Published Date: 2008-01-20 23:50:00
Subject: PRO/EDR> Dengue/DHF update 2008 (03)
Archive Number: 20080120.0255

DENGUE/DHF UPDATE 2008 (03)
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A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1] Cambodia
[2] British Virgin Islands
[3] Trinidad
[4] Puerto Rico
[5] Venezuela (Zulia)
[6] Brazil (Rio de Janeiro)

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[1] Cambodia
Date: Fri 4 Jan 2008
Source: Associated Press [edited]
<http://ap.google.com/article/ALeqM5gxvkQImMSjb3o_I-XkERO_ihklWwD8TVAV3O1>


Dengue fever killed 407 people in Cambodia last year [2007], the highest
number of fatalities in nearly a decade, a health official said on Friday
[4 Jan 2008]. Most of those who died from the disease were children, said
Ngan Chantha, director of the National Anti-Dengue Fever Program.

Dengue is a chronic problem in Cambodia, but health officials say the spike
in cases last year [2007] was due partly to the early arrival of the rainy
season, which typically runs from May through November.

More than 40 000 dengue patients were admitted to Cambodian hospitals last
year [2007], compared with 16 650 in 2006, when 158 people died.

The death toll from 2007 was the largest since 1998, when 474 people died
from dengue fever.

In 2007, South East Asia experienced the worst outbreak of dengue fever in
years, with large outbreaks also reported in Indonesia, Viet Nam, Malaysia,
Singapore, and Thailand.

Dengue infects up to 50 million people worldwide every year, according to
the World Health Organization. Most of dengue's victims are children. There
is no vaccine or cure for the mosquitoborne virus, which causes rashes,
blistering, headaches, nausea, and excruciating joint aches. The most
serious form of the disease can cause internal bleeding, liver enlargement,
and circulatory shutdown.

In Cambodia, the government conducted an intense public awareness campaign
with the help of foreign aid donors that warned residents not to keep still
water in containers around their houses where [vector] mosquitoes can breed.

--
communicated by:
ProMED-mail <promed@promedmail.org>

[There was a resurgence of dengue cases in many parts of Asia and in Latin
America and the Caribbean in 2007. A worldwide assessment of control
measures aimed at vector control providing information on lessons learned,
what worked and what was not successful would be helpful. Although cultural
differences among countries are important in community-based vector control
programs, some useful common threads would surely emerge.

A ProMED-mail interactive health map showing the location of Cambodia in SE
Asia can be accessed at: <http://healthmap.org/promed?v=12.7,104.9,5>. -
Mod.TY]

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[2] British Virgin Islands
Date: Thu 18 Jan 2008
Source: BVI News [edited]
<http://www.bvinews.com/default.asp?sourceid=&smenu=198&twindow=&mad=&sdetail=4211&wpage=1&skeyword=&sidate=&ccat=&ccatm=&restate=&restatus=&reoption=&retype=&repmin=&repmax=&rebed=&rebath=&subname=&pform=&sc=1924&hn=bvinews&he=.com>


The Ministry of Health and Social Development has received confirmation of
3 additional cases of dengue, bringing the total of confirmed cases in the
British Virgin Islands (BVI) to 5 for 2007.

Director of health services Dr Irad Potter says that the ministry has so
far had a total of 33 suspected cases. Of those cases, 19 proved negative
for dengue, 8 are awaiting test results, and one has not been tested.

Blood samples are being sent to the Caribbean Epidemiology Centre (CAREC)
to confirm the status of the suspected cases of dengue. The specimens take
at least 4-6 weeks to be processed. Persons suspected of having dengue are
treated based on their clinical presentations to their doctor.

As health officials continue to monitor the results of other suspected
cases of dengue, residents are urged to guard against mosquito bites and to
reduce mosquito breeding around homes and property in order to keep the
number of cases of dengue in the BVI to a minimum.

Dr Potter noted that in light of outbreaks in the region, persons who have
traveled to Puerto Rico, Dominican Republic, Martinique, and Guadeloupe and
are experiencing painful flu-like symptoms of high fever, nausea and
painful body aches within 3-14 days of their travel should seek medical
attention.

Dengue virus, which can also cause a rash in infected persons, is spread
through the _Aedes aegypti_ mosquito commonly found in the BVI.

The director of health services advised that due to the heightened
awareness of dengue in the sub-region, suspected cases are being
investigated and followed up to rule out or confirm the presence of the
virus. "We are asking the public to be diligent in removing possible
breeding sites in the community and around their homes. Survey personal
properties and neighbouring properties in search of containers with
stagnant water where mosquitoes can reproduce," he said.

Environmental health vector control programme manager Mr Minchington Israel
noted with the rains that continue to fall periodically within the
territory, residents should inspect their premises to identify, remove, or
seal any possible water reservoirs. He said this simple activity will help
prevent a major upsurge of mosquitoes in the coming days. "All _Aedes
aegypti_ inspectors are up and about surveying public and private spaces.
However, mosquitoes reproduce at a rapid rate. Therefore, surveys of
private and work spaces must be completed by residents themselves to break
the mosquito cycle," he said.

Mr Israel is reminding residents that mosquitoes lay their eggs in
water-bearing receptacles and that the best way of reducing mosquito
populations is to destroy all those places where mosquitoes can lay eggs
and breed more mosquitoes. All unwanted containers should be destroyed or
otherwise disposed of in the community dumpsters or at the Pockwood Pond
Incinerator.

--
communicated by:
ProMED-mail rapporteur Brent Barrett

[An interactive ProMED-mail health map showing the British Virgin Islands
and their location in the Caribbean can be accessed at:
<http://healthmap.org/promed?v=18.4,-64.6,7>. - Mod.TY]

******
[3] Trinidad
Date: Sun 6 Jan 2008
Source: Woodshed Environment [edited]
<http://woodshedenvironment.wordpress.com/2008/01/13/dengue-outbreak-in-south-trinidad/>


Newsday last week (Sun 6 Jan 2008) reported that there was a fresh outbreak
of dengue in South Trinidad. Newsday writer Cicely Asson in an article
stated that 3 members of one family of Corinth Village, Ste. Madeliene,
South Trinidad were hospitalized at San Fernando General [SFGH] as a result
of dengue fever. The victims were 2 men in their 50s and a 19 year old
woman. The results of tests done on a 21 year old man of the said household
was not yet available.

Unconfirmed reports (Sat 5 Jan 2008) stated that there are other suspected
cases of dengue fever from other parts of south Trinidad warded at the SFGH.

Public health inspector [PHI] John Ramkhelawan of the San Fernando City
Corporation, the agency responsible for dengue prevention and control, told
the Newsday reporter that on being notified about the 3 confirmed dengue
cases, a team of vector control personnel were stationed in and around
Corinth. As of Fri 4 Jan 2008, they were conducting the requisite
house-to-house and premises-to-premises inspections for the purpose of
identifying all mosquito breeding sites and to destroy the adult _Aedes
aegypti_ mosquitoes in circulation there.

PHI's Ramkhelawan and Alexander Ramnath were said to have personally
supervised the vector operation on Sat 5 Jan 2008. "We are doing a radius
of at least 150 metres (and) are fogging the immediate environs and will
continue the exercise to make sure the situation is brought under control,"
said Ramkhelawan. He further explained that his vector control officers did
find mosquitoes and that on the very Saturday [5 Jan 2008] were back doing
fogging targeting the adult mosquitoes.

--
communicated by:
ProMED-mail rappor