Dengue virus infection is an extremely common mosquito borne infection in the world. Neurologic complications are increasingly being reported in dengue cases affecting both the central and peripheral nervous system. This session is aimed to discuss the incidence and clinical spectrum of neurologic complications of dengue, methods of their diagnosis, management and outcome in patients with dengue virus infection. Methodology & Theoretical Orientation: An extensive review of the published literature was carried out using PubMed, Scopus and Google Scholar databases. The keywords used were: “Dengue AND Neurological”, “Dengue AND Neuropathy”, ”Dengue AND Plexopathy”, “Dengue AND Acute Encephalitis Syndrome”, “Dengue AND Encephalopathy”.
Diagnosis of dengue virus infection may be made by a combination of dengue NS1Ag/Real Time PCR and anti-IgM antibody in CSF. In serum samples, dengue infection may be confirmed by PCR/culture positivity, IgM detection or by four fold rise in titers of specific IgG antibodies in paired serum samples. Conclusion & Significance: In endemic regions, dengue should be considered as a differential diagnosis of neurological disorders. Early recognition of these complications is required for proper management of cases and for preventing further disabilities.
King George’s Medical University, India
Amita Jain is a multifaceted Medical Teacher who has contributed immensely in the Field of Microbiology. She has worked in many areas of Medical Microbiology including Tuberculosis, Bacteriology and Virology. She is a keen Researcher and has successfully completed many research and public health projects and published several papers, some of which are highly cited. She has guided 24 PhD students and provided guidance to many Under-graduate and Post-graduate students. She has established new diagnostic and research facilities, which are of immense help to medical students, researchers and patients. She has investigated several epidemics of swine flu, dengue, acute encephalitis, hepatitis, drug resistant TB, etc. She has provided diagnostic services to Uttar Pradesh State Health Services in the field of Virology and Tuberculosis. She has organized trainings for laboratorians and community awareness health programs.
ScientificTracks Abstracts: Virol-mycol
There’s been a huge uptick in dengue research since climate change began to double the disease’s range and it started afflicting people in rich countries. Here’s a great database, from Harvard University, that will let you do your own research:
Harvard Dataverse: Replication Data for: Advances in using Internet searches to track dengue. This dataset contains all the data to replicate the analysis performed in the manuscript entitled: “Advances in using Internet searches to track dengue” to be published in the journal PLoS Computational Biology in 2017. Specifically, it contains data for five countries/states: Mexico, Brazil, Thailand, Singapore and Taiwan. For each country/state, the data include: (1) Google Trends data, (2) Google Dengue Trends data, (3) official dengue case counts published by the government.
And here’s a fascinating development in the antigenic properties of the four dengue virus types:
“An international consortium of laboratories worldwide that are studying the differences among dengue viruses has shown that while the long-held view that there are four genetically-distinct types of the virus holds, far more important are the differences in their antigenic properties – the ‘coats’ that the viruses wear that help our immune systems identify them.
Dengue virus infects up to 390 million people each year. Around a quarter of these people will experience fever, headaches and joint pains, but approximately 500,000 people will experience potentially life-threatening complications, including haemorrhage and shock, where dangerously low blood pressure occurs. There are currently no vaccines against infection with dengue virus.
For decades, scientists have thought that there are four genetically-distinct types of the virus, known as serotypes, and that antigenic differences between the types play a key role in the severity of disease, its epidemiology and how the virus evolves – and hence these differences would be important in vaccine design.
When we become infected, our immune system sends out antibodies to try and identify the nature of the infection. If it is a pathogen – a virus or bacteria – that we have previously encountered, the antibodies will recognise the invader by antigens on its surface and set of a cascade of defences to prevent the infection taking hold. However, as pathogens evolve, they can change their antigens and disguise themselves against detection.
One of the unusual aspects of dengue is that in some cases when an individual becomes infected for a second time, rather than being immune to infection, the disease can be much more severe. One hypothesis to explain this is that the antibodies produced in response to infection with one strain of the virus somehow allow viruses of a different strain to enter undetected into cells, implying that antigenic differences between the serotypes are important.
