25 April 2006

Dengue update

Dengue is endemic in over 100 countries in tropical and sub-tropical regions of the world; globally, 2.5 billion people are at risk of acquiring dengue infection. The mosquito vector of dengue, Aedes aegypti, predominates in urban areas of tropical countries and can proliferate in small amounts of standing water. Control relies on eliminating sources of standing water and the use of insecticides. This update will summarise some of the outbreaks that have been reported in 2006. This is not a definitive list and is dependent upon media and reporting practices within the country concerned.

The Americas

Argentina/Brazil/Paraguay

An outbreak of dengue has occurred in the triple border area (known as Triple Frontera) between Argentina, Brazil and Paraguay. In 2006, 25 confirmed and 13 suspected cases have been reported from Puerto Iguazu, in Misiones Province, Argentina. In Paraguay, 112 confirmed and 480 suspected cases of dengue fever have been reported, including ten confirmed and 30 suspected cases in and around Asuncion (the capital).

In Brazil, there have been 31 confirmed and 150 suspected cases reported in Foz de Iguazu [1]. Additional cases in Brazil have been reported in Rio de Janeiro, mainly in the two districts of Barra da Tijuca and Jacarepagua. Two hundred and seventeen cases were reported during January 2006, compared with four times that number in January 2005. Two deaths have been reported and two more are under investigation [2].

Bolivia

As of week five of 2006, 225 cases of classical dengue were notified, of which nine have been confirmed. Eleven additional cases of classic dengue and one case of dengue hemorrhagic fever (DHF) were notified in epidemiological week eight [3].

Ecuador

As of 3 March 2006, 1,460 cases of dengue have been reported in Ecuador, of which 1,430 were classic dengue and 30 were DHF, resulting in two deaths [4].

El Salvador

As of the end of January 2006, there were 435 confirmed cases of dengue, almost twice the number reported in the same period in 2005. Most cases were reported from urban areas of the country [5].

Venezuela

As of 11 March 2006, there were 8,277 cases of dengue reported including 487 cases of DHF. All four serotypes of dengue virus are currently circulating. The cases reported within this period have increased by 32% compared with the number of cases reported in the same period in 2005 (6,291 cases) [6].

Asia

Indonesia

In 2006, cases of dengue have increased in Jakarta (7,624 cases including 14 deaths as of 2 April 2006) [6] and in Yogyakarta (259 cases and 12 deaths as of 6 April 2006) [7].

Viet Nam

Nearly 8,000 cases of dengue fever, including four deaths, were reported in Viet Nam in the 1st quarter of 2006, a 20% increase on the same period in 2005. Areas most affected include southern localities like Ho Chi Minh City, Soc Trang and Dong Thap provinces [8].

Philippines

In North Cotabato, there have been 107 cases of dengue including four deaths reported in January and February of 2006; the most affected area is Kidapawan City [4].

Maldives

The Maldives has experienced an outbreak of dengue since January 2006, with 602 suspected cases reported up to until 5 March 2006, including 64 cases of DHF and nine cases of dengue shock syndrome [9].

Malaysia

Dengue cases have been reported in several states throughout Malaysia. In Tanah Merah district of Kelantan state, there were 11 cases and two deaths reported in January 2006 [10]. Cases have also been reported from Penang state (88 dengue cases reported between 20 Feb and 5 Mar 2006) [11], Malacca state (113 cases of dengue were reported between January and 11 March 2006) [12], and in Kedah state (304 confirmed cases from 1 Jan to 12 Mar 2006) [12].

Other countries

Australia

There continue to be a small number of dengue cases reported in Townsville in Queensland, Australia. Seven cases have been reported, mainly from the Cranbrook region since beginning of January 2006 [13].

Saudi Arabia

At least 402 people have contracted dengue fever in Jeddah, some of them expatriates. Four deaths have also been reported [12].

Madagascar

In March 2006, a dengue outbreak was reported in the port city of Toamasina in Madagascar. The outbreak started mid-January 2006. No case numbers available [9].

Advice for travellers

 

Dengue fever is a viral illness transmitted by Aedes aegypti mosquitoes.

Symptoms of dengue include fever, headache, myalgia, and cough. A maculopapular rash, which typically spreads from the trunk to include the limbs and face also occurs. Most infections are self-limiting with a rapid recovery. However, dengue fever may progress to the more serious dengue haemorrhagic fever.

There is no vaccine to protect against dengue; therefore travelers to affected areas are advised to take measures to avoid mosquito bites. Aedes aegypti mosquitoes are most active during daylight hours.

More information on dengue fever can be found on the NaTHNaC information sheet.

References

1. ProMED-mail. Dengue/DHF update 2006 (15). ProMED-mail 2006; 8 April: 20060408.1056. Available at http://www.promedmail.org.

2. ProMED-mail. Dengue/DHF update 2006 (03). ProMED-mail 2006; 27 January: 20060127.0253. Available at http://www.promedmail.org.

3. ProMED-mail. Dengue/DHF update 2006 (08). ProMED-mail 2006; 25 February: 20060225.0618. Available at http://www.promedmail.org.

4. ProMED-mail. Dengue/DHF update 2006 (12). ProMED-mail 2006; 25 February: 20060328.0942. Available at http://www.promedmail.org.

5. ProMED-mail. Dengue/DHF update 2006 (06). ProMED-mail 2006; 8 February: 20060208.0413. Available at http://www.promedmail.org.

6. ProMED-mail. Dengue/DHF update 2006 (13). ProMED-mail 2006; 3 April: 20060403.0999. Available at http://www.promedmail.org.

7. ProMED-mail. Dengue/DHF update 2006 (14). ProMED-mail 2006; 6 April: 20060406.1031. Available at http://www.promedmail.org.

8. ProMED-mail. Dengue/DHF update 2006 (16). ProMED-mail 2006; 15 April: 20060415.1120. Available at http://www.promedmail.org.

9. WHO. Chikungunya and Dengue in the south west Indian Ocean, Disease Outbreak News [online] 17 March 2006. Available at http://www.who.int/csr/don/2006_03_17/en/index.html.

10. ProMED-mail. Dengue/DHF update 2006 (5). ProMED-mail 2006; 3 February: 20060203.0348. Available at http://www.promedmail.org.

ProMED-mail. Dengue/DHF update 2006 (10). ProMED-mail 2006; 12 March: 20060312.0779. Available at http://www.promedmail.org.

11. ProMED-mail. Dengue/DHF update 2006 (11). ProMED-mail 2006; 18 March: 20060318.0834. Available at http://www.promedmail.org.

12. ProMED-mail. Dengue/DHF update 2006 (3). ProMED-mail 2006; 16 February: 20060216.0511. Available at http://www.promedmail.org.