Dengue Fever Death Toll Hits Record In Puerto Rico.

Global Dengue Transmission Map Courtesy of World Health Organization

Caribbean Basin 09/10/10   The dengue death toll in Puerto Rico has reached a record 20 victims as the epidemic shows no signs of waning, the island Health Department reported Friday.  Lab tests confirmed that two of 14 deaths under evaluation by the federal Centers for Disease Control last week were due to the mosquito-borne virus, Health Secretary Lorenzo González said. The latest victims were both adults.  Statistics for the most recent week registered (Aug. 13-19) show 957 cases of the virus, 751 cases above the epidemic threshold for the period.  The number of hemorrhagic dengue cases rose to 28 for the year.

Hemorrhagic Dengue Victim

The municipalities with the highest incidence for the most recent week reported were: Ponce, Arecibo, Patillas, San Sebastián, Guaynabo, Aguadilla and Isabela.  Last week, González announced that all doctors in Puerto Rico would be required to undergo new training after federal authorities confirmed nearly a dozen more deaths related to dengue.  Thousands of doctors ranging from pediatricians to gynecologists will have to take courses on how to prevent, detect, manage and treat dengue, which has killed dozens of people in the Caribbean this year, including 20 in Puerto Rico.

Nearly 12,000 cases have been reported. The island’s worse dengue outbreak occurred in 1998, when the virus killed 19 people and sickened 17,000.  Characterizing the situation as “critical,” González has issued repeated calls for islanders to get rid of standing water that can serve as mosquito breeding grounds and to use insect repellent.  The Health Department chief said spraying to control mosquito populations represents a small front in the fight against the virus, with the vast bulk of resources going to awareness efforts and improving diagnosis and treatment.

Dengue cases have surged across the Caribbean this year, with more than 80,000 reported in the region as of early September, according to the Pan American Health Organization.  Health authorities blame warm weather and an unusually early rainy season, but officials in Puerto Rico also blame doctors for not providing appropriate follow-up care and patients who dismiss symptoms until they are critically ill.  Many patients leave the hospital when their fever drops, but that is when they are most at risk of becoming even sicker, according to González.  And some patients do not bother to see a doctor when they should, according to Kay Tomashek, epidemiology section chief of the Centers for Disease Control and Prevention’s dengue branch in Puerto Rico.

Elsewhere in the Caribbean, officials are warning people to protect themselves from mosquitoes as the number of cases keep climbing, especially in Guadeloupe, French Guiana and the Dominican Republic, which is reporting at least 41 deaths and nearly 9,000 cases. At the same time last year, it had reported only 3,000 cases and 27 deaths.  Nelson Rodríguez, a vice minister within the Dominican Ministry of Health, blamed the deaths on doctors not diagnosing the virus in time.

In Trinidad, health officials have reported 1,200 cases and four deaths. They also have added dozens of new hospital beds to make room for patients. Jamaica, meanwhile, has seen an uptick with 729 suspected cases.  Tomashek, with the CDC, said Central and South America are showing a similar pattern, with Colombia reporting the largest dengue outbreak in the country’s history.  Dengue causes fever, headaches and severe joint and muscle pain. Most victims recover within a week, but it can be life-threatening.


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