Dengue Fever Surges in Latin America

By MICHAEL MELIA,
AP
Posted: 2007-09-30  19:32:18
Filed Under: _Health News_ (http://news.aol.com/health) , _World News_ 
(http://news.aol.com/world) 
 
SAN JUAN, Puerto Rico (Sept. 30) - Dengue fever is  spreading across Latin 
America and the Caribbean in one of the worst outbreaks  in decades, causing 
agonizing joint pain for hundreds of thousands of people and  killing nearly 200 
so far this year. 



 
 
 
Photo Gallery: Where Is Outbreak Spreading?

 
 
 

Yuri Cortez, AFP / Getty  Images  


A home in El Salvador is  fumigated to rid it of mosquitoes transmitting the 
dengue fever in September of  2006. Four different strains of dengue are 
spreading thoughout the Americas,  worrying officials. 
The mosquitoes that carry dengue are  thriving in expanded urban slums 
scattered with water-collecting trash and old  tires. Experts say dengue is 
approaching record levels this year as many  countries enter their wettest months. 

"If we do not slow it down, it  will intensify and take a greater social and 
economic toll on these countries,"  said Dr. Jose Luis San Martin, head of 
anti-dengue efforts for the Pan American  Health Organization, a regional public 
health agency. 

The U.S. Centers  for Disease Control and Prevention in Atlanta has posted 
advisories this year  for people visiting Latin American and Caribbean 
destinations to use mosquito  repellant and stay inside screened areas whenever 
possible. 

"The danger  is that the doctors at home don't recognize the dengue," said 
Dr. Wellington  Sun, the chief of the CDC's dengue branch in San Juan. "The 
doctors need to  raise their level of suspicion for any traveler who returns with 
a fever."  

Dengue has already damaged the economies of countries across the region  by 
driving away tourists, according to a document prepared for a PAHO conference  
beginning Monday in Washington. 

Some countries have focused mosquito  eradication efforts on areas popular 
with tourists. Mexico sent hundreds of  workers to the resorts of Puerto 
Vallarta, Cancun and Acapulco this year to try  to avert outbreaks. 

Health ministers from across the region meet at the  PAHO conference and San 
Martin said he will urge them to devote more resources  to dengue fever. 

The tropical virus was once thought to have been nearly  eliminated from 
Latin America, but it has steadily gained strength since the  early 1980s. Now, 
officials fear it could emerge as a pandemic similar to one  that became a 
leading killer of children in Southeast Asia following World War  II. 

Officials say the virus is likely to grow deadlier in part because  tourism 
and migration are circulating four different strains across the region.  A 
person exposed to one strain may develop immunity to that strain - but  subsequent 
exposure to another strain makes it more likely the person will  develop the 
hemorrhagic form. 

"The main concern is what's happening in  the Americas will recapitulate what 
has happened in Southeast Asia, and we will  start seeing more and more 
severe types of cases of dengue as time progresses,"  Sun said. 

The disease - known as "bonebreak fever" because of the pain -  can 
incapacitate patients for as long as a week with flu-like symptoms. A deadly  
hemorrhagic form, which also causes internal and external bleeding, accounts for  less 
than 5 percent of cases but has shown signs of growing. 

So far this  year, 630,356 dengue cases have been reported in the Americas - 
most in Brazil,  Venezuela, or Colombia - with 12,147 cases of hemorrhagic 
fever and 183 deaths,  according to the Pan American Health Organization. With 
the spread expected to  accelerate during the upcoming rainy season in many 
countries, cases this year  could exceed the 1,015,000 reported in 2002, according 
to San Martin. 

In  Puerto Rico, where 5,592 suspected cases and three deaths have been 
reported,  some lawmakers called this week for the health secretary to resign. 

In  the Dominican Republic, which has reported 25 deaths this year, the 
health  department announced Thursday that it would train 2.5 million public school 
 students to encourage parents and neighbors to eliminate standing water.  

Researchers have not yet developed a vaccine against dengue and Sun said  
that for now, the only way to stop the virus is to contain the mosquito  
population - a task that relies of countless, relentless individual efforts  including 
installing screen doors and making sure mosquitoes are not breeding in  
garbage. 

"It's like telling people to stop smoking," he said. "They may  do it for a 
while, but they don't do it on a consistent basis and without doing  that, it's 
not effective." 

While dengue is increasing around the  developing world, the problem is most 
dramatic in the Americas, according to the  CDC. 

Health officials believe the resurgence of the malaria-like illness  is due 
partly to a premature easing of eradication programs in the 1970s.  

Migration and tourism also have carried new strains of the virus across  
national borders, even into the United States, which had largely wiped out the  
disease after a 1922 outbreak that infected a half-million people.  

Mexico has been struggling with an alarming increase in the deadly  
hemorrhagic form of dengue, which now accounts for roughly one in four cases.  The 
government has confirmed 3,249 cases of hemorraghic dengue for the year  through 
Sept. 15, up from 1,924 last year. 

The CDC says there is no drug  to treat hemorrhagic dengue, but proper 
treatment, including rest, fluids and  pain relief, can reduce death rates to about 
1 percent. 

San Martin said  he use the meetings starting Monday to urge enforcement of 
trash disposal  regulations, more investment in mosquito control and new 
incentives for  communities to participate. 

"It is a battle of every government, every  community and every individual," 
he said. 













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