Researchers from the Dengue Antigenic Cartography Consortium, writing in today’s edition of Science, analysed 47 strains of dengue virus with 148 samples taken from both humans and primates to see whether they indeed fit into four distinct types. The researchers found a significant amount of antigenic difference within each dengue serotype – in fact, the amount of difference within each serotype was of a similar order to that between the different types. This implies that an individual infected with one type may not be protected against antigenically different viruses of the same type, and that in some cases the individual may be protected against some antigenically similar strains of a different type.
Leah Katzelnick, a researcher from the Department of Zoology at the University of Cambridge, who began studying dengue after herself contracting the disease, says: “We were surprised at how much variation we saw…” Read more..
And here’s a useful discovery from a team at the University of Texas:
How dengue virus adapts as it travels
GALVESTON, Texas, July 6, 2015 – A researcher from The University of Texas Medical Branch at Galveston is an integral member of a collaborative group that is the first to explain the mechanisms that the Dengue virus has developed to optimize its ability to cause outbreaks as it travels across the globe to new places and revisits old ones. An early online version of this paper detailing the findings has recently been published in Science.
Dengue virus has been spreading throughout warm regions of the world, prompting the virus to adapt to new environments. This diversification in viral strains has resulted in the development of strains that appear associated with greater potential for sparking epidemics. Several dengue outbreaks have occurred when new dengue strains emerged and displaced the native strains that the local population had already developed immunity against. Until now, the mechanisms governing how and why some viral strains are better suited for causing widespread disease has been poorly understood.
The investigators examined the different clades of dengue virus-2 known to be circulating around Puerto Rico in 1994 when a severe epidemic broke out. Investigating the differences between the virus strain that was most commonly seen from 1986 to 1995 and a new, more potent viral strain that was first isolated in 1994 was the key to figuring out why this outbreak occurred.
They identified an interaction between the newcomer virus’s RNA and proteins within the host that allows the virus to bypass the host’s immune response, making it easier for the virus to invade. Based on the findings, the research team devised a model to explain the 1994 dengue outbreak in Puerto Rico.
“This study highlights the critical and oft forgotten role played by non-coding RNAs in the battle between viruses and their human hosts,” said author Mariano Garcia-Blanco, UTMB professor and chair of the department of biochemistry and molecular biology and also professor of emerging infectious diseases at the Duke-NUS Graduate Medical School in Singapore. “It emphasizes the importance of multidisciplinary research: a fabulous marriage of basic RNA biology and clinically informed epidemiology uncovered an unexpected route of virus evolution that explained (and perhaps could predict) epidemic potential.”
Other authors of this paper include Gayathri Manokaran, Esteban Finol, Jayantha Gunaratne, Eugenia Z. Ong, Hwee Cheng Tan, October M. Sessions, Alex M. Ward, Duane J. Gubler and corresponding author Eng Eong Ooi from the Duke-NUS Graduate Medical School; Chunling Wang, and Eva Harris from the University of California, Berkeley and Justin Bahl from the University of Texas School of Public Health, Houston.
This research was supported by the Singapore National Medical Research Council, the Ministry of Health in Singapore, Institute of Molecular and Cell Biology, Agency of Science, Technology and Research in Singapore and the U.S. National Institutes of Health.
Dengue Shock Syndrome is a collection of symptoms resulting from a dengue infection. Its symptoms – including hemorrhaging – resemble those you’d see after an accident, when someone is ‘in shock’. Typically, older children or adults suffer 2–7 days of high fever and show two or more of the following symptoms:
retro-orbital eye pain,
a diffuse erythematous maculo-papular rash, and
mild hemorrhagic manifestation.
Subtle, minor epithelial hemorrhage, in the form of petechiae, are often found on the lower extremities (but may occur on buccal mucosa, hard and soft palates and or subconjunctivae as well), easy bruising on the skin, or the patient may have a positive tourniquet test.
