Updating The Bahamas & Florida Dengue Cases

 

Aedes Albopictus Photo Credit CDC PHIL

# 5754

 

 

In a follow up to a blog from last Thursday (see U.S. Issues Dengue Warning For The Bahamas) we’ve more reports on the increasing number of suspected and confirmed Dengue cases in the Bahamas, and attempts to bring the outbreak under control.

 

The Nassau Guardian reported late last week that the Bahamas had recorded  a record number of Dengue cases – estimated at over 1,500 – and that roughly 100 new suspect cases were showing up every day.

 

Record number of Dengue fever cases

More than 1,500 so far as public health care system is stretched to the limit

Chester Robards

Published: Aug 11, 2011

 

 

Local governments have been attempting to control the outbreak with mosquito fogging, and yesterday the Freeport news ran an editorial Recognizing the seriousness of dengue fever that implored residents to take part in helping to eradicate mosquito breeding grounds.

 

Similarly, Acting Minister of Environment Phenton Neymour asked residents to get rid of mosquito breeding spots, stating that fogging won’t correct the problem until the numerous breeding sites in urban areas are removed.

 

Residents urged to get rid of breeding grounds for mosquitoes

Published On:Saturday, August 13, 2011

 

The Florida Keys, which last year saw more than 60 locally acquired cases of Dengue, mounts a similar campaign in mosquito awareness. This year, in contrast, they’ve not reported any locally acquired cases of dengue.

 

 

 

Last week, Florida reported a couple of imported Dengue cases (Martin & Marion Counties), and one suspected household transmission of the virus (see Borne In The USA). 

 

Testing has now confirmed that in the Martin County case - a traveler recently returned from the Caribbean developed dengue fever – and subsequently a second household member who had not traveled abroad, had contracted the virus.

 

First locally contracted case of dengue fever in Martin County confirmed

08/11/2011

Christin Erazo

 

Every year hundreds of travelers from countries where mosquito borne illnesses are endemic develop symptoms after they return to the United States. While the odds of those diseases being transmitted on are fairly low, they are not zero.

 

In mid-June of 2010 the MMWR came out with a new report on Travel Associated Dengue in the United States between 2006 and 2008.

 

This surveillance pre-dates the Key West outbreak, and as the study reports, `Clinically recognized cases of travel-associated dengue likely underestimate the risk for importation because many dengue infections are asymptomatic or mildly symptomatic’.

 

The link  is Travel-Associated Dengue Surveillance --- United States, 2006—2008.

 

The explosive growth of Dengue around the world is well illustrated by the following graph from the World Health Organization.

 

What this graph doesn’t indicate is another doubling of dengue cases has taken place over the past 5 years.

 

For now, major outbreaks of Dengue, Chikungunya, Malaria, or Yellow Fever remain unlikely in the United States and Europe.

 

Conditions that are conducive to these kinds of epidemics, however, continue to evolve; Dense urban populations, climate change, increased international travel, and the expanding range of mosquito vectors.

 

Florida, after all, went 60 years without seeing locally acquired cases of Dengue, only to have it reemerge in 2009 in Key West.

 

Puerto Rico, which this time last year was in the middle of a major dengue epidemic, is seeing very low activity this year. 

 

Across the rest of South America, Central America, and the Caribbean dengue activity varies considerably, with more than 700,000 cases and 400 deaths reported in 2011.

 

The chart below is gleaned from the latest PAHO Dengue surveillance report.

 

 

While the odds of contracting dengue from mosquito bites in the United States remains very low - if you visit or live in mosquito territory – it is worth remembering Florida Department of Health’s, (FDOH)
recommendation that individuals protect themselves by following the “5 D’s”.

U.S. Issues Dengue Warning For The Bahamas

 

 

# 5749

 

A couple of weeks ago in Dengue Roundup: Puerto Rico, Florida, Bahamas, I wrote about the rise in Dengue fever cases being reported in the Bahamas.  Those numbers have continued to climb, and this week the United States Embassy in Nassau issued the following email alert.

