# 4798
As evidenced by the graphic below, the number of suspected (and confirmed) cases of Dengue Fever in Puerto Rico continues to climb and remains well above the Epidemic Threshold.
The number of weekly suspected cases has increased by more than 50% over the past two reporting periods, and is now running roughly 5 times above average.
Last month the CDC’s MMWR came out with a field report on the Dengue situation in Puerto Rico, which you can read about at MMWR: Dengue Epidemic In Puerto Rico.
Despite these sobering statistics, the odds of contracting Dengue Fever while visiting Puerto Rico are actually quite low, and none of this should dissuade you from making that long anticipated trip to the Caribbean.
Visitors are advised, however, to protect themselves from mosquitoes by remembering to follow the `5 D’s’.
The CDC has issued a Health Advisory via their HAN (Health Alert Network) primarily to inform health care providers of the possibility of seeing Dengue Fever in returning visitors from areas where the virus is being seen.
This is an official
CDC HEALTH ADVISORYDistributed via Health Alert Network
Sunday, July 25, 2010, 22:35 EDT (10:35 PM EDT)
CDCHAN-00315-2010-07-25-ADV-NIncreased Potential for Dengue Infection in Travelers Returning from International and Selected Domestic Areas
Summary
Dengue virus transmission has been increasing to epidemic levels in many parts of the tropics and subtropics. Travelers to these areas are at risk of acquiring dengue virus and developing dengue fever (DF) or the severe form of the disease, dengue hemorrhagic fever (DHF). The Centers for Disease Control and Prevention (CDC) strongly advises that health care providers in the United States should: 1) consider DF and DHF when evaluating patients returning from dengue-affected areas--both domestic and abroad--who present with an acute febrile illness within two weeks of their return, 2) submit serum specimens for appropriate laboratory testing, and 3) report all presumptive and confirmed cases of DF and DHF to their local or state health department.
Of course, you don’t have to travel to Florida or the Caribbean to pick up a mosquito borne virus.
Every year we see scattered cases of West Nile Virus, St. Louis Encephalitis, La Crosse virus (LACV), and the rare Eastern Equine Encephalitis (EEE) reported across the United States.
Canada and Europe are not immune, either.
Greece is currently dealing with a limited outbreak of West Nile Virus, and since the first large outbreak in Romania in 1996, WNV has been increasingly viewed as an emerging public health concern in much of Europe.
Dengue, Malaria, Chikungunya and Yellow Fever all have potential to re-emerge – at least in limited outbreaks - in places like the United States and Europe. In fact, Chikungunya showed up – in all places – Northern Italy a few years ago.
I told the story in It's A Smaller World After All, but the crux of the matter being that a traveler, returning from India, brought the virus to Italy in 2007 which led to more than 290 cases reported in the province of Ravenna, which is in northeast Italy.
Last March Eurosurveillance carried a series of articles on vector borne diseases and their potential to impact those living in Europe.
Yellow fever and dengue: a threat to Europe?
by P Reiter
The introduction and rapidly expanding range of Aedes albopictus in Europe is an iconic example of the growing risk of the globalisation of vectors and vector-borne diseases. The history of yellow fev(...)
West Nile virus in Europe: understanding the present to gauge the future
by P Reiter
The appearance of West Nile virus in New York in 1999 and the unprecedented panzootic that followed, have stimulated a major research effort in the western hemisphere and a new interest in the presenc(...)
Rift Valley fever - a threat for Europe?
by V Chevalier, M Pépin, L Plée, R Lancelot
Rift Valley fever (RVF) is a severe mosquito-borne disease affecting humans and domestic ruminants, caused by a Phlebovirus (Bunyaviridae). It is widespread in Africa and has recently spread to Yemen (...)
Leishmaniasis emergence in Europe
by PD Ready
Leishmaniasis emergence in Europe is reviewed, based on a search of literature up to and including 2009. Topics covered are the disease, its relevance, transmission and epidemiology, diagnostic method(...)
Arthropod-borne viruses transmitted by Phlebotomine sandflies in Europe: a review
by J Depaquit, M Grandadam, F Fouque, P Andry, C Peyrefitte
Phlebotomine sandflies are known to transmit leishmaniases, bacteria and viruses that affect humans and animals in many countries worldwide. These sandfly-borne viruses are mainly the Phlebovirus, the(...)
As a native Floridian, I don’t live in fear of being bitten by a mosquito. It happens. I understand that the odds of acquiring a disease that way are very slim, but that they are not zero either.
So I take reasonable precautions, and try to remember to follow the `5 D’s’:
Don't go outdoors at DUSK and DAWN when mosquitoes are most active.
DRESS so your skin is covered with clothing
Apply mosquito repellent containing DEET to bare skin and clothing.
Other effective repellents include picaridin, oil of lemon eucalyptus, and IR3535
Empty containers and DRAIN standing water around your home where mosquitoes can lay eggs.
Good advice, no matter where you live or travel.
