# 6435
In 2010 Puerto Rico suffered from the worst dengue outbreak in two decades, which infected more than 20,000 people and killed at least 31.
The graph below, taken from week 46 of 2010, shows the level of Dengue activity declining rapidly by year’s end.
During that time, I wrote extensively about the outbreak (see here, and here) including this report from the CDC’s MMWR: Dengue Epidemic In Puerto Rico.
Thankfully, 2011 saw levels of dengue in Puerto Rico drop below the epidemic threshold, and hover right about at historical averages.
The Bahamas, on the other hand, saw a very active dengue season (see Updating The Bahamas & Florida Dengue Cases), illustrating how variable dengue outbreaks can be from one year to the next.
While a far cry from the epidemic of 2010, the number of dengue case in Puerto Rico are once again on the rise, with the rate running above the epidemic threshold for the past 5 weeks.
With roughly 4 million residents and another 4 million annual visitors to Puerto Rico – 2,263 infections is a miniscule fraction of the exposed population.
The odds of contracting the virus are actually pretty low.
But they are not zero.
So it makes sense to take reasonable precautions whenever you are around mosquitoes (and not just in Puerto Rico). Those who travel to, or live in areas where mosquitoes are present are reminded that to follow the `5 D’s’:
The CDC offers the following advice on their Update: Dengue in Tropical and Subtropical Regions
What is Dengue?
Dengue fever is the most common cause of fever in travelers returning from the Caribbean, Central America, and South Central Asia. This disease is spread through the bites of infected mosquitoes and cannot be spread person to person.
Severe dengue can be fatal, but with good treatment, less than 1% of patients die from dengue.
Symptoms of dengue include:
- fever
- headache
- pain behind the eyes
- joint and muscle pain
- rash
- nausea/vomiting
- mild bleeding, such as nose or gum bleeding or easy bruising
People who have had dengue before may get severe dengue if they are infected again. Anyone with dengue who experiences the following warning signs should go to a doctor or emergency room immediately:
- Severe abdominal pain or persistent vomiting
- Red spots or patches on the skin
- Bleeding from nose or gums
- Vomiting blood
- Black, tarry stools (feces, excrement)
- Drowsiness or irritability
- Pale, cold, or clammy skin
- Difficulty breathing
How Can Travelers Protect Themselves?
Travelers can reduce their risk of dengue infection by protecting themselves from mosquito bites:
- Stay in hotels that are well screened or air conditioned.
- Use insect repellent on uncovered skin.
- Look for a repellent that contains one of the following active ingredients: DEET, picaridin (KBR 3023), Oil of Lemon Eucalyptus/PMD, or IR3535.
- Always follow the instructions on the label when you use the repellent.
- If sunscreen is needed, apply before applying insect repellent.
- For more information on the use of insect repellents, see the information on the Mosquito and Tick Protection webpage.
- Wear loose, long-sleeved shirts and long pants when outdoors.
- For more protection, clothing may be sprayed with a repellent containing permethrin. (Don't use permethrin on skin.)
If you return from a trip abroad and get sick with a fever, seek medical care right away. Tell the doctor about your recent travel.
Despite the sobering tone of the advice above, the odds of contracting Dengue Fever while visiting Puerto Rico are actually quite low.
None of this should dissuade you from making that long anticipated trip to the Caribbean. But it does pay to be aware of the risks, and to take prudent steps to reduce them.