 

 

 

Emergency Message for U.S. Citizens: Bahamas, Dengue Fever Warning

Disease Outbreak

Western Hemisphere > Bahamas

8/9/2011

U.S. Embassy Nassau released the following Emergency Message for U.S. Citizens on August 9, 2011:

U.S. citizens should be aware of the recent dengue fever outbreak in The Bahamas.   In the past few weeks, over 200 cases have been reported and almost 1,000 cases have been reported of individuals suffering from symptoms that match dengue.

 

The Ministry of Health has begun spraying local communities, especially the more densely populated areas, and they have stressed to the public the importance of prevention.

 

The local government continues to combat this outbreak through greater public awareness of dengue and the importance of mosquito control.

(Continue . . . )

 

The lengthy email then goes into detail on the causes, transmission, symptoms, and treatment of the illness.

 

The email offers the following advice:

 

How Can I Prevent Dengue?

The best way to prevent dengue virus infection is to take special precautions to avoid being bitten by mosquitoes. Several dengue vaccines are being developed, but none is likely to be licensed by the Food and Drug Administration in the next few years.

When outdoors in an area where dengue fever has been found, use a mosquito repellent containing DEET, Picaridin, and oil of lemon eucalyptus are less effective than DEET so are not recommended as a substitute unless there is an allergy or a contraindication to DEET or it is unavailable. Dress in protective clothing-long-sleeved shirts, long pants, socks, and shoes.

Because Aedes mosquitoes usually bite during the day, be sure to use precautions especially during early morning hours before daybreak and in the late afternoon before dark.

Other precautions include:

Keep surrounding areas free from free standing water.

 

Wear long sleeves and light colored clothes.

 

Use insect repellent when outside.

 

Unscreened windows should be kept closed to prevent the mosquitoes from entering.

 

Carefully inspect your environment to detect and eliminate all areas with standing water where mosquitoes can breed, such as flower pots, containers, birdbaths, discarded tires, etc.

Dengue Roundup: Puerto Rico, Florida, Bahamas

 

 

# 5712

 

Aedes aegypti

 

This time last year Dengue fever was a big story in Puerto Rico, and to a lesser extent, also in South Florida and the Bahamas. 

 

• The worst epidemic in more than a decade had swept across the island of Puerto Rico, and at one point as many as  900 new cases were being reported each week (see Puerto Rico Dengue Week 31: Cases Back On The Ascendant).
• Florida, for the second year in a row, was reporting relatively small numbers of Dengue infections - (2010: a total of 63 locally-acquired cases in Key West, one in Broward County, and one in Miami-Dade County) – after more than six decades without a locally acquired case.
• And last September the Bahamas issued a public health advisory after a rise in Dengue cases and at least one death (see Dengue Reports From The Bahamas).

 

 

Outbreaks of Dengue fever are often cyclical, and thus far in 2011 - for Florida, Puerto Rico, and the Bahamas - reports of Dengue fever have been far lower than we saw last year.

 

The epidemic in Puerto Rico, which claimed 31 lives, finally burned itself out over the winter.  The chart below shows what a difference a year can make.

 

 

 

While fewer than 100 cases are being reported each week right now, it should be noted that the rainy season still lies ahead.  Precautions against mosquitoes are still important.

 

In Florida, only one locally acquired case of Dengue has been reported in 2011, likely due to the extended drought the state has been experiencing. That situation could change, of course, with the arrival of one good tropical storm.

 

For now, mosquito activity remains relatively low for this time of year (see report  Florida Arbovirus Surveillance :Week 28: July 10 – July 16, 2011) with only one county (Seminole) under a mosquito-borne illness advisory.

 

 

 

According to a recent report in The Bahamas Weekly, the Bahamas are once again seeing a rise in Dengue activity, with two laboratory confirmed cases in New Providence, and another eleven cases awaiting test results. 

 

DEHS ‘steps up’ source reduction in response to 2 cases of dengue

Jul 21, 2011 - 5:27:13 PM

 

 

Across the rest of South America, Central America, and the Caribbean dengue activity varies considerably, with more than 700,000 cases and 400 deaths reported in 2011.

