St. Maarten/St. Martin, St. Barths, Saba Dengue worsens

St. Maarten       St. Martin     St. Barths      Saba

Original Post on October 08, 2008; update 3 on October 14

To put it bluntly, the Dengue situation on St. Maarten/St. Martin, St. Barths and Saba is growing worse and worse.

It could not get any more worse though, now that a 54 year old male of St. Maarten has died from complications of Dengue Fever. And the only reason he died, says Sector Health Care, is because he failed to seek medical care in a timely fashion. This is the first death attributed to Dengue Hemorrhagic Fever on St. Maarten for some time.

The overall number of Dengue infections on record may appear to be small, but looking at the percentages, St. Maarten labs confirmed 200% more cases in August than in July. Comparatively, there was a 400% percent increase from August to the third week of September.

On the Dutch side, there were 3 laboratory Confirmed Cases in July and 9 in August.

On the French side, there was a dramatic increase in hospitalisations from 1 in the month of August to 6 in September. 5 of the September hospitalisations were adults with 3 deemed to be very severe. The other one was a child.

However, the number of infections recorded on French St. Martin was of a much gloomier hue than previously thoughy. The Prefecture (French health authorities) recorded 72 Suspected Dengue Cases in the last week of September, twice as many than in the third week of that month. Conversely, the rate of Biological confirmations in week four (15) was markedly slower than in week three (10).

St. Martin has, therefore, declared a state of vigilance, called the ‘Vigilance Phase’ in Vector Control jargon. St. Barths is already in an Inter-epidemic Phase.

Saba is now in Epidemic mode with 9 Confirmed Cases. 2 of the 9 were hospitalised. Dr. Jack Buchanan and Dr. Gys Koot of Saba, as quoted by the St. Maarten Daily Herald in its Tuesday, October 7 online edition, predicted that there will be more cases yet. 20 individuals from Saba were first screened on French St. Martin before confirmatory tests were conducted at the Diagnostic Center in Curaçao.

Head of the Vector Control Rudolph Johnson is very surprised by this development. He told the Daily Herald that he was aware of only 1 case of Dengue on Saba in his thirty-seven years on the job. Johnson has stepped up premises inspections and is posting extra notices of appeal to residents to eliminate free standing water and protect water-bearing containers in their homes and surroundings.

The Saba outbreak has been traced back to Orient Beach on St. Maarten. This is based on the fact that three individuals who showed signs and symtoms of Dengue had all been to Orient Beach and that one other person who contracted the disease had never left the island.

One year ago, the average monthly infection rate on Dutch St. Maarten was just 2 per month. Bear in mind that about ten times more individuals carrying the virus probably never presented to a doctor and were not even diagnosed with the disease, far less to be confirmed with it. The question is, how much darker might the true Dengue picture be on St. Maarten?

The answer to that lies in the Sector Health Care Affairs (SHCA) Dengue Action Response Team (DART) revelation that 27 cases of Dengue were Laboratory Confirmed for the entire month of September. The results for 26 Suspected Dengue Cases are still pending. By the way, these figures include Dutch side residents who crossed the border unto the French side for testing, a not too rare occurrence, and those who had their blood samples tested in Curaçao.

SHCA/DART and the Sous Prefecture have started a fogging campaign, the latter on Friday, October 3.

Unconfirmed reports from Philipsburg has it that 11 persons have been hospitalised with Dengue on Dutch St. Maarten since the beginning of October. 5 of these patients were Laboratory Confirmed while 1 result was Negative for the disease. The balance of the results is pending.

A release from SHCA/DART indicates that the Dengue outbreak has been broadcast from the St. Johns residential area to which it was confined in August, evidence enough that the Dengue mosquito is moving the virus around at a rapid pace. This is only possible when mosquito breeding is to be found in more than one in a hundred houses within a given community.

It is for this reason that the St. Maarten health authorities continue to urge residents of the island to take all preventative measures to curb the breeding of the Aedes aegypti mosquito and thereby stem the spread of the Dengue virus before the outbreak gets more acute.

Further, the Hygiene Department is calling on residents of the protectorate to cooperate fully with their inspectors who are currently carrying out spot checks and taking immediate vector control measures where necessary.

