Tuesday, November 23, 2010

Puerto Rico/Florida Dengue Update

 

 

# 5080

 

 

With the cholera epidemic raging in Haiti, a rare but high profile bird flu case in Hong Kong, and a plethora of stories on antibiotic resistance over the past couple of weeks, the dengue epidemic in Puerto Rico has taken a bit of a backseat in the news.

 

Yesterday, however, the CDC updated their dengue surveillance numbers for the past two weeks. It shows that after several weeks of steep decline, a leveling off of new dengue cases, albeit at levels still far above the epidemic threshold.

 

 

PR-week43

 

PR-Summary

 

Although endemic to the island, the last really big dengue outbreak was in 1998, when just over 10,000 cases were recorded (and 19th deaths). 

 

Much of Central and South America, along with many islands islands of the Caribbean, are dealing with unusually high numbers of Dengue cases this year.

 

PAHO, the Pan American Health Organization, recently (Nov. 5th) released updated year-to-date numbers indicating more than 1.5 million total infections for the Americas.

 

image

 

 

A little over a year ago, locally acquired Dengue was reported in Florida after an absence of roughly 60 years.  The Florida Department of Health’s arbovirus surveillance system  - in their latest report (issued Nov 20th) – indicates 2 new Dengue cases last week, both in Key West.

 

 

            Year to Date Human Case Summary

                               (Excerpts)

Eastern Equine Encephalitis Acquired in Florida: Four human cases of EEE have been reported in 2010  . . . One incidental infection was reported in Hillsborough County.

West Nile Virus Infection Acquired in Florida: Eleven human cases of WNV have been reported in 2010  . . .  One positive asymptomatic blood donor was reported in Brevard County.

Dengue Acquired in Florida: In 2010, 62 cases of locally acquired dengue have been reported in Broward (1),  Miami-Dade (1) and Monroe (60-Key West) counties. 

Imported Dengue: One hundred and twenty-three cases of dengue with onset in 2010 have been reported in individuals with travel history to a dengue endemic country in the two weeks prior to onset.

Imported Malaria:  One hundred and seven imported cases of malaria with onset in 2010 have been reported. 

Imported cases of Dengue (and Malaria), as you can see, far exceed locally acquired cases.  The CDC  addressed this issue earlier this summer (see MMWR: Travel Associated Dengue Surveillance 2006-2008), warning:

 

`Clinically recognized cases of travel-associated dengue likely underestimate the risk for importation because many dengue infections are asymptomatic or mildly symptomatic’.

 

 

 

Dengue’s spread has increased dramatically over the past 50 years, and since the 1950s a rare, but far more serious form of the disease – DHF or (Dengue Hemorrhagic Fever) –  has emerged.

 

Dengue Trends

 

None of this should dissuade you from making that long anticipated trip to Florida or the Caribbean, of course. The odds of acquiring a mosquito-borne disease while visiting these locales remain quite small.

 

Particularly if you follow the advice of health departments who continue to urge people to follow the `5 D’s’:

 

 

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For an extensive list of my blogs on Dengue and Mosquito Borne Diseases you can select the DENGUE Quick Search here,  on my sidebar.