Worldwide Update - Dengue Fever
ProMED
In this update:
[1] Philippines (Cordillera Administrative Region)
[2] Indonesia (East Java)
[3] India (Kerala)
[4] Madagascar ex Comoros
[5] Japan ex Tanzania
[6] Honduras
[1] Philippines (Cordillera Administrative Region)
Date: Sun 21 Mar 2010
Source: Infectious Diseases Today
Dr Myrna Cabotaje, the Department of Health Cordillera Administrative Region (CAR) director, has warned citizens of the northern region about how the mosquito-borne disease [virus], dengue fever, has spread during the dry spell caused by El Nino. She went on to say that people should not be lax in protecting themselves from mosquitoes, and reminded citizens to be vigilant to prevent breeding areas for the mosquitoes by keeping tight lids on water containers and consistently clean their surroundings.
Dengue fever has increased by 10 percent from the same time last year [2009] in the Cordillera Administrative Region.
[Posted by: Robert Herriman]
[A similar report in the Manila Bulletin dated 21 Mar 2010 () indicated that there have been 103 reported dengue cases and 2 dengue deaths in the 1st 8 weeks of 2010 in the Cordillera region.]
[2] Indonesia (East Java)
Date: Fri 19 Mar 2010
Source: The Jakarta Post
A dengue fever outbreak in Malang regency, East Java, has killed 5 people over the past 3 months, local health authorities said Friday [19 Mar 2010]. The 5 fatalities were part of the 550 people infected by the dengue virus during that period, said the head of the Malang Health Office for communicable disease prevention, Mulyatim Koeswo. Out of the 550 infected people, 382 were infected in January [2010], he said.
"Dengue fever attacks residents in 8 subdistricts of the regency every year," Koeswo told Antara state news agency. East Java is one of the most vulnerable provinces in Indonesia. During this year’s rainy season, dengue fever has also killed 4 residents from Mojokerto, East Java.
The World Health Organization (WHO) has warned that bites by [dengue virus] infected female _Aedes aegypti_ mosquitoes can transmit the dengue virus to human beings.
In addition to dengue fever, about 700 people in Malang had also suffered from chikungunya [disease], a viral disease caused by an Alphavirus virus, which is also spread by the _Aedes aegypti_ mosquitoes, he said.
Both dengue fever and chikungunya disease hit locals during the rainy season, in-line with the breeding season of the _Aedes_ mosquitoes, he said.
[3] India (Kerala)
Date: Thu 18 Mar 2010
Source: The Times of India, Indo Asian News Service (IANS) report
Nearly 270 cases of dengue have been reported in Kerala this year [2010], catching the authorities unaware as the mosquito-borne disease [virus] usually spreads during the monsoon.
According to the latest report from the Kerala health department, the state capital has accounted for 215 of the 268 dengue cases that have been reported in state-run hospitals, while the figure is expected to higher because there is no compilation of records from the numerous private hospitals in the state. Ernakulam has reported 21 cases while the remaining 12 districts have reported 32 cases between them.
Authorities are surprised as the fever has arrived months before the monsoon, when the density of mosquitoes multiplies at a rapid pace.
Speaking to IANS, Thomas Mathew, who heads the department of community medicine at the Thiruvananthapuram Medical College, said that a recent study showed that 75 percent of the areas that have reported the fever face water shortages. "The main reason for this is that all these areas which reported a high rate of dengue cases face a serious water shortage. There are areas under the Thiruvananthapuram Corporation where water comes only once a week and hence people are forced to store water and it is here that mosquitoes breed," Mathew said. "The perception that dengue is associated with the rains is wrong because the National Institute of Communicable Diseases has in a study pointed out that it is endemic in nature," he added.
Health minister PK Sreemathi Tuesday [16 Mar 2010] called a high-level meeting to take stock of the situation. The meeting decided to form a joint coordination committee of various departments and to launch a campaign to spread awareness among the people, officials said.
[This is an excellent example of how the necessity for household water storage due to lack of a constantly available supply can create situations for _Aedes aegypti_, the dengue virus vector, to breed irrespective of rains.]
[4] Madagascar ex Comoros
Date: Fri 19 Mar 2010
From: Jean-Michel Heraud
The National Reference Laboratory (NLR) for Arbovirus and Hemorrhagic Fever Virus at the Institut Pasteur from Madagascar wishes to report what we believe to be the 1st case of dengue virus type 3 (DENV-3) in Union of the Comoros and probably in the Region. After developing dengue-like illness, 2 scientists in a return from Moroni (Union of The Comoros) visited the NLR. One of them had mild symptoms (fever, headaches, myalgia) but the other one had more also dengue-like syndrome (fever, headaches, arthralgia, myalgia) but also more severe symptoms (hematuria, and rash). No malaria was found. Blood was collected (sera) and molecular negative and serological analyses were performed. IgM assays were positive for dengue and West Nile [virus antibodies] for both sera. PCR confirmed DENV-3 viremia in one serum [sample]. The virus is under investigation by the NLR.
