DENGUE/DHF UPDATES (12): 31 MAR 2002
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[see also:
Dengue/DHF updates (01): 14 Jan 2002 20020115.3265
Dengue/DHF updates (11): 22 Mar 2002 20020322.3800
2001
----
Dengue - USA (Hawaii)      20010922.2296
Dengue - USA (Hawaii) (07) 20011130.2912
Dengue/DHF - Ecuador      20010531.1075
2000
----
Dengue virus strains - Ecuador: RFI      20000321.0399
Dengue - Ecuador (02) 20000319.0387
Dengue - Ecuador      20000317.0375
1998
---
Dengue/DHF - Cuba (14) 19980417.0706
Dengue/DHF - Cuba (12) 19980412.0672
1997
---
Dengue/DHF - Cuba (11) 19971112.2292
Dengue/DHF - Cuba (02) 19970618.1299
Dengue/DHF - Cuba: RFI      19970617.1287
1996
----
Dengue - Hawaii, USA      19960428.0816
Dengue - Hawaii, USA (2) 19960501.0838]

In this update:
[1] USA (Hawaii)
[2] Ecuador
[3] Cuba
[4] Brazil

*****
[1]
Date: Fri 22 Mar 2002
From: H.Larry Penning <hlpenning@yahoo.com>
Source: Centers for Disease Control and Prevention, Travelers' Health;
Released 2 Oct 2001; updated 4 Mar 2002 [edited]


Hawaii: Dengue Fever Update
---------------------------
As of 15 Mar 2002, Hawaii state health officials reported one additional 
recent case of dengue fever and 6 cases that occurred last year but were 
not confirmed by laboratory testing until 2002. The single recent case 
occurred in February 2002 in Haiku, Maui, and 5 of the cases from last 
year occurred among residents of Hana, Maui. The other case from last 
year occurred in early December [2001] in a visitor from New Mexico 
who stayed in a private residence in a forested area of Hana. 

A total of 118 cases of dengue fever have been reported since 10 Jun 
2001. Of these, 77 occurred in the Hana area. Overall, the severity of 
illness has been relatively mild and the outbreak appears to be waning.

Available data suggest that the risk of dengue infection to most visitors 
to Hawaii is very low. Nevertheless, returning travelers who develop 
any dengue-like illness are encouraged to inform their Health 
Departments and health care provider of a potential exposure to this 
illness.

--
H.Larry Penning
<hlpenning@yahoo.com>

******
[2]
Date: Tue 26 Mar 2002
From: Jaime R. Torres, ProMED-ESP
Source: El Comercio (Ecuador), Tue 26 Mar 2002 [edited]
<http://www.elcomercio.com/noticias.asp?noid=18852>


Ecuador: Dengue/DHF and Malaria Epidemics Unleashed in Coastal
Provinces
----------------------------------------------------------------------
According to a spokesperson from the State Tropical Medicine 
Secretariat in Guayaquil, the intense rainstorms that have hit the coastal 
provinces of Ecuador beginning Feb 2002 have unleashed epidemics of 
dengue/DHF and malaria. 

The spokesperson reported that, to date, there are 816 cases of 
suspected dengue fever, 23 of which have been confirmed [including 2 
cases of dengue hemorrhagic fever (DHF)]. [The Ministry of Health] 
indicated that an additional 21 cases of suspected DHF are being 
investigated. [The vector mosquitoes] have increased because of the 
intense rainstorms that have affected the coastal provinces of Guayas, 
Manabi, El Oro, Los Rios, and Esmeraldas during the past weeks.

The Tropical Medicine Secretariat revealed that cases of Asiatic 
[serotype 2] and serotype 3 dengue virus infection have been 
identified, and that they probably reached Ecuador through Venezuela 
and Central America. The spokesperson remarked that in 2001, 4 
persons died of type 2 dengue virus infection in this region. The 
severity of the winter season has forced the government to declare a 
state of public health and economic emergency in the coastal states as 
well as in 2 Andean states also affected by torrential rains.

Patricio Hernandez, Deputy Director of the Infectious Diseases Hospital 
in Guayaquil, noted that the case curve for both malaria and dengue 
fever would show a doubling during the second trimester of this year. 
He further explained that climatologic changes and a decrease in 
rainfall starting in April [2002] would facilitate the propagation of 
disease-transmitting vectors in stagnant water in large and small spaces. 
[It is estimated that] in Guayaquil alone there are 1.5 million water 
storage tanks, of which 70 per cent are potential breeding sites for 
[mosquitoes]. However, people do not give adequate care to water 
storage facilities. Tanks are not adequately covered and are left either 
open or covered with wood wrapped in plastic.

