Dengue remains a public health problem in our region, despite the efforts of many countries to stop and mitigate the impact of epidemics.
The number of dengue cases in the region of the Americas increased five-fold between 2003 and 2013, according to data from the Pan American Health Organization/World Health Organization (PAHO/WHO).
Between 2009 and 2012, over one million cases were reported annually, on average, with more than 33,900 severe cases and 835 deaths. The year 2013 was one of the worst years for dengue in the hemisphereâs history, with 2.3 million cases, including 37,705 severe cases and 1,289 deaths.
Despite countriesâ efforts to control the disease, dengue continues to spread due to uncontrolled, unplanned urbanization, lack of basic services in communities, poor environmental management, and climate change, among other reasons.
Dengue fever is a disease transmitted by the aedes aegypti mosquitoes. It is an acute illness of sudden onset that usually follows a benign course, with symptoms such as headache, fever, exhaustion, severe muscle and joint pains, swollen lymph nodes and rash. The presence of fever, itchy rash, and headache, referred to as the “dengue triad,â is characteristic of the disease. Other signs of dengue fever include bleeding gums, severe pain behind the eyes, and red palms and soles.
Dengue can affect anyone, but tends to be more severe in people with compromised immune systems. Because it is caused by one of five serotypes, the dengue virus, it is possible to get dengue fever multiple times. However, an attack of dengue produces immunity for a lifetime to that particular viral serotype to which the patient was exposed.
Dengue hemorrhagic fever is a more severe form of the viral illness. Symptoms include headache, fever, rash, and evidence of hemorrhage in the body. Petechiae (small red spots or purple splotches or blisters under the skin), bleeding in the nose or gums, black stools, or easy bruising are all possible signs of hemorrhage. This form of dengue fever can be life-threatening and can progress to the most severe form of the illness, dengue shock syndrome.
There is no specific medicine or antibiotic to treat dengue. For typical dengue, the treatment is concerned with relief of the symptoms and signs. Rest and fluid intake for hydration is important. Pain relievers should only be taken under a doctorâs supervision because of the possibility of worsening bleeding complications.
The transmission of the virus to mosquitoes must be interrupted to prevent the illness. To this end, patients are kept under mosquito netting until the second bout of fever is over and they are no longer able to transmit the virus to a biting mosquito.
The prevention of dengue fever requires control or eradication of the mosquitoes carrying the virus. People are urged to empty stagnant water from old tires, trash cans, and flower pots. Governmental initiatives to decrease mosquitoes, such as fogging activities and other vector control activities, also help to keep the disease in check, but have been poorly effective.
To prevent mosquito bites, wear long pants and long sleeves. For personal protection, use mosquito repellent sprays that contain DEET. There are no specific risk factors for contracting dengue fever, except living in or traveling to an area where the mosquitoes and virus are endemic. Limiting exposure to mosquitoes, especially at the times when the mosquito bites more will help, as the aedes aegypti mosquito is a daytime biter, with peak periods of biting around sunrise and sunset. It must be noted that it may bite at any time of the day and is often hidden inside homes or other dwellings, especially in urban areas.
Dr Rosmond Adams is a medical doctor and a public health specialist.