Other forms of hemorrhage such as epistaxis, gingival bleeding, gastrointestinal bleeding, or urogenital bleeding can also occur, but are rare.
Leukopenia is frequently found and may be accompanied by varying degrees of thrombocytopenia.
Children may also present with nausea and vomiting.
Patients with DF do not develop substantial plasma leak (hallmark of DHF and DSS, see below) or extensive clinical hemorrhage.
Serological testing for anti-dengue IgM antibodies or molecular testing for dengue viral RNA or viral isolation can confirm the diagnosis, but these tests often provide only retrospective confirmation, as lab results are typically not available until well after the patient has recovered.
Clinical presentation of DF and the early phase of DHF are similar, and therefore it can be difficult to differentiate between the two forms early in the course of illness. With close monitoring of key indicators, the development of DHF can be detected at the time of defervescence so that early and appropriate therapy can be initiated.
Dengue Hemorrhagic Fever (DHF) or Dengue Shock Syndrome (DSS): The third clinical presentation results in the development of DHF, which in some patients progresses to DSS. Vigilant is critical for identifying warning signs of progressing illness and early symptoms of DHF which are very similar to those of DF. Case Definitions Page
There are three phases of DHF:
the Febrile Phase;
the Critical (Plasma Leak) Phase; and
the Convalescent (Reabsorption) Phase.
The Febrile Phase: Early in the course of illness, patients with DHF can present much like DF, but they may also have hepatomegaly without jaundice (later in the Febrile Phase). The hemorrhagic manifestations that occur in the early course of DHF most frequently consist of mild hemorrhagic manifestations as in DF. Less commonly, epistaxis, bleeding of the gums, or frank gastrointestinal bleeding occur while the patient is still febrile (gastrointestinal bleeding may commence at this point, but commonly does not become apparent until a melenic stool is passed much later in the course). Dengue viremia is typically highest in the first three to four days after onset of fever but then falls quickly to undetectable levels over the next few days. The level of viremia and fever usually follow each other closely, and anti-dengue IgM anti-bodies increase as fever abates.
The Critical (Plasma Leak) Phase: About the time when the fever abates, the patient enters a period of highest risk for developing the severe manifestations of plasma leak and hemorrhage. At this time, it is vital to watch for evidence of hemorrhage and plasma leak into the pleural and abdominal cavities and to implement appropriate therapies replacing intravascular losses and stabilizing effective volume. If left untreated, this can lead to intravascular volume depletion and cardiovascular compromise. Evidence of plasma leak includes sudden increase in hematocrit (≥20% increase from baseline), presence of ascites, a new pleural effusion on lateral decubitus chest x-ray, or low serum albumin or protein for age and sex. Patients with plasma leak should be monitored for early changes in hemodynamic parameters consistent with compensated shock such as increased heart rate (tachycardia) for age especially in the absence of fever, weak and thready pulse, cool extremities, narrowing pulse pressure (systolic blood pressure minus diastolic blood pressure <20 mmHg), delayed capillary refill (>2 seconds), and decrease in urination (i.e., oliguria). Patients exhibiting signs of increasing intravascular depletion, impending or frank shock, or severe hemorrhage should be admitted to an appropriate level intensive care unit for monitoring and intravascular volume replacement. Once a patient experiences frank shock he or she will be categorized as having DSS. Prolonged shock is the main factor associated with complications that can lead to death including massive gastrointestinal hemorrhage. Interestingly, many patients with DHF/DSS remain alert and lucid throughout the course of the illness, even at the tipping point of profound shock. CDC:
India’s botanical Dengue drug is getting world wide attention. At last! India, the home of ayurvedic medicine, has begun work to develop, test and market a botanical drug to treat of dengue, with drug major Sun Pharma announcing its collaborative effort with the International Centre for Genetic Engineering and Biotechnology (ICGEB).
The move follows a March announcement of success in the drug’s initial development stage through a joint project between the ICGEB, the Department of Biotechnology (DBT).