-- 
ProMED-ESP
<promed-esp@promedmail.org>

[The Ecuadorian authorities are to be commended for their continuing 
practice of recording the types of dengue virus in circulation in dengue 
fever outbreaks in Ecuador. Similar information from elsewhere would 
enhance the value of these dengue fever outbreak updates. - Mod.CP]

******
[3]
Date: Thu 28 Mar 2002 
From: ProMED-mail <promed@promedmail.org>
Source: Associated Press report, Thu 28 Mar 2002 [edited]


Cuba: Dengue Virus Declared Eradicated
--------------------------------------
President Fidel Castro declared victory in his government's military-
style campaign against dengue fever during a ceremony honoring those 
whose efforts helped wipe out the mosquito that spreads the virus. 
"The dengue virus has been eradicated in our homeland," Castro said 
late on Wed 27 Mar 2002 after handing out diplomas to representatives 
of groups recruited for the campaign. "Today is a day of satisfaction 
for all residents of the capital and the entire country."

Cuba had earlier reported 2 deaths among dengue cases in Havana in 
recent months. Castro on Wed 27 Mar 2002 confirmed that was the 
final fatal toll.

The Cuban leader on 12 Jan 2002 launched a highly organized and 
widespread education and fumigation campaign aimed at wiping out 
the mosquito that [transmits the virus.] ... During the campaign in 
Cuba, homes and other buildings, especially in the hard-hit capital of 
Havana, were repeatedly sprayed over a period of more than 3 months, 
sometimes several times a week. Cuba's government-controlled 
newspapers printed educational articles about clean-up efforts, 
alongside a logo of a mosquito in a circle with an "X" through it. 
Because the virus was seen here as a matter of national security, 
cooperation in the campaign was obligatory. Residents who refused to 
let their homes be fumigated were sometimes fined.

Cuba suffered a serious dengue epidemic in 1971 that made more than 
400 000 people sick. During another dengue epidemic 10 years later, 
Cuba reported 350 000 cases.
[Byline: Anita Snow]

--
ProMED-mail
<promed@promedmail.org>

[Cuba's dengue epidemics have occurred at irregular intervals: 1971 
(type 1), 1981 (type 2), 1997 (type 2) & 2002 (type 3).  If the country 
has the misfortune to import type 4, & is unable to maintain control of  
_Aedes aegypti_, which is continually arriving on its shores in small 
boats, imported tires and other cargo, they will suffer again. - Mod.JW]

****
[4]
Date:  Sun 31 Mar  2002 11:49 AM EST
From:  ProMED-mail <promed@promedmail.org>
Source:  Agencia EFE 31 Mar 2002 [edited]


Dengue cases double those of first quarter last year
---------------------------------------------------
Dengue cases reported in Brazil in the first quarter of the year [2002] 
were more than twice the number of those in the same period last year, 
the local press reported Sunday.

Between January and March this year [2002], 317 787 cases of dengue 
were reported in Brazil, compared to 153 148 in the same period last 
year, according to a report published Sunday by the daily Folha de Sao 
Paulo, based on health department data from each of the states in the
country.

The newspaper says that if the disease spreads at last year's rate, [it 
could break]  the 1998 record, when 559 237 cases were confirmed.

Hemorrhagic dengue has killed 59 people around the country in the 
first quarter of the year, more than doubling the 28 deaths last year, and 
could exceed the 75 deaths reported between 1990 and 2001, according 
to Health Ministry data.

The hardest-hit state is Rio de Janeiro, with 129 920 cases, accounting 
for 41%  of the national total and more than quadrupling the number 
reported in the first quarter last year [2001].

There were 1373 cases of hemorrhagic dengue reported between 
January and March [2002], of which 1271 (53%) were in Rio de 
Janeiro. Rio has the highest number of deaths from hemorrhagic 
dengue, with 47 cases.

The campaign against dengue has mobilized various sectors of 
Brazilian society, including the army, whose members in some states go 
house-to-house to eliminate breeding [sites] of _Aedes aegypti_, the 
mosquito that carries the disease.

--
ProMED-mail 
<promed@promedmail.org>
...............cp/mpp/pg/jw

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