Dengue activity is usually reported in East Africa and Islands of South West Indian [Ocean] and during recent outbreak of chikungunya [virus infection] in this region, co-circulation of DENV-1 was notified in Toamasina (Madagascar) (Emerg Infect Dis 2008 Jul; 14(7), [available at http://www.cdc.gov/eid/content/14/7/1135.htm]). The Union of the Comoros reported an outbreak of dengue/DHF in 1993 due [dengue virus] serotype 1 and in relation with high density of _Aedes aegypti_ mosquitoes [Ann Soc Belge Med Trop 1994, 74(3): 217-29 [abstract available at http://cat.inist.fr/?aModele=afficheN&cpsidt=3391963]. DENV-3 has recently caused unexpected outbreaks of dengue hemorrhagic fever (DHF) in Sri Lanka, East Africa (Mozambique, Kenya and Somalia) and Latin America (Emerg Infect Dis. 2003 Jul; 9(7):800-9; [available at http://www.cdc.gov/ncidod/EID/vol9no7/03-0038.htm]).
Madagascar built a sentinel network which aims to monitor all fever and in particular (malaria, arboviruses, and influenza). With this information we need to intensify surveillance for further suspect cases.
Jean-Michel Heraud, PhD
Chief of the Virology Unit
Institut Pasteur de Madagascar
BP 1274
Antananarivo 101 - Madagascar
[5] Japan ex Tanzania
Date: Fri 19 Mar 2010
From: Tomohiko Takasaki
On 9 Feb 2010 and 10 Mar 2010, 2 imported dengue cases from Tanzania were confirmed in Japan. The 1st case was a 55-year-old male who stayed in Tanzania from 20-27 Jan [2010] and returned to Japan on 29 Jan [2010]. On 31 Jan [2010], he developed high fever (39 deg C [102 deg F], rash, arthralgia, and thrombocytopenia (platelet count of 98 000/microL). Dengue virus type 3 (DENV-3) genome was detected in the serum sample by real-time PCR and the virus was isolated. The isolated DENV-3 demonstrated 99 percent homology with that previously (GenBank No. AB447989) isolated from the patient who returned from Cote d’Ivoire in 2008 (ProMED-mail archive no. 20080818.2573).
The 2nd case was a 23-year-old female who stayed in Dar Es Salaam, Tanzania from 3-25 Feb [2010]. She returned to Japan on 28 Feb [2010] via London. On 4 Mar [2010], she developed high fever (39 deg C [102 deg F]) with thrombocytopenia (platelet count of 40 000/microL), leucopenia (WBC 1800/microL), and slight transaminase elevation (AST 154U/L, ALT 73 U/L). DENV-3 genome was detected in the serum sample by real-time PCR. Anti-dengue IgG and IgM antibodies were positive. Isolation of DENV is in progress.
Both cases were negative for chikungunya virus by RT-PCR.
We believe that there are the 1st 2 confirmed dengue fever cases caused by DENV-3 among travelers to Tanzania. It is possible that DENV-3 is being actively transmitted in Tanzania, although no dengue outbreaks have been reported.
Tomohiko Takasaki
Moi Meng Ling
Akira Kotaki
Ichiro Kurane
Researcher (Virologist)
National Institute of Infectious Diseases, Japan
Mitsuo Sakamoto
Clinical medical doctor
Kawasaki Municipal Kawasaki Hospital, Japan
Kenichiro Kobayashi
Clinical medical doctor
Tokyo Metropolitan Bokutoh Hospital, Japan
[6] Honduras
Date: Mon 22 Mar 2010
Source: Latin American Herald Tribune
A pregnant woman died from DHF in Honduras, raising the death toll from the disease in the Central American country to 4 this year [2010], the Health Ministry said. The 19-year-old woman was from Jutiapa, a city in the Caribbean province of Atlantida, and died at a hospital in the region several days ago.
The Health Ministry had confirmed Thursday [18 Mar 2010] that a 17-year-old boy from Orica, a city in the central province of Francisco Morazan, died at the public Teaching Hospital in Tegucigalpa, becoming the 3rd person to die from hemorrhagic dengue in Honduras this year [2010]. A teenager and a man died from the mosquito-borne disease [virus] in February [2010].
Health officials have registered 3124 cases of classic dengue this year [2010], while 172 DHF cases, including the 4 people who died, have been confirmed. Some 500 other people are believed to have contracted DHF in Honduras this year [2010], health officials said.
Last year [2009], 4 adults and 8 children died from DHF in Honduras. Honduras reported at least 367 cases and 9 deaths from DHF in 2008, while classic dengue cases totaled more than 16 000.
Worldwide Update - Dengue Fever
Posted 24 March 2010
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