Sun Pharma will fund entire development programme of Cissampelos pariera (Cipa), the botanical drug to treat all strains of dengue. While the pharma giant will pay royalty following commercialisation of the drug, the ICGEB will provide the technical know-how and pre-clinical expertise.
“Using the knowledge of traditional Indian medicine, we explored the indigenous herbal bio-resource to identify plants with pan-DENV inhibitory activity and identified CIPA as a safe, affordable and effective solution,” said Dr Dinakar M Salunke, director, ICGEB, New Delhi.
Given the densely-populated cities and the high prevalence of the mosquito that spreads dengue — aedes aegypti — India is home to close to 50% of the global population estimated to be at risk of dengue. Severe dengue, which can potentially kill, correlates with very high-virus load, reduction in platelet counts and haemorrhage.
The new drug is expected to reduce high-virus load and make the disease milder, leading to fewer hospitalisations. The collaboration aims to explore how the extract prepared from Cipa Linn can inhibit the replication of virus in living cells against dengue infection.
The terms of this agreement permits Sun Pharma’s access to all the intellectual properties of this drug cross 17 countries.
“In tropical countries like India, where dengue outbreaks are significantly intense, a drug for dengue is an unmet public health need. Our partnership with ICGEB aims to develop Cipa as a safe, effective & affordable botanical drug for treatment of dengue,” said Kirti Ganorkar, senior V-P, business development and portfolio management, Sun Pharma, the world’s fifth largest generic pharmaceutical company.
The ICGEB will establish assay systems for development of Cipa for treatment of dengue infection for a pre-defined period of time. The ICGEB will work exclusively with Sun Pharma for the development of this drug, and clinical treatment strategies based on botanical and phyto-pharmaceuticals. Sun Pharma will pay royalties on sales post commercialisation. Other financial details of this agreement are confidential.
Dengue is estimated to costs India over $1.1 billion (about Rs 7,260 crore) annually, with the cost of medical care being nearly $550 million and the indirect cost, in terms of lost wages, being another $550 million. Read more..
Are Dengue, Zika and GM Mosquitoes Connected by a larvicide?
Could it be that Dengue, Zika and Larvicides are connected? Dengue, and outbreak of Zica, and GM mosquitoes are being discussed in the same breath. The Zica disease is similar to dengue, and the two have long cohabited, but Zica has never afflicted as many people as seriously as it is doing in Brazil. The fact that the range for zica’s vectors overlaps the aedes aegypti range – and that there’s a GM mosquito test going on within that vast territory – suggest that the presence of the GM mosquitos and the outbreak of zica are probably coincidental. Especially since the date of release of the GM insects is given as 2015 – hardly sufficient time to breed and spread zica so far.
There’s always a chance that an Oxitec mosquito is to blame, but here’s a persuasive article suggesting that a chemical is to blame and Zica is not the culprit:
Argentine and Brazilian doctors name larvicide as potential cause of microcephaly:
A report from the Argentine doctors’ organisation, Physicians in the Crop-Sprayed Towns, challenges the theory that the Zika virus epidemic in Brazil is the cause of the increase in the birth defect microcephaly among newborns. The increase in this birth defect, in which the baby is born with an abnormally small head and often has brain damage, was quickly linked to the Zika virus by the Brazilian Ministry of Health.
However, according to the Physicians in the Crop-Sprayed Towns, the Ministry failed to recognise that in the area where most sick people live, a chemical larvicide that produces malformations in mosquitoes was introduced into the drinking water supply in 2014. This poison, Pyriproxyfen, is used in a State-controlled programme aimed at eradicating disease-carrying mosquitoes. The Physicians added that the Pyriproxyfen is manufactured by Sumitomo Chemical, a Japanese “strategic partner” of Monsanto.
