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Dengue Fever – Symptoms and Prevention

Spraying for mosquitos in La PazUpdated December 8, 2014 Dengue Fever runs in 7 year cycles for an unknown reason and this year, in conjunction with the abundant rains, has brought out a heavier than normal season of this common, but rarely fatal tropical disease.

In the week ending December 8, new cases were down significantly again in Baja California Sur with just 122 reported in the state. This is down from 185 last week and a fall epidemic peak when more than 425 cases were reported in a week. So far this year a total of 4,392 cases have been documented in the state. No deaths have been attributed to this outbreak and only 92 of the reported cases have been of the most severe homoragic variety.

Dengue has been prevalent since July of this year and significant control measures, including aerial spraying have been in place since early September across Baja California Sur.

Dengue fever is also present in Mazatlan, Puerto Vallarta and points further south. The state of Jalisco reported a total of just over 1200, mostly in coastal communities. The state of Sonora reported 1221 cases so far this year. The Pacific state of Nayarit reported just over 1000 cases, down significantly from the previous year, due to an aggressive clean up campaign.

Final medical testing is underway on a vaccine for Dengue, which may be available as soon as the second half of 2015. The French drug maker Sanofi Pasteur intends to ask to release the vaccine in several endemic countries next year, the company said in a statement. The new vaccine has proven about 95% effective in clinical trials.

Dengue suffererDengue is a common tropical afflicton and although rarely fatal, hospitalizes more than half a million people world wide each year. There are four strains of Dengue, including the most serious, Hemoragic Fever, and you can only get Dengue once for each strain.

The Federal Health Ministry said the lack of citizen participation to keep yards clean and avoid places where water can accumulate in puddles or dirty water is a factor to increase cases of dengue. 

"I have always said, that the reduction of cases at par and is proportional to the participation of the community, as a community and private institutions become involved it decrease dengue cases by the same proportion." said Garcia, Federal Minister of Health. 

Local health officials announced that the number of new cases in the last week dropped dramatically over the previous week. But they also advised that the cooler weather will not end the out break, as Baja California Sur never receives a 'killing frost' to eliminate the mosquito population. what is happening is that since the end of the rainy season, breeding grounds for the mosquito are drying up.

Aedes albopictusThe latest statistics 12/08/14

In the week ending December 8 there were a total of 122 new cases. For the second week in a row Los Cabos lead the way, with 65 new cases, La Paz reported 45 new cases and less than 6 new cases in each of Comondu, two cases each in Loreto and Mulege.

According to the State Health Secretary the Dengue outbreak has had the most reported cases in La Paz, with approximately a total of 2,704 in the peninsula's largest city. Cabo San Lucas is in second place with 903 total cases. The sparely populated region of Comondu is in third place with 429, and Mulege with 223 and Loreto weighing in at around 133 cases. These numbers do not reflect those that did not seek medical attention, the Federal Health Minister speculated that about 30% more cases are unreported.

Although Dengue is a very 'uncomfortable' thing to have, it is less fatal than even common influenza. There have been no deaths attributed to the disease in Baja California Sur during this outbreak.

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The total number of cases reported in Baja California Sur since the beginning of the outbreak in July now stands at 4270. Of all the reported cases only 91 have shown symptoms of the most aggressive and painful version, Hemorrhagic Fever.
Cases of Dengue as a percentage of population: Updated 12/08/14

La Paz 1.3%
Comondu 0.9%
Los Cabos 1.0%
Loreto & Mulege about 0.8%

Although the weather has cooled and mosquito propagation has slowed the city of La Paz has advisd residents not to abandon their efforts to limit mosquito breeding areas. Since the region never receives a killing frost the threat will only diminish, not disappear.

Care should be taken to avoid contracting mosquito bites. Infection rates are still very low, this is in comparison with 2003, following Hurricanes Ignacio and Marty, when the outbreak reach epidemic proportions in many parts of Baja California Sur.

Dengue Hemorrhagic Fever is the most serious of the four strains of the disease and a only a handful this strain have been treated in Los Cabos in this time around.

The city of La Paz has announced an aggressive spray program in the hopes of averting an outbreak of Dengue fever. Fumigation by malathion will be increased in the evening hours in select neighborhoods. In the past public announcements of neighborhoods to be sprayed has appeared in advance on the radio and newspapers, but this isn't much use to gringos who are Espanol illiterate.

Residents have been urged in the media to clean up standing water in their yards, to make sure their tanacos (water cisterns) are bug proof . In the past the city has handed out little packets of sterilizer for these cisterns, of which nearly every home in La Paz has at least one. A couple of tablespoons of unscented bleach will also sanitize the tanks, but using bottle water following either treatment is recommended.

