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.)