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5 Oct 07
Dengue fever epidemic hits Caribbean, Latin America
By John Marino
Dengue, a mosquito-borne virus that causes high fever, nausea and painful body aches, is reaching epidemic levels in the Caribbean and Latin America, health officials say.
Changing weather patterns as well as increased tourism and migration have raised its prevalence, according to a Pan American Health Organization report released this week.
The disease is raging now during the wettest time of year for most countries in the region.
The virus, which has four distinct strains, usually keeps victims bed-ridden for a week with painful flu-like symptoms. About 5 percent of cases develop into the more severe and sometimes fatal hemorrhagic form marked by internal and external bleeding.
Victims can also die from dehydration if they do not receive prompt treatment, which normally includes bed rest and hydration. Severe cases can require hospitalization.
The Pan American Health Organization expects dengue cases in the hemisphere to top 1 million this year.
It has logged 630,356 cases so far this year, 11 percent more than for all of 2006. Of those, 12,147 were of the severe hemorrhagic type and 183 people died.
The U.S. Centers for Disease Control and Prevention recently issued a dengue outbreak notice that included Puerto Rico, Guadeloupe, Martinique, Mexico, Nicaragua and Brazil.
Puerto Rico's health department on Friday said it was seeing more than 500 new cases weekly and had recorded 6,175 so far this year with 4 confirmed deaths.
With no vaccine available, public health experts rely on fumigation and other campaigns to control mosquitoes.
On Friday, Health Department employees handed out educational material on street corners, urging people to eliminate potential breeding grounds for mosquitoes and seek medical attention at the first sign of the disease.
"We need the commitment and participation of all sectors of society to be able to prevent and control dengue," Puerto Rico State Epidemiologist Enid Garcia Rivera said. "Given the amount of rain these days, the dengue mosquito can reproduce at astonishing speed."
The Dominican Republic has reported more than 6,000 cases and 30 deaths this year, according to local press reports.
Mexico has reported 67,562 cases with 5,212 developing into the hemorrhagic form, according to the Pan American Health Organization.
Guadeloupe registered 899 cases. Health officials in Martinique declared a dengue epidemic last month with more than 1,300 cases reported, and Jamaica has had about 100 cases.
A report delivered at the PAHO conference this week in Washington identified unprecedented population growth in crowded urban areas, where a lack of basic services can help mosquitoes breed, as one factor behind the surge.
Travel and tourism help also spread the disease, according to the report, "Dengue Prevention and Control in the Americas." It also cited "radical, destabilizing" climate changes as a result of global warming, as well as cyclical weather patterns that have increased the intensity and duration of the region's rainy seasons.
Dr. Raul Castellano, the PAHO coordinator in Puerto Rico, said nearly every country in the region was trying to control the disease but greater efforts were needed.
"It's very difficult because it takes changing people's behavior. Fumigation in the streets won't work because we have to go inside people's houses," he said. "We have to break the chain of the mosquito."
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