Caribbean Island Visitors Warned Of Dengue Virus Risk

The Caribbean Public Health Agency (CARPHA) issued a warning to Caribbean countries saying ‘to brace for a severe outbreak of the dengue fever’ reported the Jamaican Observer on January 18, 2019.

CARPHA is advising Caribbean countries to implement enhanced measures to reduce mosquito breeding and prevent the spread of infectious diseases. 

This advice is important since the Aedes aegypti mosquito spreads dengue, and is present in all Caribbean territories. 

According to CARPHA, the current dengue fever outbreak in Jamaica has raised the level of concern throughout the Caribbean islands. 

Previously, on January 3, 2019, Dr. Christopher Tufton, the Jamaican Ministry of Health, held an emergency press conference at its New Kingston offices, announcing 123 dengue fever cases and 2 confirmed fatalities during 2018. 

This total surpasses the epidemic case threshold of 96, reported the Red Cross. 

The last major regional outbreak of dengue occurred in the Caribbean during 2009. 

Since then, the Region has experienced 2 other infectious disease outbreaks, Chikungunya in 2014 and Zika in 2016. 

During November 2018, the Florida Department of Health confirmed the 1st locally-acquired case of the Dengue in Miami-Dade County. 

As of November 10, 2018, 43 travel-related Dengue cases have been reported in Florida. 

The measures used for controlling the spread of Dengue are the same as those for Zika and Chikungunya viruses.

The most effective way to avoid becoming ill from viruses spread by mosquitoes is to prevent mosquito bites. 

Preventing dengue infection is important since there is no specific treatment available for dengue, says the US Centers for Disease Control and Prevention (CDC).

Dengue, an acute febrile illness, is caused by infection with any of 4 related positive-sense, single-stranded RNA viruses of the genus Flavivirus, dengue viruses 1, 2, 3, or 4. 

Dengue is also known as 'break-bone fever' since it can cause debilitating disease marked by prolonged episodes of high fever and severe joint pain.   

Dengue is a flu-like illness that typically begins 4 to 10 days after infection and includes a high fever, headache, vomiting, muscle, and joint pains, and a characteristic skin rash. 

Infection can progress unpredictably to a life-threatening form of the disease called Dengue Hemorrhagic Fever, that often requires hospitalized care, says the CDC. 

With the arrival of the rainy season within a few months, mosquito control and awareness activities need to be intensified, said CARPHA. 

Research carried out by CARPHA and the Pan American Health Organization/World Health Organization (PAHO/WHO) show that drums and tires are the main mosquito breeding sources in our countries. 

“The 2 most important things to manage mosquito populations in our Caribbean countries are to manage water storage drums and tanks, and properly dispose of used vehicle tires to prevent mosquito breeding,” stated Dr. C. James Hospedales, Executive Director of CARPHA, in a web statement. 

Additionally, infants, young children, older adults and women who are pregnant or trying to get pregnant should take extra precautions to avoid mosquito bites by using insect repellents containing DEET, Picaridin, IR 3535, and Oil of Lemon Eucalyptus. 

Recently, in December 2018, the European Commission granted marketing authorization to Sanofi Pasteur for its Dengvaxia® vaccine, for use in dengue virus endemic areas in Europe, for individuals 9-45 years of age, with a documented prior dengue infection. 

Additionally, in November 2018, Takeda’s dengue vaccine candidate, TAK-003, and presented data on its most recent analysis. The TAK-003 vaccine candidate includes live attenuated strains of each of the 4 dengue serotypes. 

The CDC recommends Americans ensure they are up-to-date on routine vaccines before visiting Jamaica, and other Caribbean Islands. These vaccines include the MMR vaccine, diphtheria-tetanus-pertussis vaccine, varicella vaccine, polio vaccine, and your yearly flu shot. 

As of January 19, 2019, the CDC had not issued a Dengue Fever Travel Alert for the Caribbean Islands.   

But, the CDC’s Level 2 Travel Alert regarding Zika in the Caribbean Islands remains active.   

CARPHA is the regional public health agency for the Caribbean established in July 2011 by an inter-Governmental agreement signed by Caribbean Community member states. 

Dengue and other mosquito-borne diseases threaten health, tourism, social and economic development, and a collaborative effort is required to reduce the spread of disease, said CARPHA. 

The agency rationalizes public health arrangements in the region combining the functions of five Caribbean regional health institutes — Caribbean Food and Nutrition Institute, Caribbean Environmental Health Institute, Caribbean Epidemiology Centre, Caribbean Health Research Council, and Caribbean Regional Drug Testing Laboratory. 

For more information please visit CARPHA’s website, which provides information on what can be done to fight the threat posed by mosquitoes.