CARPHA urges region to prepare for the possibility of a severe outbreak of dengue fever

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PORT OF SPAIN, Trinidad — The last major regional outbreak of dengue occurred in 2009. Since then, the region has experienced two large outbreaks of mosquito-borne diseases, chikungunya in 2014 and zika in 2016, which are unlikely to reoccur soon. Disease modelling, however, predicts that another regional outbreak of dengue may occur in the near future.

In 2018, Latin America showed an increase in the number of dengue cases. More recently, the outbreak of dengue in Jamaica has elevated the level of concern in other Caribbean islands. The Caribbean Public Health Agency (CARPHA) is therefore advising countries to implement enhanced measures to reduce mosquito breeding and prevent the spread of disease.

Dengue is a flu-like illness that affects infants, young children and adults. Symptoms typically begin four to ten days after infection, and include a high fever, headache, vomiting, muscle and joint pains, and a characteristic skin rash. This illness can evolve to severe dengue, characterized by potentially deadly complications, such as internal haemorrhaging, intense and continuous abdominal pain or tenderness and persistent vomiting. In some cases, dengue may be severe and cause death.

Dengue and other mosquito-borne diseases threaten health, tourism, social and economic development, and a collaborative effort is required to reduce the spread of disease. Dengue remains a global health problem and like zika and chikungunya, there is no specific treatment for the disease. The Aedes aegypti mosquito vector, which spreads dengue, is present in all Caribbean territories.

The measures used for controlling the spread of dengue are the same as those for zika and chikungunya as these diseases are also transmitted by the Aedes aegypti mosquito. With the arrival of the rainy season within a few months, mosquito control and awareness activities need to be intensified. Caribbean ministries of health are advised to:

• Increase health promotion messages to prevent mosquitoes biting and breeding

• Combine efforts with communities to eliminate mosquito breeding sites

• Intensify vector surveillance and control

• Disseminate appropriate clinical care and treatment guidelines

The most effective way to avoid becoming ill from viruses spread by mosquitoes is to prevent mosquito bites. Research carried out by CARPHA and the Pan American Health Organization/World Health Organization (PAHO/WHO) show that discarded drums and tyres are the main mosquito breeding sources in the region.

“We all need to clean up our surroundings. The two most important things to manage mosquito populations in our Caribbean countries are to manage water storage drums and tanks, and properly dispose of used vehicle tyres to prevent mosquitos breeding,” stated Dr C. James Hospedales, executive director of CARPHA.

Actions that can be taken include covering drums and tanks, cleaning the guttering, removing stagnant water sources, such as old tyres, bottles and buckets, and individuals protecting themselves and their family from bites. Infants, young children, older adults and women who are pregnant or trying to get pregnant should take extra precautions to avoid mosquito bites by using insect repellents containing DEET, Picaridin, IR 3535, and Oil of Lemon Eucalyptus. Individuals would also do well to work together with family, friends and neighbours to destroy breeding sites in and around their homes and communities to achieve total community impact.

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