They have made it clear too that all persons who have symptoms resembling those of Dengue Fever should consult a physician without delay. An advisory has gone out to all physicians officially informing them of the Dengue Outbreak and telling them that any of their patients who demonstrate the classic signs and symptoms of the disease be sent for testing, of which there should be no less than two tests.

Health Department DSDS (French side) has, for its part, embarked upon an awareness campaign to prevent the further spread of Dengue. The target group are the students of the three French colleges.

Dengue 1 and 2 have so far been identified on French St. Martin. Dengue 4 was isolated in one case on Dutch St. Maarten in September.



Later Post:- Dengue: What 2008 has brought – to St. Maarten


Other Source: Dengue Outbreak on French Side— Island under Vigilance (French)

MARIGOT — Residents of French St. Martin are urged to exercise precaution now that ihas been confirmed that there is another outbreak of dengue. A press release from the Sous Prefecture states that based on information collected , they can confirm that there an outbreak of dengue, which began some ten days ago.

The Inter-Regional Epidemiology (WAX) Antilles Guyana met with the Committee of Experts on infectious diseases within the Northern Islands for a meeting on October 1st, 2008 to assess the epidemiological situation of dengue.

The latest data from the local sentinel network confirmed the start of the resurgence of dengue.

Given the climatic conditions which are in favour of the breeding of mosquitoes, the population should implement the preventive measures widely known to them without delay.

In addition to these preventive measures, an insecticide spraying campaign will run throughout the island of Saint Martin as of today October 3rd.

Even though the number of confirmed cases has not been released, they said that the population needs to apply the preventative measures rigorously.  The release also states that the dengue epidemic is in its early stage.

The committee plans to meet again on October 16 to reassess the local situation.

Some of the actions to be taken to eradicate the mosquito (Aedes aegypti) which is known to transmit dengue are as follows:

The prefecture of Saint-Barthélemy and St. Martin is reminding residents of the most effective ways to fight the proliferation of the single mosquito vector for dengue, “Aedes aegypti.”

– Avoid mosquito bites in the morning and evening: use repellent sprays or creams to fight the mosquitoes; wear long sleeved clothing in the evenings; install screens on doors and windows; and young children and the elderly especially should sleep under mosquito nets.

– Be sure to remove stagnant water in and around your homes because clear stagnant water in flower pots for instance is the preferred breeding place for the Dengue mosquito.

– Protect the tanks and cisterns of your home from the proliferation of mosquitoes with a canvas net.

– If your tanks or cisterns are not treated, you can stock them with guppies, fish that eat the larvae of the Aedes aegypti mosquito, to curb the proliferation of the pest.

– Periodically clean your gutters to make sure they do not trap water after rain episodes.

– Check the state of repair of your septic tank and when fogging is being done, leave your doors and windows wide open.

17 responses to “St. Maarten/St. Martin, St. Barths, Saba Dengue worsens

  1. Enjoy your vacation on St. John. My family and I have already been there, done that – and loved it.

    And thank you. The questions keep me alert and sharp. So there.

  2. Christine

    Israel, you are fantastic. It is difficult to express how grateful I am for this information. It’s odd actually that I have never heard of Dengue until last summer when my friend got it in St. Barts. Funny how easy travel can be when you are in the dark. I have to look at this now as that I am informed. I am grateful for the time you have spent chatting here. I look forward to visiting St. John without fear, but knowledge and insight to prepare us for a wonderful and healthy time. Thank you ever so much! I am lucky too that my “international” flight is a short one and direct from St. Thomas. Take good care and keep up the good work.

  3. You’re welcome Christine.

    My apologies for my tardiness in responding this time. We had a massive islandwide blackout last night, just as I was about to start processing Comments and mail.

    Anyhow, the consensus of opinion on the application of sunscreen and DEET (make that Deep Woods Off!) is that you apply the sunscreen first. The rationale is that if you are out in the sun for an extended period of time, you will lather up more than once whereas the DEET may demand a single application. However, do stagger the application of DEET for about a half hour after putting on the sunscreen.

