Warden Message #03 FY2009
Warden Message: Dengue Fever Outbreak
U.S. citizens should be aware of the recent dengue fever outbreak in Jalisco, concentrated in the Guadalajara suburb of Zapopan. In the past year, 276 cases have been reported in Jalisco state, including five cases of the more severe dengue hemorrhagic fever. No deaths in Jalisco have been attributed to dengue fever since 2006, and the number of reported cases has dropped significantly in recent weeks.
The 271 reported cases of dengue fever by municipality are as follows:
Zapopan 191, Guadalajara 22, Puerto Vallarta 16, Tequila 13, Tlaquepaque 9, Jilotlan 7, Pihuamo 3, Tomatlan 2, Zapotlan El Grande 2, Cihuatlan 1, Sayula 1, Tamazula 1, Tecalitlan 1, Tuxpan 1, Hostotipaquillo 1. Most of these cases occurred in six neighborhoods within the Zapopan municipality: El Batan, Victor Hugo, Constitucion, Mesa de los Octoes, La Martinaca, and Balcones de la Cantera.
The five reported cases of dengue hemorrhagic fever by municipality are as follows: Zapopan 4, Puerto Vallarta 1. Only one of these patients remains hospitalized, while the remaining four have recovered.
According to local media and Consulate sources, one U.S. citizen living in the Jocotepec municipality of Ajijic was infected with the dengue virus in September 2008. Jalisco’s Health Department, however, has not received official notification of any confirmed dengue cases in the Chapala/Ajijic basin area. The Consulate is not aware of any other affected U.S. citizens at this time.
Local media attributed the death of an 18-year old female resident of the Victor Hugo neighborhood in Zapopan to dengue hemorrhagic fever; however, the Jalisco Health Department confirmed that her death was not a result of dengue,
The local government is working to combat this outbreak through a public information campaign to raise public awareness of the dengue and the importance of mosquito control. Local government is also procuring more mosquito control equipment, such as spraying equipment to eradicate mosquito breeding areas
Residents should report any suspected or confirmed cases of dengue fever by calling the Jalisco Health Department (Secretaria de Salud, Gobierno de Jalisco) at 33-3030-5065.
What is Dengue Fever?
Overview
Dengue fever is an infectious disease carried by mosquitoes and caused by any of four related dengue viruses. This disease used to be called "break-bone" fever because it sometimes causes severe joint and muscle pain that feels like bones are breaking. Health experts have known about dengue fever for more than 200 years.
Dengue fever is found mostly during and shortly after the rainy season in tropical and subtropical areas of:
· Africa
· Southeast Asia and China
· India
· Middle East
· Caribbean and Central and South America
· Australia and the South and Central Pacific
An epidemic in Hawaii in 2001 is a reminder that many locations in the United States are susceptible to dengue epidemics because they harbor the particular types of mosquitoes that transmit dengue virus.
Worldwide, 50 to 100 million cases of dengue infection occur each year. This includes 100 to 200 cases in the United States, mostly in people who have recently traveled abroad. Many more cases likely go unreported because some health care providers do not recognize the disease.
During the last part of the 20th century, many tropical regions of the world saw an increase in dengue cases. Epidemics also occurred more frequently and with more severity. In addition to typical dengue, dengue hemorrhagic fever (DHF) and dengue shock syndrome also have increased in many parts of the world. Globally, there are an estimated several hundred thousand cases of DHF per year.
Cause
Dengue fever can be caused by any one of four types of dengue virus: DEN-1, DEN-2, DEN-3, and DEN-4. You can be infected by at least two if not all four types at different times during your lifetime, but only once by the same type.
Transmission
Dengue virus can be transmitted from the bite of an infected Aedes mosquito. Mosquitoes become infected when they bite infected humans, and can later transmit the infection to other people. Two main species of mosquito, Aedes aegypti and Aedes albopictus, have been responsible for all cases of dengue transmitted in Mexico. Dengue cannot be transmitted from person to person without a mosquito as the intermediate vector.
Symptoms
Symptoms of typical uncomplicated (classic) dengue usually start with fever within 4 to 7 days after you have been bitten by an infected mosquito. These symptoms include:
· High fever, up to 105ºF
· Severe headache
· Retro-orbital (behind the eye) pain
· Severe joint and muscle pain
· Nausea and vomiting
· Rash
The rash may appear over most of the body 3 to 4 days after the fever begins, and then subsides after 1 to 2 days. There may be a second rash a few days later.
Symptoms of dengue hemorrhagic fever include all of the symptoms of classic dengue plus bleeding from the nose, gums, or under the skin, causing purplish bruises, which results from damage to blood vessels. This form of dengue disease can cause death.
Symptoms of dengue shock syndrome--the most severe form of dengue disease-include all of the symptoms of classic dengue and dengue hemorrhagic fever, plus severe bleeding and ‘shock’ (very low blood pressure). This form of the disease usually occurs in children (sometimes adults) experiencing their second dengue infection. It is sometimes fatal, especially in children and young adults.
How is Dengue Diagnosed and Treated?
Dengue can be diagnosed by doing two blood tests, 2 to 3 weeks apart. The tests can show whether a sample of your blood contains antibodies to the virus. However, in epidemics, a health care provider often diagnoses dengue “presumptively” by typical signs and symptoms without waiting for lab results.
Treatment
There is no specific treatment for classic dengue fever, and most people recover within 2 weeks. To help with recovery, health care experts recommend:
· Getting plenty of bed rest
· Drinking lots of fluids
· Taking medicine to reduce fever
The U.S. Centers for Disease Control advises people with dengue fever not to take aspirin. Acetaminophen or other over-the-counter pain-reducing medicines are safe for most people.
For severe dengue symptoms, including shock and coma, early and aggressive emergency treatment with fluid and electrolyte replacement can be lifesaving.
Complications
Most people who develop dengue fever recover completely within 2 weeks. Some, especially adults, may be tired and/or depressed for several weeks to months after being infected with the virus.
The more clinically severe dengue hemorrhagic fever and dengue shock syndromes can result in vascular (blood vessel) and liver damage, and can be life-threatening.
How Can I Prevent Dengue?
The best way to prevent dengue virus infection is to take special precautions to avoid being bitten by mosquitoes. Several dengue vaccines are being developed, but none is likely to be licensed by the Food and Drug Administration in the next few years.
When outdoors in an area where dengue fever has been found:
· Use a mosquito repellent containing DEET, Picaridin, and oil of lemon eucalyptus are less effective than DEET so are not recommended as a substitute unless there is an allergy or a contraindication to DEET or it is unavailable.
· Dress in protective clothing-long-sleeved shirts, long pants, socks, and shoes
Because Aedes mosquitoes usually bite during the day, be sure to use precautions especially during early morning hours before daybreak and in the late afternoon before dark.
Other precautions include:
· Keeping unscreened windows and doors closed
· Keeping window and door screens repaired
· Carefully inspect your environment to detect and eliminate all areas with standing water where mosquitoes can breed, such as flower pots, containers, birdbaths, discarded tires, etc.
Government Link
More information can be found at the Centers for Disease Control and Prevention website:
http://www.cdc.gov/ncidod/dvbid/dengue/index.htmU.S. Consulate General Guadalajara
175 Progreso Street; Col. Americana
Guadalajara, Jalisco, Mexico
011 52 33 3268 2100
The Consulate office hours are Monday through Friday from 08:00 a.m. to 04:30 p.m.
(except from Mexican and U.S. holidays).
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