Background on Dengue Fever

This is the original text of this article from 2010. Every year, following the rains, it is important to clear your property of standing water and drain puddles. The cities usually issue a small packet of chemicals to sanitize tanaco (water cisterns) to prevent the spread of the disease. Dengue usually runs in 7 year cycles. In recent years, has become a major international public health concern.

Although a serious disease, the mortality rate is very low, about 1% and it poses the greatest threat to the very young, elderly and those under treatment for other diseases which may compromise the bodies ability to resist infection. The disease can be very debilitating, incapacitating the sufferer during the early stages and robbing the victim of energy for many weeks to follow.

Dengue is found in many tropical sub-tropical regions in Mexico and around the world, predominantly in urban and semi-urban areas. Dengue viruses are transmitted by infected Aedes mosquitoes, (Aedes albopictus) which are most active during the day but can be found out at night. There is no truth to the rumor that only a species of daytime mosquito carry the virus. The Asian Tiger Mosquito is denoted by the black and gray stripes on the abdomen and is know for its ability to bite quickly, more quickly that it can be swatted away.

The mosquito that carries Dengue FeverThere are four variations of Dengue fever, and you can only contract each version once, as the body develops antibodies to the virus. Unfortunately, as anyone who has had any of the varieties will tell you, once is enough. There are no medications for the disease, antibiotics are ineffective and may only prevent secondary infections and further reduce the bodies ability to combat the disease. Hospitalization can be required and intravenous fluids administered to prevent dehydration, a major threat of the infection.

The first reported epidemics of Dengue occurred in 1779-1780 in Asia, Africa, and North America.  The near simultaneous occurrence of outbreaks on three continents indicates that these viruses and their mosquito vector have had a worldwide distribution in the tropics for more than 200 years.

A pandemic of dengue began in Southeast Asia after World War II and has spread around the globe since then.  Epidemics caused by multiple serotypes (hyperendemicity) are more frequent, the geographic distribution of dengue viruses and their mosquito vectors has expanded, and DHF has emerged in the Pacific region and the Americas. In Southeast Asia, epidemic DHF first appeared in the 1950s, but by 1975 it had become a frequent cause of hospitalization and death among children in many countries in that region. The unusual 1975 outbreak was particularly virulent in Southeast Asia and that year was the 5th leading cause of infectious death of children under 10 in that region.

Dengue Campoaign adThe city of La Paz distributes packets of pesticides beginning late each summer, following our torrential rains, to homeowners and encourages removal of any standing water. The standing water is a key link in the development of the mosquito responsible for transmission of the disease. Night time spray trucks have been seen throughout the city in an effort to contain the adult mosquito. Dengue is usually most prevalent in northern hemisphere tropical areas from late June to mid October.

The classic symptoms of Dengue Fever include a high fever that may last from 5 to 7 days; intense headache; eye, joint and muscle pain; and a rash. The rash typically begins on the arms or legs three to four days after the beginning of the fever. Symptoms can range widely in severity. Significant symptoms usually resolve within 1 to 2 weeks, but like the diseases' relative Malaria, lethargia and some other symptoms can revisit the victim for months.

Dengue Hemorrhagic Fever is the most serious form of this illness. Individuals with Dengue Hemorrhagic Fever experience blood clotting problems which result in bleeding and shock (extremely low blood pressure). Hospitalization is usually required.

Dengue Fever is diagnosed by clinical symptoms and by specific blood tests.

There is no curative treatment for Dengue Fever. If there are no complications, recovery will occur within 1 to 2 weeks. Hospital care with intravenous fluids is usually necessary for individuals with the more serious Dengue Hemorrhagic Fever. Antibiotic treatments are usually only applied to the Hemorrhagic version to prevent secondary infection. Antibiotics have little or no effect of the disease itself.

An individual infected with Dengue Fever is not directly infectious to other individuals except through sharing of blood contaminated needles. Untreated individuals, if bitten by Dengue Fever-capable mosquitoes, could infect a small number of mosquitoes. These could transmit Dengue Fever if they subsequently bite another human at least 1 to 2 weeks later, depending upon environmental conditions.

The best tactic to prevent Dengue is to avoid being bitten by mosquitoes. This includes sleeping in areas screened from mosquitoes, wearing long sleeves and pants, and using mosquito repellents and insecticides.

There is no vaccine which can prevent Dengue Fever, however such vaccines are in development. End

Alternate Names: Breakbone Fever, Dengue-Like Disease, O'nyong-Nyong Fever

Tomas

Additional Resources

For more on Dengue fever see the Center for Disease Control web page on Dengue.
About the World-wide War on Dengue