Thank you for the very timely post. I mentioned this issue a short time ago in another post but here is an update from the region.....
Health Dept. says increase in dengue fever reports not unusual
Rainy weather - and the beginning of cold and flu season - led to recent rise in suspected cases
By JOY BLACKBURN
Thursday, November 8th 2007
The number of suspected cases of dengue fever reported in the territory has stepped up in recent months, but a Health Department official said that an upswing in reports is not unusual for this time of year.
Eugene Tull, V.I. Health Department epidemiologist, outlined the following results of dengue fever surveillance in the territory this year:
- January through April - no dengue cases reported.
- May, June and July - one suspected case reported each month.
- August - five suspected cases reported.
- September - 17 suspected cases reported, with 14 of them on St. Croix.
- October - 17 suspected cases reported, with 16 of them on St. Thomas.
Tull said that with rainy weather - and the start of cold and flu season - reports of suspected dengue fever cases tend to rise in September and October. Some of the reports may, after blood testing, turn out to be influenza and not dengue, he said.
However, he said he remains concerned about a major dengue fever outbreak in Puerto Rico, an outbreak in which Dengue 3 - a strain of the virus that has, so far, not been reported in the Virgin Islands - is responsible for about 60 percent of the cases.
There are four strains of the dengue virus, which is transmitted to people through the bite of a mosquito.
A person who has been infected by one strain of dengue develops immunity to it but is still vulnerable to the others. Those who have had dengue more than once are at greater risk for its more serious complications.
So, Tull said, if Dengue 3 made its way to the territory, it would find a large number of people who are susceptible to it - one of the factors necessary to spawn a major outbreak.
Health officials have asked local physicians to send blood work on suspected dengue cases to the Centers for Disease Control and Prevention's Dengue Branch in Puerto Rico, where virology testing can isolate the strain of dengue. Many private labs may not do this, Tull said.
If Health officials can pick up on any Dengue 3 cases early, they may be able to avert a major outbreak by concentrating mosquito extermination efforts where the person lives, he said.
"Our goal would be that Dengue 3 doesn't leave their home," he said. "An introduction of that strain would surely cause a major outbreak."
Last month, Health Commissioner Vivian Ebbesen-Fludd issued an advisory to local residents who travel to Puerto Rico, urging them to seek immediate medical care if they start to show dengue symptoms after returning to the territory - and to notify Tull by calling 773-1311 ext. 3241.
Dengue symptoms can include high fever, joint and muscle pain and generalized discomfort, severe headache and backache, and pain behind the eyes. A rash may appear a few days after the fever starts. Nausea, vomiting and a loss of appetite also may occur.
Countries around the Caribbean and in Latin America have reported an upswing in dengue fever cases this year.
Health, which did fogging for mosquitoes on St. Thomas and St. Croix on Tuesday and Wednesday, plans to finish on those islands tonight. On St. John, fogging is scheduled for Sunday evening in Cruz Bay and Coral Bay.
The department plans to begin routinely fogging for mosquitoes after heavy rains.
Tull said he is conducting a study, focusing on the dengue prevention campaign Health has launched, to try to determine which outreach strategies are most effective at getting people to actually change their behaviors - and take steps to eliminate mosquito breeding grounds in and around their homes.
The department also hopes to begin conducting tests for dengue fever in its laboratory soon, said Joseph Mark, a microbiologist who is Health's bioterrorism laboratory coordinator.
Health has the equipment to do the testing, but it still has to be installed and local workers have to be trained. That training, which has not yet been scheduled, will come from the CDC Dengue Branch in Puerto Rico, he said.
Mark declined to estimate when the local testing would begin.
"I would like it to happen yesterday," he said.
Symptoms of dengue fever
- High fever.
- Joint and muscle pain and generalized discomfort; dengue is known locally as breakbone fever.
- Severe headache and backache.
- Eye pain.
- Nausea and vomiting.
V.I. Health Commissioner Vivian Ebbesen-Fludd issued an advisory last month to local residents who travel to Puerto Rico, urging them to seek immediate medical care if they start to show dengue fever symptoms after returning to the Virgin Islands - and to notify epidemiologist Eugene Tull by calling 773-1311 ext. 3241.
Hospitals, private physicians, clinics and medical agencies are required, by law, to report suspected dengue cases to the Health Department.
Phil & Liz