at sea-surface temperature records and satellite images depicting greenness in Costa Rica.  And by correlating these two variables with the incidence of Dengue, Fuller’s team says they have derived the tools by which to predict future outbreaks, anywhere in the world, with 64% accuracy.

The logic is that tropical storms increase atmospheric moisture, which in turn causes vegetation cover to thicken and grow lusher.  Taken together, these conditions are prime for adult mosquitoes to speed up the rate of breeding and larval development.

As of now, the reliability of the predictive model is said to be better (83%) going back in time.  The forward-looking model, at 64%, is however capable of giving Vector Control professionals up 40 weeks advance notice of an impending outbreak of Dengue.  This translates to some thirteen breeding cycles, more than enough time for competent Vector Control operators to mount a successful public awareness and containment campaign against the Aedes aegypti mosquito.

“In its current form we believe the model may be used to inform national vector control programs and policies regarding control measures, including prevention and planning of medical services for those likely to be affected during future outbreaks,” write the researchers.

(Source: environmentalresearchweb)

 

Dengue in the Americas currently (update 3, June 18)

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.)

 

…from PAHO Director’s chair

Washington (PAHO)

Dr. Mirta Roses, Director of the Pan American Health Organization, (has) called on all countries in the Americas to increase their efforts and work together in the fight against dengue, which has broken out in almost every country in the Region.

Serious dengue outbreaks in Bolivia, Paraguay, Argentina, Brazil and significant numbers of cases in other countries should put the entire Region on alert, said Dr. Roses.  She said it was urgent that governments “strengthen surveillance, control mosquito breeding sites and clinical management of the patient, and make avoiding deaths their first priority.”

The only way to prevent dengue transmission is to combat the disease-carrying mosquitoes, which breed in small pools of water around homes.  There is no vaccine or treatment for dengue, but appropriate medical care frequently saves the lives of patients with the most serious form of the disease, dengue hemorrhagic fever.

Dr. Roses said public awareness and community participation play a key role in fighting dengue.  The most effective prevention efforts are cleaning up stagnant water in old tires, vases and water containers where mosquitoes can breed, including containers inside houses as well as in patios or yards.  Personal protection is also important; people should use repellents and avoid exposure to mosquitoes, especially among children.

Dengue is common in tropical climates, particularly in cities and peri-urban areas, and has emerged in almost every country in the Americas.

(At the end of March 2009)…countries reported 113,758 cases of dengue, including 2,052 cases of dengue hemorrhagic fever and dengue with complications, and 42 deaths.  Last year, countries reported 850,769 cases, including more than 38,000 cases of dengue hemorrhagic fever and 584 deaths.  (These numbers have risen to 289,754 cases, including 4,238 cases of Dengue Hemorrhagic Fever, and 97 deaths at April 22, 2009.

Dengue is transmitted by the bite of an Aedes mosquito infected with any one of the four dengue virus strains. Symptoms appear 3 to 14 days after the infective bite.  Symptoms range from a mild fever to incapacitating high fever, with severe headache, pain behind the eyes, muscle and joint pain, and rash.  The most serious forms are dengue hemorrhagic fever and dengue shock syndrome, which can lead to death.  There are no specific antiviral medicines for dengue, but it is important to maintain hydration.

The rise of dengue is due in part to the spread of informal settlements, lack of sewer systems and running water, and an overall deterioration of the physical environment, including crowded urban and suburban dwellings and lack of universal access to basic health services.

“Dengue is not only a health sector responsibility,” Dr. Roses said.  “It requires an integrated and multidisciplinary approach, including municipalities, and strong support of the mass media with clear and precise prevention and education measures.  The health services must guarantee timely treatment.  The community, church groups and associations should come together to clear neighborhoods of receptacles that can hold water and mosquitoes, and to share prevention information.”

