By NewsDesk  @infectiousdiseasenews

Following recent reports of two imported dengue fever cases on Guam, the Department of Public Health and Social Services has reported the first autochthonous dengue transmission on the island in 75 years.

The individual had no travel history outside of Guam.

According to the Guam Public Health Laboratory, the virus was identified as dengue type 3 (DEN-3), the same strain causing outbreaks in Yap, Palau, Marshall Islands, and the Philippines.

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Public Health has activated its Arboviral Disease Response Plan, which includes the following:

  • Activation of the Public Health Incident Command;
  • Enhanced surveillance for dengue fever;
  • Targeted vector control; note that part of normal vector response is to fumigate areas at high risk for mosquito transmission;
  • Update on dengue case management; and
  • Community outreach and awareness.

All health care providers are urged to be on alert for additional cases of dengue fever. A physicians’ alert has been disseminated.

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Aedes aegypti/CDC

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).

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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.