After reporting 80 dengue fever cases since the beginning of the year, health authorities in New Caledonia have declared an epidemic on the South Pacific islands.

Aedes aegypti/CDC
Aedes aegypti/CDC

Since the start of Dec. 2016, the territory has reported more than 160 dengue cases and a dozen people required hospitalization for their illness. The dengue strain circulating is DENV1.

The island chain of Vanuatu is also experiencing a dengue outbreak; however, the strain involved is DENV2.

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.

New Caledonia experienced a dengue epidemic in 2003, which resulted in nearly 20 deaths.

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