Following a recent outbreak of dengue fever in Brazil, the Centers for Disease Control predicts surges in the mosquito-borne disease in Puerto Rico and throughout the Caribbean. The last serious flare-up on St. Croix was in 2012 and before that, 2005.
“We do anticipate that the USVI will experience another dengue outbreak. Dengue outbreaks usually occur every 10 years or so, and our last one was 12 years ago. Additionally, with upticks in neighboring regions and recent heavy rainfall which provides additional breeding opportunities for mosquitoes, it’s highly likely,” Dr. Esther Ellis, epidemiologist for the V.I. Health Department, said.
Dengue fever is transmitted by the bite of the female Aedes aegypti mosquito. The territory is considered endemic for the disease, meaning an outbreak can occur at any time. Symptoms include a headache, vomiting, high fever, joint and muscle pain, pain around the eyes and a rash. Severe or hemorrhagic dengue can be fatal if left untreated.
According to the New York Times Feb. 12 article, due to the heat and wet weather in South America, the mosquito population also soared in Argentina, Paraguay and Uruguay. At the same time, there has been an upsurge in France, which normally doesn’t even report the disease, so healthcare officials are on the watch.
Ellis said the Health Department has already taken steps to avoid or minimize an outbreak. The VIDOH has increased education for providers and the ability to test more people for the disease. They are increasing surveillance and testing pools of mosquitoes for the presence of the virus.
“Mosquito control consists of many methods which also include community participation. Everyone can help control mosquitoes both inside and outside their homes,” Ellis said.
Recommendations from VIDOH advise the population to remove standing water where mosquitoes can lay eggs. Old tires, buckets, planters, toys, pools, birdbaths and trash containers should be monitored. If containers don’t have lids, use wire mesh with small holes to cover the opening. Fill tree holes and repair cracks in gaps of septic tanks.
The Health Department will continue to use larvicides and outdoor pesticides in large bodies of water to kill larvae and adult mosquitoes.
Additionally, VIDOH is educating medical providers about testing and symptoms, reporting cases and treatment.
Ellis said the department already started providing education to the schools – beginning this school year in anticipation of an outbreak. They are increasing surveillance to better track cases and focus on mosquito control.
While not considered an outbreak, in 2010 the CDC confirmed that 20 deaths in Puerto Rico were attributed to dengue and also confirmed the presence of 28 cases of hemorrhagic dengue in the Virgin Islands. Locally, the fever was confirmed in nine of 19 suspected cases on St. Thomas-St. John and four cases of dengue are suspected on St. Croix. While rumors of death due to severe dengue circulated, they were never confirmed.
In 2012, the CDC reported that a school nurse on St. Croix reported suspected dengue in 27 of 369 students and staff members. Then a study was conducted in six schools and of 320 participants screened, 40 (20 percent) and 17 percent of the staff members had been infected within the last three months.
Ten schools were tested to determine the presence of adult and immature mosquitos and all but one tested positive for carriers of the disease. The St. Croix hospital then tested 194 people and 61 were positive. The testing confirmed St. Croix was under an island-wide outbreak.
