Dengue Fever Surges in Latin America
Pastor Dale Morgan
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Sep 29, 2:57 PM EDT
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Dengue Fever Surges in Latin America*
By MICHAEL MELIA
Associated Press Writer
SAN JUAN, Puerto Rico (AP) -- 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.
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.