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During the 32nd reporting week (early August), Puerto Rico would normally be seeing about 125-150 Dengue cases, with the peak usually occurring in October or November.
Dengue has been endemic on the island for decades, and on average, a couple of thousands cases are reported every year. Dengue outbreaks are cyclical, however, and every 3 to 5 years there is an upsurge in cases.
The 974 suspected cases reported in the latest CDC surveillance report is well above the epidemic threshold (roughly 200/wk) for this time of year.
A pattern that has persisted since an epidemic was declared in February of this year.
The last major epidemic of Dengue in Puerto Rico was in 1998, with roughly 9800 cases of suspected dengue reported through the end of August.
Through early August of this year more than 10,000 suspected cases have been reported. Of particular concern, the number of reported fatalities has spiked in the past week jumping from 8 to 18.
And according to an Associated Press report (Caribbean dengue deaths force new measures in PR) another 14 deaths are under investigation.
Health Secretary Lorenzo Gonzalez at a press conference on Friday called the situation both `serious’ and `critical’ and called for all doctors on the island to take courses on how to prevent, detect, manage and treat dengue cases.
The sudden drop in cases detected in 1998 was due to Hurricane Georges interrupting surveillance efforts/
Of the 4 serotypes of Dengue, only DENV-3 has not been reported in 2010. DENV-1 is the most prevalent strain, followed by DENV-4.
In July the CDC’s MMWR came out with a field report on the Dengue situation in Puerto Rico, which you can read about at MMWR: Dengue Epidemic In Puerto Rico.
The CDC also issued a Health Advisory via their HAN (Health Alert Network) primarily to inform health care providers of the possibility of seeing Dengue Fever in returning visitors from areas where the virus is being seen.
This is an official
CDC HEALTH ADVISORYDistributed via Health Alert Network
Sunday, July 25, 2010, 22:35 EDT (10:35 PM EDT)
CDCHAN-00315-2010-07-25-ADV-N
Summary
Dengue virus transmission has been increasing to epidemic levels in many parts of the tropics and subtropics. Travelers to these areas are at risk of acquiring dengue virus and developing dengue fever (DF) or the severe form of the disease, dengue hemorrhagic fever (DHF). The Centers for Disease Control and Prevention (CDC) strongly advises that health care providers in the United States should: 1) consider DF and DHF when evaluating patients returning from dengue-affected areas--both domestic and abroad--who present with an acute febrile illness within two weeks of their return, 2) submit serum specimens for appropriate laboratory testing, and 3) report all presumptive and confirmed cases of DF and DHF to their local or state health department.
Of course, you don’t have to travel to Puerto Rico to be at risk of contracting a mosquito borne disease.
Each year we see hundreds of cases of West Nile Virus, EEE (Eastern Equine Encephalitis), La Crosse Virus, and St. Louis Encephalitis on the mainland here in the United States.
And over the past year, there have been a relative small handful of Dengue cases reported in Florida as well.
Which is why health departments often urge people to remember to follow the `5 D’s’:
Don't go outdoors at DUSK and DAWN when mosquitoes are most active.
DRESS so your skin is covered with clothing
Apply mosquito repellent containing DEET to bare skin and clothing.
Other effective repellents include picaridin, oil of lemon eucalyptus, and IR3535
Empty containers and DRAIN standing water around your home where mosquitoes can lay eggs.
For more on Mosquito Borne diseases, you may wish to check out:
Eastern Equine Encephalitis (EEE)
ASTMH: Dengue and Insect-Borne EIDs In The US
Update On The Florida Dengue Cases
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