While the last dengue outbreak in the Caribbean region occurred 10 years ago, The Caribbean Public Health Agency (CARPHA) says disease modelling predicts that another regional outbreak of dengue may occur in the near future, prompting officials to advise countries to implement enhanced measures to reduce mosquito breeding and prevent the spread of disease.
In 2018, Latin America showed an increase in the number of dengue cases. More recently, the outbreak of dengue in Jamaica has elevated the level of concern in other Caribbean islands.
Most recently, the region experienced outbreak of other mosquito-borne viruses–Chikungunya in 2014 and Zika in 2016.
The measures used for controlling the spread of Dengue are the same as those for Zika and Chikungunya as these diseases are also transmitted by the Aedes aegypti mosquito. With the arrival of the rainy season within a few months, mosquito control and awareness activities need to be intensified. Caribbean Ministries of Health are advised to: Increase health promotion messages to prevent mosquitoes biting and breeding, combine efforts with communities to eliminate mosquito breeding sites, intensify vector surveillance and control and disseminate appropriate clinical care and treatment guidelines.
“We all need to clean up our surroundings. The two most important things to manage mosquito populations in our Caribbean countries are to manage water storage drums and tanks, and properly dispose of used vehicle tires to prevent mosquitoes breeding,” states Dr C. James Hospedales, Executive Director of CARPHA.
Dengue is a viral infection transmitted by the bite of an infected mosquito. There are four closely related but antigenically different serotypes of the virus that can cause dengue (DEN1, DEN 2, DEN 3, DEN 4).
- Dengue Fever (DF) – marked by an onset of sudden high fever, severe headache, pain behind the eyes, and pain in muscles and joints. Some may also have a rash and varying degree of bleeding from various parts of the body (including nose, mouth and gums or skin bruising).Dengue has a wide spectrum of infection outcome (asymptomatic to symptomatic). Symptomatic illness can vary from dengue fever (DF) to the more serious dengue hemorrhagic fever (DHF).
- Dengue Hemorrhagic Fever (DHF) – is a more severe form, seen only in a small proportion of those infected. DHF is a stereotypic illness characterized by 3 phases; febrile phase with high continuous fever usually lasting for less than 7 days; critical phase (plasma leaking) lasting 1-2 days usually apparent when fever comes down, leading to shock if not detected and treated early; convalescence phase lasting 2-5 days with improvement of appetite, bradycardia (slow heart rate), convalescent rash (white patches in red background), often accompanied by generalized itching (more intense in palms and soles), and diuresis (increase urine output).
- Dengue Shock Syndrome (DSS) — Shock syndrome is a dangerous complication of dengue infection and is associated with high mortality. Severe dengue occurs as a result of secondary infection with a different virus serotype. Increased vascular permeability, together with myocardial dysfunction and dehydration, contribute to the development of shock, with resultant multiorgan failure.
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