    To be on the safe side though, use the highest SPF the manufacturer will allow for age and skin sensitivity. This is because, it is possible, though not conclusive, that repellents could degrade the effectiveness of sunscreens by up to 30%.

    Never make the mistake Christine of delaying treatment for one day if your daughter (or you for that matter) develops the classic signs and symptoms of Dengue. A rash, in conjunction with the typical intense headache, very high fever, pain behind the eyes, joint and muscle pain, gastrointestinal discomfort with vomiting and nausea as well as a loss of appetite, demands a visit to a physician without delay. The fact is that a blood sample is to be taken while the fever is high for an accurate Clinical diagnosis to be made.

    That is the same blood that will guarantee reliable serological test results later.

    Depending on the severity of the infection, the patient must be put on drips for the re-hydration of the body. That could mean being in the hospital for a few days. But by the same token, it could make the difference between life and death.

    So yes, it may be one international flight home. However, my advice is do not take the chance to leave your destination unless you have the explicit go-ahead from a competent physician.

  4. Christine

    Israel, Thank you for your quick response. We live in Miami and are accustomed to protecting ourselves from mosquitoes so we know the drill. Any suggestions on whether to put sunscreen on first, then repellent or vice versa? We are religious in applying sunscreen, being diligent with the repellent will be a new to us. How do I use it in conjunction with sunscreen so it is most effective. Also, my daughter is 8 and has extremely sensitive skin. She is dark skinned but still sensitive. If she was exposed to the fever and developed a rash, should I just fly home for her to be treated? I just want to be well informed of how to react if one of us does get it. Thank you

  5. First of all Christine, it is important to be acutely aware that the Dengue mosquito and thus the Dengue virus is likely to be in circulation in the Caribbean at any time of year, but more so in the summer months. Consequently, there is nowhere you can go to be completely out of range of the fever. However, right now, we are prepared to take the line that St. John is one of the safest places you can ever dream of visiting in the Caribbean, at any time.

    But we do have to caution you that a few persons living on St. John were diagnosed with Dengue in the last quarter of 2008. We have not been able to follow up on these individuals to find out whether they were eventually confirmed for reasons we cannot reveal here. Suffice it to say that if they did turn out to be positive for the disease, this could have resulted in up to at least ten times more infections on the island.

    Either way, this did not seem to be the case. Go ahead and book that flight.

  6. Christine

    Dear Israel,

    I found you here in an attempt to find Dengue information on St. John. We travel to St. Barts often and planned on vacationing there this summer. I canceled these plans due to alarming information about numerous cases in early January and since October 2008. I was there last summer and a friend of mine got it when she was there, but my family (7 of us) did not. I have now changed my island to St. John thinking I was safe but just now have been investigating to make sure. I can’t seem to find any current info on this area. Can you assist me? I do not want to be paranoid on my vacation with my children. I am a little freaked out about it.

  7. Why do I suspect that your nocturnal problem is not a mosquito problem? In your two comments, you mentioned suffering “hundreds of insect bites.” But not once did you claim to have seen the mosquitoes in your room. Did you?

    The mosquitoes that are active late at night are most active in the early morning hours after sunup to 08:00 am and again for the last two hours before sundown. If they are in your room at night, they will surely come after you around bath time as well. You will see them.

    Also, you insist that the hotel linen was changed a number of times. It seems to me that there would be no need to change the linen to resolve a mosquito problem when all you needed was an air conditioned room, which if it is kept open during daylight hours would have to be sprayed with a commercially available aerosol and then closed up.

    I get the impression too that the repellents work during the day while you are at the eateries. Why not at night?

    Let me put it this way Nakri. My hunch is that your issue is something other than mosquitoes. Otherwise, my advice from the previous comment would have been enough: cover up and/or lather up.

  8. Thank you for your response,

    Now, I do get bitten during the day by mosquitoes in St Martin. Most restaurants/bars have OFF that they supply to their customers. (Sauce on the side, OFF on my side) But my problems always occur at night, in my bed. It happened 4 times out of the seven times I went to St Martin! Hundreds of what looks like insect bites keeping me awake and scratching throughout the night. As I mentioned the hotels kept giving fresh linens, matelas..etc. But to no avail.
    Any suggestions??

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