Pyriproxyfen is a growth inhibitor of mosquito larvae, which alters the development process from larva to pupa to adult, thus generating malformations in developing mosquitoes and killing or disabling them. It acts as an insect juvenile hormone or juvenoid, and has the effect of inhibiting the development of adult insect characteristics (for example, wings and mature external genitalia) and reproductive development. It is an endocrine disruptor and is teratogenic (causes birth defects), according to the Physicians.The Physicians commented: “Malformations detected in thousands of children from pregnant women living in areas where the Brazilian state added Pyriproxyfen to drinking water are not a coincidence, even though the Ministry of Health places a direct blame on the Zika virus for this damage.” Read more here….
Fighting Zika – Not The Virus Itself – Might Have Caused Birth Defects
June 26, 2016
The media said that the mosquito borne Zika virus is likely causing microcephaly as well as dozens of other illnesses. They also claimed that insecticides were not related to the development disorder. They seem to have been wrong on both cases.
Since December 2015 U.S. media ran a panic campaign round the Zika virus. That virus was said to cause many bad things including microcephaly, a development distortion of the head of unborn babies, if the mother was infected with Zika during pregnancy.
The virus is long known, harmless and the main current scare, that the virus damages unborn children, is based on uncorroborated and likely false information.
There is absolutely no sane reason for the scary headlines and the panic they cause.The virus is harmless. It is possible, but seems for now very unlikely, that it affects some unborn children. There is absolutely no reason to be concerned about it.
As this is all well known or easy to find out why do the media create this sensation?
[E]ven while Zika is known to be less harmful than an average flue, one headline after the other tries to create the impression that it is some really awful, new bug that may be responsible for about any ailment. That it may spread like wildfire and may have other terrible consequences. May, as in ‘the sky may fall’, is indeed the most operative word here.
There followed a collection of 35 recent “Zika may cause …” headlines.
Meanwhile doctors in the Zika affected areas in Brazil pointed out that the real cause of somewhat increased microcephaly in the region was probably the insecticide pyriproxyfen, used to kill mosquito larvae in drinking water:
The Brazilian doctors noted that the areas of northeast Brazil that had witnessed the greatest number of microcephaly cases match with areas where pyriproxyfen is added to drinking water in an effort to combat Zika-carrying mosquitoes. Pyriproxyfen is reported to cause malformations in mosquito larvae, and has been added to drinking water in the region for the past 18 months.
Pyriproxyfen is produced by a Sumitomo Chemical – an important Japanese poison giant. It was therefore unsurprising that the New York Times and otherscalled the doctors report a “conspiracy theory” and trotted out some “experts” to debunk it.
But facts are facts and as these come to the fore the embarrassed media will now likely stay silent.
In Brazil, the microcephaly rate soared with more than 1,500 confirmed cases. But in Colombia, a recent study of nearly 12,000 pregnant women infected with Zika found zero microcephaly cases. If Zika is to blame for microcephaly, where are the missing cases? Perhaps there is another reason for the epidemic in Brazil.
Well, maybe those doctors on the ground in Brazil knew what they were talking about. The scientist at the New England Complex Systems Institute also researched the pyriproxyfen thesis. They found.. Read more..
Genetically modified mosquitoes that would help fight the Zika virus are getting urgent attention from U.S. regulators as global health officials raise alarms about the pathogen’s spread. The U.S. Food and Drug Administration is in the final stages of reviewing an application from Intrexon Corp.’s Oxitec unit to conduct a field trial in the Florida Keys, Oxitec Chief Executive Officer Hadyn Parry said in a phone interview. Parry wasn’t able to provide further details on the timing of an FDA decision. Oxitec genetically modifies the males in a breed of mosquito known as Aedes aegypti — responsible for transmitting Zika, Dengue, Chikungunya and Yellow Fever — so that their offspring die young. The Zika virus has been spreading “explosively” in South and Central America, the World Health Organization said Thursday. Developing a vaccine could take years, drugmakers and health experts have cautioned.