 

The chart below is gleaned from the latest PAHO Dengue surveillance report.

 

 

 

 

The explosive growth of Dengue around the world is well illustrated by the following graph from the World Health Organization. . 

 

Since the 1950s a rare, but far more serious form of the disease – DHF or (Dengue Hemorrhagic Fever) –  has emerged.  

 

The WHO now estimates there may be as many as 50 million dengue infections each year (Dengue and dengue haemorrhagic fever fact sheet).

 

 

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

 

Despite the lower numbers of dengue cases this year, the threat of mosquito borne illnesses (which may include Dengue, EEE, St. Louis Encephalitis, West Nile Virus, and others) remains.

 

So if you live in mosquito territory, it pays to be mindful of the 5 D’s.

 

Dengue Reports From The Bahamas

 

 

# 4931

 

 

 

Although Dengue fever cases have been increasing throughout the Caribbean (see Dengue: Puerto Rico & Beyond - Week 33), and even making inroads into the southernmost reaches of Florida, Dengue fever in the Bahamas has till now been an uncommon occurrence.

 

According to PAHO numbers released in August, through the 24th week of the year, the Bahamas had only reported 1 laboratory confirmed case of Dengue in 2010.

 

 

 

 

But two reports this morning suggest that Dengue may be suddenly on the rise in that island nation. 

 

First, the Bahamas Press is reporting that there have been 16 recent cases of Dengue fever reported in the Capital, including a suspected fatal case this week  – that of a 23 year-old woman, and mother of 3.

 

Officials have not, apparently confirmed this fatality.

 

One reported death as a result of Dengue Fever in the Bahamas

Posted by media on Sep 23, 2010

 

 

Meanwhile, the Department of Public Health has issued this advisory – carried by The Bahamas Weekly – on the recent spike in Dengue cases.

 

 

Public Advisory on Dengue Fever By Bahamas Department of Public Health and the Ministry of Health

Sep 23, 2010 - 5:31:46 PM

The Bahamas - There has been significant increase in dengue activity throughout the Caribbean region and the Region of the Americas with outbreaks reported from Barbados, Grenada, Puerto Rico, Trinidad and Tobago, and the French Territories.

 

The Department of Public Health has confirmed that there have been five laboratory confirmed cases to date and more than twenty persons have been investigated for dengue fever in The Bahamas.  The Department is working closely with the Department of Environmental Health Services to prevent and control the spread of dengue fever, a viral infection which is transmitted through the bite of an infected Aedes aegypti mosquito.

 

Symptoms of dengue fever include fever, muscle and joint pains, excessive tiredness, headache and pain behind the eyes.  Nausea and vomiting may also occur.  A more severe form of dengue fever, Dengue Haemorrhagic Fever, presents with episodes of bleeding.

 

There is no vaccine to prevent dengue fever and treatment is given to lessen the symptoms of the infection.  The majority of persons recover within five to fourteen days.

 

The public is advised to seek medical attention at your nearest clinic if you experience any of these symptoms.

 

The Department of Public Health and the Ministry of Health wish to advise the public to:

(1) avoid mosquito bites by wearing protective clothing and applying insect repellent to  exposed areas;

(2)  use safe household insecticides indoors;

(3)  where possible, have intact window and door screens; and

(4)  remove all breeding sites that collect water, such as old tires, flower vases, planters and garbage.

 

While the number of cases don’t quite match up between these stories, the underlying message is that Dengue does appear to be increasing in Nassau, and around the Bahamas.

 

Of course, you don’t have to travel to the Bahamas, or Puerto Rico, or South Florida to be exposed to mosquito borne illnesses.  

 

West Nile virus (WNV), La Crosse virus (LACV), and St. Louis encephalitis virus (SLEV) (among others) also circulate at very low levels in the United States, as well as many other countries around the world. 

 

The odds of contracting any of these viruses are actually pretty low.   But they are not zero.

 

So it makes sense to take reasonable precautions whenever you are around mosquitoes.