# 4756
Twelve days ago I posted the Dengue Surveillance numbers out of Puerto Rico showing the rapid spread of the disease (see Puerto Rico: Dengue Running Above Epidemic Threshold).
Today, updates from Puerto Rico, Trinidad, and the Dominican Republic . . . plus a little background on the hemorrhagic form of the disease.
The latest summary shows a slight leveling off of cases over the past two weeks in Puerto Rico, but the rate of detection remains very high – roughly 400 suspected cases a week.
(Note: Contents of link will change over time)
This represents an increase of 2 deaths and about 1200 suspected cases in the past 3 weeks.
Further south, in Trinidad and Tobago, the Associated Press is reporting on 3 recent deaths due to Dengue.
Jul. 25, 2010
Trinidad: 3 Deaths From Severe Form Of Dengue
3 Die From Hemorrhagic Variant Of Dengue Fever In Trinidad And Tobago
(AP) PORT-OF-SPAIN, Trinidad (AP) - Health officials in Trinidad says three people have died from a severe form of mosquito-borne dengue fever.
The health ministry says its epidemiologists have confirmed three deaths from the hemorrhagic form of dengue and are investigating two others.
Meanwhile the Trinidad and Tobago Guardian is reporting a serious outbreak of Dengue in the Dominican Republic.
Region on dengue alert
Published: 26 Jul 2010
The dengue fever situation in the Dominican Republic, where they have declared an epidemic, is worse than the rest of the region.
A report on BBC Caribbean.com said that across the Caribbean, health officials were tallying growing numbers of cases and advising residents to take precautionary measures. The report said officials were worried that mosquito-borne dengue fever was reaching epidemic stages in the region. The report noted that dozens of deaths had been reported and officials said they were concerned it could get much worse as the rainy season advances.
Although Classical Dengue - or Dengue-like illness – is usually a non-fatal illness producing severe flu-like symptoms (and body aches) – in a small percentage of cases the virus can be serious or even fatal.
In the 1950s, a new form of Dengue was identified in Southeast Asia – DHF (Dengue Hemorrhagic Fever) – that while still relatively rare, if left untreated, can have a fatality rate as high as 50%.
Since there are 4 different serotypes of the Dengue Fever virus, a person can become infected several times over their lifetime.
Although the process is not fully understood, the evidence suggests that those having a prior Dengue infection are at greatest risk of developing DHF.
One of the theories (greatly simplified, so even I can understand it . . . scientists may want to avert their eyes) is the body’s immune system falsely `recognizes’ the new infection as being the old virus and attacks it, but its antibodies are unable to successfully inactivate it.
In response, the immune system releases a flood of cytokines that have the unfortunate side-effect of increasing the permeability of endothelial tissues (the lining inside blood vessels) which can lead to blood and fluids leaking into surrounding tissues.
This `leakage’ can lead to Hypovolemic shock, anemia, and sometimes death.
Treatment is mostly supportive while the body builds the proper antibodies to fight the infection; blood transfusions, IV fluids, Oxygen, and rehydration.
Crof at Crofsblog and Arkanoid Legent are both providing nearly daily coverage of Dengue outbreaks around the world. You’ll also find extensive coverage on Chen Qi.
These are my `go to’ sources for up-to-date Dengue information.
A few of my recent blogs on the subject include:
MMWR: Dengue Epidemic In Puerto Rico
MMWR: Travel Associated Dengue Surveillance 2006-2008
MMWR: Dengue Fever In Key West
Dengue Resurfaces In Key West
The Threat Of Vector Borne Diseases
While not yet a major public health issue in the United States and most of Europe, many officials believe it is just a matter of time before this mosquito borne disease makes greater inroads into these areas.