Here’s the background: Oxitec, an American-owned British company, has been working to develop a genetically modified mosquito in hopes of controlling dengue outbreaks on a broad scale. They breed and release millions of modified insects in populated areas where dengue is endemic. The story below,
In 2015 Oxitec proudly announced that the mosquitos they’d genetically modified – which they call ‘friendly Aedes aegypti’ – had decimated the local mosquito population in a field trial in Juazeiro, Brazil by 95%. New dengue cases were way below the modelled threshold for epidemic disease transmission.
Here’s a map showing where the deformed babies are being born:
Zika was first confirmed in Brazil in May, 2015, but had been seen in other nations before. But Zika in Brazil does not seem to behave like the Zika they were familiar with.
Why didn’t zika cause an epidemic of birth defects in any other country?
How would you miss a tenfold increase in children born with most of their brain missing?
Could the Zika epidemic be linked to genetically modified mosquitoes?
Oxitec released a strain of male mosquitoes in Juazeiro which create larvae that normally die in the absence of antibiotics. This is supposed to help decimate wild mosquito populations when these males are released in the wild. But Oxitec estimates 3-4% of the larvae survive to adulthood in the absence of the tetracycline antibiotic. These larvae should then be free to go on and reproduce and pass on their genes. In fact, they may be the only ones that are passing on their genes in places that have their wild mosquito population decimated by these experiments. Here are some questions whose answers we’ll post as they come in:
What is the effect on these mosquitoes that grow up with a mutilated genome?
Will the genetic modification introduce a fitness cost?
Should they have greater difficulty surviving?
What do we know about Oxitec’s mosquitoes?
Has sufficient research been done on how a genetically mutilated mosquito copes with viral infections?
Could Oxitec’s mosquito be more susceptible to certain pathogens?
Dengue in the USA is here to stay. With the Department of Health of Hawaii confirming two locally-acquired dengue fever cases in the state, two video bloggers have decided to share their own struggles dealing with the tropical disease to help raise public awareness.
Hawaii State health officials are investigating a dengue fever cluster. Thirty-three people on Hawaii’s Big Island have become sick with dengue since September – the first locally transmitted outbreak of the viral illness on the Big Island and the first outbreak in the state since five people were infected on Oahu in 2011. Twenty-five of those infected in this current outbreak are residents of the Big Island, while eight are visitors. Four children are among those who have become ill. All patients have recovered or are recovering.
Allie Wesenberg and Charles Trippy feature prominently on an ongoing web series known as “Internet Killed Television” on the YouTube channel CTFxC.
For the past seven years, the channel, which caters to more than 1.5 million subscribers, has been uploading adventure clips of the duo taken in different parts of the world.
On one of their recent trips dated on Oct.13, Wesenberg and Trippy visited several popular spots in Hawaii, including South Kona’s Honaunau, the Volcanoes National Park and South Point.
However, by the time they got back from their Big Island trip, Wesenberg suddenly fell ill and was taken to the hospital on Oct. 22. Yep, dengue in the USA is a reality. Now watch the video:
The southern Chinese city of Guangzhou has introduced a fish that eats mosquito larvae, in an effort to control its worst-ever dengue fever outbreak, state news media have reported.
Some scientists have warned that use of the nonnative mosquito fish could have unexpected consequences, while others say that mosquito fish are already found in Guangdong waters and the environmental impact might not be significant, but that the effectiveness of the fish may also be limited. As of Monday, the number of dengue cases in Guangdong Province this year had reached 41,155, the local health authorities reported, with six deaths. The province has seen 200 to 300 new cases a day in recent days. That is lower than the more than 400 per day last week and the more than 1,000 per day the week before that, offering some hope that the outbreak is beginning to ease…. Read more.
Natural Dengue Strategies
Here are some natural tricks that discourage aedes aegypti mosquitoes:
Eat raw garlic, cook with onion and bell pepper, and take vitamin B. All these foods help produce a body odor that mosquitoes find unattractive.
Grow mint, roses, tuberose (Polianthes tuberosa), orchid tree (Aglaia odorata var. microphylla), and marigold. All repel mosquitoes to some degree.
