…again

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In 2007, approximately 900,000 persons came down with Dengue in the Americas and the Caribbean.  900,000!  We are now at the half way point in 2008 and already more than 540,000 people have been diagnosed with the disease.  The prospects do not look good.

The writing was on the wall when, earlier this year, Brazil fell victim to an unprecedented outbreak.  The health care system became so overwhelmed at the time that the military set up field hospitals, private clinics were called into action and government toyed with the idea of soliciting countries like Cuba to send in medical professionals to lend a hand.

Some data filtered out during the dog days of the outbreak, but it has become all too clear in recent days that the true picture as regards the number of infections was grossly depressed.  The PAHO (Pan American Health Organization) “Figures for 2008” would attest to that.

At Week 22, Brazil had recorded 472,997 Classic Dengue Cases, 9,957 of which were of the severe form, Dengue Hemorrhagic Fever.   199 of the DHF cases did not survive making for a 2% mortality rate.

None of the other countries in the region that have reported up to Week 22 comes anywhere close to Brazil.  Venezuela is a distant second with 20,601 Classic Dengue Cases.  All of the 1,410 cases that progressed to DHF recovered.    

Mexico and Columbia are doing better still insofar as they are 2 weeks behind on their reporting.  In terms of Classic Dengue, these two countries fall in the teen thousands.  Mexico has 16,285 cases and Columbia, on 11,145, is five thousand cases removed.  However, Columbia has lost 5 persons; Mexico, 0.

In the under ten thousand column, referring to Classic Dengue, are Peru (7,096), Honduras (2,527), Costa Rica (2,447), El Salvador (1,954), Ecuador (1,894), Paraguay (1,953) and Puerto Rico (1,281).

The Caribbean has fared very well comparatively.  273 is the total number of Classic Dengue diagnoses that have been made, but to a maximum of 17 Weeks into the year.  No deaths have occurred, thankfully. 

What is evident here though is that the countries that make up our immediate region have been lax in submitting their weekly reports to the Caribbean Epidemiological Centre (CAREC).  A number of them, including the British Virgin Islands, have not submitted a single report to date.  The others are Aruba, Bahamas, Curaçao and Haiti. 

But the PAHO June 2008 report of Dengue and Dengue Hemorrhagic Fever does not tell the whole story about Dengue in the Caribbean.  The Coalition perused the CAREC Surveillance Report (CSR) of May 2008 in which mention is made of the identification of Dengue 2 & 4 in the BVI and Type 1 in Antigua and Barbuda.  These data, although submitted to PAHO by CAREC, were not uploaded to their database designed to capture the Dengue figures for the wider Americas and which the Coalition often relies on.

Based on the separate reporting by CAREC, a reasonable conclusion could be that the BVI had 2 or more cases of Dengue between January 2008 and the present. 

No deductions were necessary with respect to Antigua and Barbuda because the CSR has it that ”As at February 29, 2008, Antigua and Barbuda reported 14 laboratory confirmed cases, but the distribution of cases by date were not reported.“   

Anyway, the leaders of the Caribbean Classic Dengue pack are Jamaica and Trinidad.  Jamaica was clocking 143 cases at Week 16, Trinidad, 64. 

With respect to Trinidad, the Coalition just reported on a very recent Dengue event in the south where one female died and seven members of her family were hospitalized.  Well, Carec/PAHO had Trinidad’s DHF toll at 5 in March.  The question is what transpired in April and May?  And what might the Classic Dengue totals be when all of the data are in?

According to PAHO statistics, the countries with active Classic Dengue apart from Jamaica and Trinidad are Guyana (25), St. Lucia (22), the Commonwealth of Dominica (11), Suriname (5) and Anguilla, Cayman Islands and St. Vincent and the Grenadines (1 each).      

There is a bigger question still.  Could we, one year from now, be looking back at Dengue 2008 and be caught saying that Dengue 2007 Totals from around the Americas no longer stand as the worst ever?