PAHO/WHO is providing technical cooperation in dengue prevention and response to outbreaks for all the countries in the Region, with experts in epidemiological surveillance in accordance with the International Health Regulations (IHR), as well as vector control, clinical management of the patient and risk communication.

PAHO, founded in 1902, works with all the countries of the Americas to improve the health and quality of life of their peoples.  It also serves as the Regional Office for the Americas of the World Health Organization (WHO).

This message was reprinted from the PAHO website with one or two edits, which are clearly defined in brackets.

 

Rain=Dengue in Puerto Rico

Puerto Rico

The rainy season seemed to have come early in the Caribbean this year.  Dark, overhanging clouds are a constant reminder of that.

But in this region, rainfall is equal to mosquitoes, especially Aedes aegypti, the carrier of Dengue Fever.  Why?  Because we the home-owners and renters continue to ignore the basic rule of self-responsibility regarding mosquito control: to conduct a survey of our premises for uncovered containers (cans, barrels, discarded, tyres, flower pots, ornamental fountains, trash and cisterns etc.) that collect rain water and either get rid of them or the water in them.

In February, Puerto Ricans learned a hard lesson when 350 Dengue Cases were recorded there, the largest number of new cases ever.

Fact: 90 percent of mosquito breeding places exist at private premises.

The Puerto Rican Health Department has taken notice of that.  In a communiqué released to the media, Health Secretary-designate Jaime Rivera Dueño warned the public that there could be a resurgence of Dengue mosquitoes leading up to the start of the hurricane season – unless the entire community participates in the elimination of mosquito breeding grounds.

1,325 persons have suffered with Dengue Fever in Puerto Rico in the last year or so.

(Source: Latin American Herald Tribune)

 

‘Dengue Fever is Dangerous’ slideshow v.1.2 is here…

Version 1.1, originally published on May 7, 2008

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

 

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

 

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 X, Dengue pummels Venezuela, Dengue Totals Rising…

 

Antigua and Puerto Rico Dengue flying high

Antigua           Puerto Rico

Antigua and Barbuda and Puerto Rico have started off the year with more Dengue than one could have imagined.  Chief Environmental Health Officer, Lionel Michael, told the Antigua Sun newspaper in January that 38 Classic Dengue Cases were scattered around the country.  No deaths were reported there.  And in PR, it was revealed in mid-April that there were 373 more Dengue cases than last year.  PR had over 1,ooo Cases – the real minimum number of Cases may be more like 3,000 if other reports are taken into account.

Antigua’s CEHO Michael and PR Governor Luis Fortuno both implored their compatriots to be more cooperative with them by not keeping containers with standing water in and around their homes and businesses and to clean up their properties regularly.  We say once a week.

Michael, obviously concerned about the level of mosquito breeding in Antigua, which he put down to negligence, and wanting to reduce the frequency of fogging, was adamant that “people really need to get involved.”  He stressed that “the government alone cannot control (the mosquitoes)…We can’t be at your home 24 hours (a day),” he continued.  PR Gov. Fortuno was on the same page.  His government launched a nationwide public awareness campaign to discourage people from hoarding used tires in particular and to motivate them to pay increased attention to basic sanitation.

Indeed, Fortuno expressed alarm over the matter of tires in a radio interview on Thursday, April 16, reported by the Associated Press.  In that regard, facilities in the towns of Toa Baja and Utuado have been made available for the storage of discarded tires removed from residential surroundings.

Residents of Antigua may very well have heeded the call from Michael because he did not have to declare an Outbreak, although he very well might have.  On the other hand, an Outbreak has been declared in Puerto Rico, and for good reason.  Their numbers are exceedingly high.

Only Aruba, French Guiana and Guyana in the Non-Hispanic Caribbean region have described Outbreaks so far in 2009.

 

Malaria Pod Blog: Joe DeRisi solves medical mysteries

Joe DeRisi hunts for the genes that make us sick.  At his lab, he also works to understand the genome of Plasmodium falciparum, the deadliest form of malaria.