Burn the leaves of the lemon-scented gum eucalyptus (Eucalyptus citriodora Hook) for household protection.
Use outdoor LED lights on your porch and around your house. They don’t attract pests like other lights.
Burn citronella candles outside.
Natural (Mostly) Insecticides & Repellents
If natural options are not available to everyone mosquito sprays can be a good alternative. Some of the least toxic sprays:
Oil of Lemon Eucalyptus has been used for many years in China as a mosquito repellent.
Essential Oils – Some essential oils used in repellents include Cedarwood, Soybean Oil (www.biteblocker.com), and Geraniol (MosquitoGuard- www.wildroots.com, Bite Stop- www.bitestop.com, Bugband- www.bugband.net).
Picaridin – a synthetic dervived from pepper. The CDC says its protection is comparable to DEET at similar concentrations (Cutter Advanced).
Citronella – The active ingredient in those candles. It’s in some natural spray blends like Insect Shield (Bug Off) Synergy: an undiluted, therapeutic grade blend of the essential oils of Citronella, Eucalyptus, Cedarwood, Lemongrass, Lavender, Litsea, Tea Tree, Patchouli & Catnip.
Vanillin – Adding vanillin 5% to plant-based repellents and to DEET repellents increased their protection by about 2 hours. [Read this]
Some Commercial Products
All these repellents have different durations of effectiveness so be sure to reapply them following the directions on the label to repel mosquitoes most effectively.
Sales Pitch: Cutter lemon eucalyptus pump spray is an effective, naturally plant to based repellent that repels mosquitoes for up to 6 hours. Contains oil of lemon eucalyptus to the only plant to based ingredient recommended by the centers for disease control and prevention (CDC). Average Score: 4.2/5
Sales Pitch: Bite Blocker’s proven effective Insect Repellent now in a highly effective waterproof formulation though enough for extreme environments and safe for the entire family. This Xtreme botanical formula provides protection form bites for up to 8 hours against mosquitoes, blackflies and more than 2 hours for ticks. Average Score: 4.1/5.0
The number of dengue fever cases in Taiwan in the past four months has jumped to more than 4,000, recording the worst summer outbreak in the country since it started keeping systematic track of the disease in 2003, the Centers for Disease Control (CDC) said Thursday. As of Wednesday, the total number of dengue cases reported around the country since May 1 had reached 4,343, compared with 3,704 in the same period of last year, the CDC said. “The situation might ease up after September if we could effectively get things under control,” said CDC Deputy director-general Chuang Jen-hsiang. More…
Though much of the world is focused on the Ebola virus, pockets of Asia are struggling with record outbreaks of a mosquito-borne infectious disease called dengue fever, which has no specific drug treatment. Read more…
Dengue deaths nearly triple in Malaysia
KUALA LUMPUR – Prime Minister Najib Razak on Tuesday urged people to take precautions against dengue fever, which has caused 44 deaths in the first five weeks of the year in Malaysia. “Dengue is now a growing concern in several areas around Malaysia,” he said. “I hope you will take precautions as well and immediately seek medical help if you experience symptoms of dengue.” Najib said the government was intensifying its efforts to deal with the mosquito-borne disease, including sanitation awareness campaigns and taking actions against contractors who neglect to clean up their work sites. Health Ministry director general Noor Hisham bin Abdullah said 44 people died from dengue from Jan 1 to Feb 7, compared with 17 deaths during the same period last year. A total of 15,039 cases of dengue fever were reported nationwide during the first five weeks of 2015, compared with the 9,453 last year. More…
MANILA, Philippines – With almost half of the world’s population now at risk of dengue, the World Health Organization (WHO) is pushing for “cross-border” collaboration to stop the spread of the mosquito-borne disease.
The WHO said collaboration to build regional capacity is the key to avert the impact of the dengue outbreak that has affected more than 100 countries worldwide. “Through such cross-border collaboration and sharing of dengue information, timely sensing of the dengue situation can improve preparedness within each country in the event of an outbreak,” the WHO said. The agency said the incidence of dengue has been increasing dramatically in the last few decades, with an estimated 50-100 million dengue infections occurring worldwide each year.
Before 1970, only nine countries had experienced severe dengue epidemics, but today the disease is endemic in more than 100 countries. “Not only is the number of cases increasing as the disease spreads to new areas, but frequent explosive outbreaks are occurring,” the WHO said.
It said the Western Pacific, home to a quarter of the world’s population, bears the heavy socio-economic burden due to dengue. In 2013, member-states of the Western Pacific region reported 428,635 cases and 964 deaths from the disease. The Philippines recorded over 204,906 cases and 660 deaths last year. The WHO recently held the 10-day Fourth Asia-Pacific Dengue Workshop to discuss measures to lessen the dengue epidemic.
It said there is currently no available vaccine or effective medication against dengue, thus preventing mosquitoes from breeding and propagating and protecting people from Aedes mosquito vectors are the best defense against the disease. Early detection of suspected cases, access to proper medical care and disease management, especially during outbreaks, can help in reducing the number of fatal cases, the WHO noted.
The WHO supports countries through its collaborating network of centers and laboratories, and provides technical and financial support and guidance for the effective management of dengue. WHO regional director for Western Pacific Shin Young-soo said dealing with a deadly disease such as dengue requires strong and consistent collaboration from everyone.
“Dengue hinders progress, which prevents our people from enjoying quality life. It is therefore imperative that we pool our considerable resources together to rid our region of dengue,” he said. He then urged governments, communities, stakeholders and donor agencies to strengthen efforts and programs for the routine control of vector-borne diseases and to ensure that systems are in place to detect, prepare for and respond to dengue outbreaks.
Dengue in Australia is not new, but Dengue mosquitoes have been found in Darwin.
The exotic breed of mozzies, capable of carrying the virus, was found at Darwin’s East Arm Wharf. The mosquitoes were discovered in traps set up around the port by Department of Agriculture staff.
Medical entomologist William Petit said where the blood suckers came from was being investigated.
“It is likely they have emerged from water holding cargo that has arrived from a country where this variety of mosquito is prevalent,” he said.
“Two female Aedes aegypti mosquitoes were detected on Monday from a trap set last week.”
He said people couldn’t catch dengue in the Territory thanks to strict monitoring.
“We jump straight into action to ensure we eliminate them quickly, to maintain the Northern Territory’s dengue mosquito-free status,” he said.
“We work collaboratively … to carry out a surveillance and control operation which includes fogging with a safe household-strength insecticide and inspecting the area to ensure we’ve stopped the incursion. With a busy international port this variety of mosquito appears from time to time, but thanks to our surveillance and control measures they are picked up and dealt with swiftly.”
Dengue fever is a viral disease that is spread when mosquitoes bite an infected person and then pass the infection on to others.
It is a problem in many tropical and subtropical parts of the world, including north Queensland. It is estimated about 100 million cases occur worldwide each year. Read more in The Northern Territory News.
Cairns’ dengue fever outbreak spreads to Trinity Beach
Dengue fever has spread from Cairns’ southern suburbs to the northern beaches.
The outbreak had been contained to Edmonton since it began two weeks ago but a person has fallen ill with the mosquito-borne virus in Trinity Beach.
It brings the total number of cases so far this season to eight.
Tropical Public Health Services’ Dr Richard Gair said it appeared the latest case was linked to the Edmonton outbreak.
“They hadn’t really been anywhere else during the incubation period and because their house is quite close to somebody else we know acquired dengue in Edmonton it’s fairly sure and the Edmonton outbreak is a dengue type one,” he said.
He said it appeared the patient fell ill after someone with dengue fever from Edmonton visited the area.
“The mosquitoes actually never move very far. They usually stay in an area about 100-200 metres across,” he said.
“So the mosquitoes more or less stay where they are, it’s people that move around and spread dengue because they get it in one area and they move to another area and infect the mosquitoes there.” More on Dengue in Australia…