, , , , , , , , , , ,

From VOA News:
Dengue Fever Spreading Rapidly Across Central America
By VOA News September 27, 2019 08:46 AM
Dengue fever is spreading rapidly across Central America, the International Federation of Red Cross and Red Crescent Societies said Friday.   

The size of this outbreak is unprecedented across Central America,” said Dr. Maria Frana Tallarico, head of health of IFRC’s regional office for the Americas.

Guatemala, Nicaragua, El Salvador and Costa Rica are reporting “massive increases in dengue cases compared to previous years,” the IFRC said.

More than 71,200 people in Honduras have been affected by the mosquito-borne viral disease.

Seasonal rains and high temperatures have created stagnant pools that are “perfect breeding grounds for mosquitoes,” according to IFRC.
What is alarming about the disease in Honduras, however, is that 65 percent of the 128 deaths thus far are children under 15 years-old.

“This is due to a lack of immunity in young people to to the deadliest of the four strains of dengue currently circulating in the region,” says Tallarico.

IFRC says it is “scaling up” emergency assistance to help countries contain the disease, including teams of IFRC volunteers who are going door-to-door to raise awareness about the disease and how to prevent its spread“. https://www.voanews.com/americas/dengue-fever-spreading-rapidly-across-central-america

Outbreaks in many countries and more information: https://www.cdc.gov/dengue/index.html

Dengue is already in the USA. Most is from travel but several cases in Florida were locally transmitted, and possibly one in DC:

See state level details here: https://www.cdc.gov/dengue/statistics-maps/index.html

An estimated 40%–80% of infections are asymptomatic. Symptomatic infection (dengue) most commonly presents as a mild to moderate, nonspecific, acute febrile illness. However, as many as 5% of all dengue patients develop severe, life-threatening disease. Early clinical findings are nonspecific but require a high index of suspicion, because recognizing early signs of shock and promptly initiating intensive supportive therapy can reduce risk of death among patients with severe dengue by at least 20-fold to <0.5%. See Box 4-02 for information regarding the World Health Organization guidelines for classifying dengue.

Dengue begins abruptly after an incubation period of 5–7 days (range, 3–10 days), and the course follows 3 phases: febrile, critical, and convalescent. Fever typically lasts 2–7 days and can be biphasic. Other signs and symptoms may include severe headache; retroorbital pain; muscle, joint, and bone pain; macular or maculopapular rash; and minor hemorrhagic manifestations, including petechiae, ecchymosis, purpura, epistaxis, bleeding gums, hematuria, or a positive tourniquet test result. Some patients have an injected oropharynx and facial erythema in the first 24–48 hours after onset. Warning signs of progression to severe dengue occur in the late febrile phase around the time of defervescence and include persistent vomiting, severe abdominal pain, fluid accumulation, mucosal bleeding, difficulty breathing, lethargy/restlessness, postural hypotension, liver enlargement, and progressive increase in hematocrit (hemoconcentration).

The critical phase of dengue begins at defervescence and typically lasts 24–48 hours. Most patients clinically improve during this phase, but those with substantial plasma leakage develop severe dengue as a result of a marked increase in vascular permeability. Initially, physiologic compensatory mechanisms maintain adequate circulation, which narrows pulse pressure as diastolic blood pressure increases. Patients with severe plasma leakage have pleural effusions or ascites, hypoproteinemia, and hemoconcentration. Patients may appear well despite early signs of shock. However, once hypotension develops, systolic blood pressure rapidly declines, and irreversible shock and death may ensue despite resuscitation efforts. Patients can also develop severe hemorrhagic manifestations, including hematemesis, bloody stool, melena, or menorrhagia, especially if they have prolonged shock. Uncommon manifestations include hepatitis, myocarditis, pancreatitis, and encephalitis…” Read much more here: