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  • Denque in Veracruz, Mexico

    Veracruz aún es primer lugar en casos de dengue

    ANDRES T. MORALES CORRESPONSAL
    http://www.jornada.unam.mx/2006/10/25/044n2est.php



    Veracruz, ver., 24 de octubre.

    La Secretaría de Salud en Veracruz informó que la entidad continúa en el primer lugar nacional en casos de dengue clásico y hemorrágico, con 4 mil 500 personas infectadas en el año; 457 desarrollaron la enfermedad con manifestaciones hemorrágicas.

    Jon Rementeria Sempé, titular de la dependencia, precisó que 50 por ciento de los casos se ubican en la conurbación Veracruz-Boca del Río, donde siete colonias, incluido el centro histórico del puerto, han sido identificadas como ''sitios de alto contagio.

    La situación ya está bajo control, aunque seguimos siendo el primer lugar en casos de dengue en todo el país''.

    Desmintió que la muerte de un joven del municipio de Soledad de Doblado se debiera al dengue hemorrágico, como se especuló en la prensa local.

    Detalló que en los municipios conurbados de Veracruz y Boca del Río hay 267 casos de fiebre hemorrágica y durante agosto y septiembre hubo semanas en que se diagnosticaron hasta 350 pacientes con la infección clásica.

    El jefe de la jurisdicción sanitaria número 8, Gilberto Zamorano, precisó que con apoyo del Ejercito y la Armada de México se realizan fumigaciones masivas y se destruyen cacharros donde anida el mosquito transmisor del dengue.

    babelfish:
    The Secretariat of Health in Veracruz informed that the organization continues in the first classic and hemorrágico national place in cases of dengue, with 4 thousand 500 people infected in the year; 457 developed the disease with hemorrágicas manifestations.

    Jon Rementeria Sempé, to title of the dependency, needed that 50 percents of the cases are located in the conurbación Veracruz-Boca of the River, where seven colonies, including the historical center of the port, have been identified as ' ' stop sites I infect.

    The situation already is under control, although we continued being the first place in cases of dengue in all país''.

    It denied that the death of a young person of the municipality of Solitude of Dubbing had dengue hemorrágico, as were speculated on in the local press.

    It detailed that in the conurbados municipalities of Veracruz and Boca of the River there are 267 cases of hemorrágica fever and during August and September were weeks in which they were diagnosed up to 350 patients with the classic infection.

    The head of the sanitary jurisdiction number 8, Gilberto Zamorano, needed that with support of Ejercito and the Navy of Mexico massive fumigations are made and earthenware vessels are destroyed where nests the transmitting mosquito of dengue.
    Last edited by sharon sanders; October 26th, 2006, 09:21 PM. Reason: added English babelfish translation

  • #2
    Re: Veracruz aún es primer lugar en casos de dengue

    http://www.cdc.gov/MMWR/preview/mmwrhtml/00000321.htm
    International Notes Dengue -- Mexico, 1983

    Although fewer dengue cases were reported in Mexico in 1983 than in 1982 (12,967, compared with 32,640), dengue transmission was reported over a wider geographic area (1). In 1982, 17 Mexican states reported dengue cases, and in 1983, 22 reported cases. For the first time, Guaymas (in the northwest state of Sonora), Guaymuchil (in the neighboring state of Sinaloa), and Zihuatanejo (in the south-central state of Guerrero) reported cases in 1983. Only the north-central part of the country and Northern Baja California, areas predominated by desert and mountains, were free of the disease (Figure 2). Of 10 large cities involved in an epidemiologic surveillance program, Tuxtla Gutierrez (Chiapas), Tapachula (Chiapas), Acapulco (Guerrero), and Merida (Yucatan) had the most dengue cases (Table 2). Transmission appears distinctly seasonal, with most cases occurring between August and October.

    As of week 40 (October 15, 1983), 117 paired sera had been tested for dengue hemagglutination-inhibition (HI) antibodies by the Instituto de Salubridad y Enfermedades Tropicales, Mexico City, and 56 (48%) were reported positive (Table 3). Although the infecting virus serotypes are not known for all outbreaks, a collaborative effort by the above laboratory and CDC has confirmed that at least three serotypes are currently circulating in Mexico. Dengue 4 was isolated from two persons in the state of Oaxaca and dengue 2, from two specimens taken in Guerrero state; dengue 1 was isolated from southern Puebla state and Sonora state.

    To date, no deaths or serious illnesses associated with documented dengue have been reported from Mexico. Reported by L Cabrera-Coello, MD, Director de Vigilancia y Epidemiologia, E Gallardo, MD, Epidemiologist, Dengue Surveillance Program, Secretaria de Salubridad y Asistencia, Mexico City, E Zorilla, MD, Director, ML Zarate de Guaneros, MD, Virology Dept, Instituto de Salubridad y Enfermedades Tropicales, Mexico City, Mexico; Dengue Br, Div of Vector-Borne Viral Diseases, Center for Infectious Diseases, CDC.
    Editorial Note

    Editorial Note: Epidemic dengue has been recognized in Mexico only since 1978, when the hemispheric pandemic of dengue 1 spread to southern Mexico. In 1980, dengue 1 moved up the east coast of Mexico into the lower Rio Grande valley of Texas (2) and subsequently spread to most other regions of Mexico (3). Serologic evidence of dengue 4 and dengue 2 transmission in Mexico was first detected in 1981 and 1982, respectively (4), but 1983 was the first year these serotypes were associated with known epidemic activity. With Aedes aegypti prevalent throughout much of the country, these serotypes may also spread to other areas with susceptible human populations.

    Comment


    • #3
      Re: Veracruz aún es primer lugar en casos de dengue

      http://www.cenave.gob.mx/dengue/default.asp?id=32

      Comment


      • #4
        Re: Veracruz aún es primer lugar en casos de dengue

        <FORM id=search name=search action=http://news.ufl.edu/uf-news-controller.php method=get> </FORM><!-- end header -->
        Carbon dioxide mosquito traps no magic bullet, say UF experts

        Filed under Research, Environment, Florida on Thursday, May 19, 2005.
        VERO BEACH, Fla. — With spring rains promising a bumper crop of mosquitoes, some Floridians may consider buying expensive high-tech traps that use carbon dioxide to lure the bloodsuckers. But University of Florida experts warn that buyers who don’t do their homework could still get bitten – in the pocketbook.
        Priced from $300 to $1,500, the traps do capture mosquitoes and other biting insects, said Jonathan Day, an entomologist with UF’s Institute of Food and Agricultural Sciences. The real question is whether they will protect a yard from the pests, he said.
        The state is home to 74 species of mosquitoes, of which about half prey on people, he said. Only a few species are likely to be controlled with a CO2 trap because variables such as flight range, habitat preference and feeding behavior determine whether the trap will capture mosquitoes in large enough numbers to reduce biting around the home.
        “Before you buy a trap, it’s crucial that you know what mosquito species is causing your problem,” Day said. “The traps can be very effective if the target insect is one that doesn’t fly very far or has its breeding site near your home. But most of the mosquitoes people complain about in Florida have flown a considerable distance before they end up in someone’s back yard and using a trap to control them is like trying to capture all the grains of sand on the beach.”
        Consumers can get help identifying mosquitoes by contacting UF/IFAS county extension agents, he said. To assess whether a CO2 trap could help, an agent will need to know about vegetation and surface water in and around the property.
        The traps lure mosquitoes by emitting carbon dioxide, a gas people and animals produce when they breathe, Day said. Some traps use additional chemicals to mimic other scents. When mosquitoes reach the trap they are captured by a vacuum or adhesive.
        Day, who has used CO2 traps as a research tool for 10 years at the Florida Medical Entomology Laboratory in Vero Beach, said despite the traps’ efforts to fool mosquitoes with CO2 and other attractants, the insects prefer people and animals. He is concluding a study that showed CO2 traps were significantly outperformed by traps that used live hosts as bait.
        Because CO2 traps have only been available to consumers since the late 1990s, manufacturers are still refining the technology, said Joe Conlon, a staff entomologist and spokesman with the American Mosquito Control Association, a nonprofit organization in New Jersey.
        “The attractants don’t seem to be working as well as theoretically possible, and we need a whole lot more research into the physiology of attractiveness of humans to mosquitoes,” Conlon said.
        Species-specific attractants could help consumers solve pest problems more reliably, said Raymond Iannetta, chairman and chief executive officer of American Biophysics Corporation, the first company to produce a CO2 mosquito trap for the consumer market, the Mosquito Magnet trap. The Rhode Island company is also the first to develop attractants based on human skin scents, and recently introduced an attractant designed for the Asian tiger mosquito, he said.
        Iannetta said consumers and scientists may view CO2 traps with skepticism because other mosquito control devices such as electric “bug zappers” are not based on valid science. He asserts that his company’s products are effective, and are based on 14 years of rigorous scientific research and testing.
        “A significant hurdle was getting over the industry’s gadget or gimmick syndrome,” he said. “We’re constantly working with the scientific community and the public to change that perception.”
        The company maintains an extensive Web site to educate consumers about the traps, how they work and how consumers can best use them, Iannetta said.
        Experts agree that operator error can impair a CO2 trap’s performance, said Dan Kline, a research entomologist with the U.S. Department of Agriculture’s Center for Medical, Agricultural and Veterinary Entomology in Gainesville.
        “It’s important that people read and follow the owner’s manual,” said Kline, who regularly tests CO2 traps for manufacturers and is conducting a study to determine if multiple CO2 traps can protect a neighborhood. “Placement is a big issue – you need to keep the trap out of the immediate area where people gather, and try to put it between the people and the source of the mosquitoes.”
        Another common problem is that consumers sometimes use the traps only during outdoor activities, rather than running them continuously during warm weather, as manufacturers recommend, he said. ‘Round the clock operation of one trap can cost $20 to $25 per month.
        No one should rely exclusively on a CO2 trap for mosquito control, said Roxanne Rutledge, an entomologist at the UF laboratory in Vero Beach. Consumers should also follow traditional precautions such as using repellent, eliminating sources of standing water and patching holes in screens.
        “Try to keep a balance,” she said. “Do things around your home to reduce the number of mosquitoes that breed or get inside, but understand there are factors beyond your control.”
        Ultimately, a consumer’s tolerance for mosquito bites may be the only way to measure success with a CO2 trap, Rutledge said.
        “It comes down to a matter of perception,” she said. “You can have one of these in your yard, and if you feel like you’re not being bitten by mosquitoes anymore and you’re happy with it, then for you it works.”
        For more information about CO2 mosquito traps, see Rutledge’s fact sheet “Mosquito Control Devices and Services for Florida Homeowners” at http://edis.ifas.ufl.edu/BODY_IN171.


        http://news.ufl.edu/2005/05/19/mosquito-traps/
        "May the long time sun
        Shine upon you,
        All love surround you,
        And the pure light within you
        Guide your way on."

        "Where your talents and the needs of the world cross, lies your calling."
        Aristotle

        “In a gentle way, you can shake the world.”
        Mohandas Gandhi

        Be the light that is within.

        Comment


        • #5
          Re: Veracruz aún es primer lugar en casos de dengue

          Dengue Fever in Mexico and Other Countries in the Americas: Update
          http://www.phac-aspc.gc.ca/tmp-pmv/2002/df1114_e.html

          November 14, 2002
          Health Canada continues to monitor dengue fever (DF) activity in Central and South America and the Caribbean, where the disease is known to occur.

          Dengue fever (DF) is an acute viral illness of varying severity. It is caused by one of the four strains, or serotypes, of dengue flaviviruses. Dengue fever is spread by the bite of an infected mosquito. Aedes aegpyti, the most common mosquito species that transmits the dengue virus, is a day-time biter and lives in close proximity to humans in urban areas.

          Mexico is currently experiencing increased reports of dengue following hurricane Kenna from the Pacific and hurricane Isidoro from the Gulf of Mexico. The increased rains have provided excellent breeding conditions for mosquitoes. The government of Mexico is actively responding to the current outbreak with mosquito control activities including spraying of mosquito breeding sites and increased public health education. Mosquito control measures are being implemented along the Pacific coast in the states of Sinaloa, Nayarit, and Jalisco. In the state of Sinaloa, measures are being implemented in the city of Mazatl&#225;n, and in the municipalities of Escuinapa and El Rosario. Along the Gulf of Mexico, measures are being implemented in the states of Campeche and Yucat&#225;n. To date this year, Mexico has reported 8,363 laboratory confirmed cases of dengue.

          Source: Secretary of Health of Mexico

          Some other recent country reports of interest are:

          In Barbados, as of week 25 of 2002, 532 case of dengue fever were reported with an incidence rate of 198.51 per 100,000 population.

          In Brazil, as of week 30 of 2002, 711,919 cases of dengue fever were reported with an incidence rate of 412.57 per 100,000 population.

          In Costa Rica, as of week 38 of 2002, 9,138 cases of dengue fever were reported with an incidence rate of 268.76 per 100,000 population.

          In El Salvador, as of week 37 of 2002, 17,648 cases of dengue fever were reported with an incidence rate of 275.75 per 100,000 population.

          In Grenada, as of week 31 of 2002, 236 cases of dengue fever were reported with an incidence rate of 251.06 per 100,000 population.

          In Honduras, as of week 34 of 2002, 27,113 cases of dengue fever were reported with an incidence rate of 412.37 per 100,000 population.

          In St. Vincent & Grenadines, as of week 28 of 2002, 169 cases of dengue fever were reported with an incidence rate of 148.25 per 100,000 population.

          In Trinidad & Tobago, as of week 30 of 2002, 2,805 cases of dengue fever were reported with an incidence rate of 215.77 per 100,000 population.

          In Venezuela, as of week 35 of 2002, 29,000 cases of dengue fever were reported with an incidence rate of 117.73 per

          Comment


          • #6
            Re: Veracruz aún es primer lugar en casos de dengue

            http://www.sunstar.com.ph/static/pam...in.mexico.html
            MEXICO -- A nine-year-old boy in Barangay San Jose Malino here died of dengue last Sunday.

            The victim, Glen Cornelio, a grade 3 pupil in a public elementary school, succumbed to the disease after a weeklong suffering from on-and-off fever. Cornelio was said to have attended his classes whenever his fever subsided.

            Sun.Star Network Online coverage on journalist Marlene Esperat's murder case


            The boy was brought to the Angeles University Hospital (AUH) last Friday for treatment but eventually expired on Sunday evening.

            Several dengue cases had been reported in the barangay days prior to the boy's death. Most of those who were stricken were elementary students in public schools, prompting some parents to keep their children from school out of fear.

            Residents have asked the barangay officials to conduct fogging operations to rid the community of the dengue-carrying mosquito known as Aenid egypti.

            Sources said health personnel from the barangay health center have already inspected the schools. Health authorities will also inspect the schools soon, according to sources.

            Comment


            • #7
              Re: Veracruz aún es primer lugar en casos de dengue

              http://cat.inist.fr/?aModele=afficheN&cpsidt=3197717
              Titre du document / Document title
              Unrecognized spotted fever group rickettsiosis masquerading as dengue fever in Mexico
              Auteur(s) / Author(s)
              ZAVALA-VELAZQUEZ J. E. ; YU X.-J. ; WALKER D. H. ;
              Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
              Faculty of Medicine, Universidad Autonoma de Yucatan, Merida, Yucatan, MEXIQUE
              Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas, ETATS-UNIS
              R&#233;sum&#233; / Abstract
              Although Rocky Mountain spotted fever was documented in northern Mexico during the 1940s, spotted fever group (SFG) rickettsioses have subsequently received little attention in Mexico. In this study, sera collected in 1993 from 50 patients from the Mexican states of Yucatan and Jalisco, who were suspected clinically to have dengue fever but had no antibodies to dengue virus, were examined by indirect immunofluorescence for IgM antibodies reactive with Rickettsia rickettsii, R. akari, and R. typhi. Twenty (40%) of the patients' sera contained IgM antibodies to SFG rickettsiae at a titer of 128 or greater. Among five sera reactive only against R. akari, four were from patients in Jalisco where a cluster of cases occurred in June and July. Among five sera reactive only with R. rickettsii, all were from Yucatan patients. Sera of 10 patients contained antibodies reactive with antigens shared by R. rickettsii and R. akari. The clinical signs and symptoms (fever, 100% ; myalgia, 95% ; headache, 85% ; rash, 85%) were similar to those of dengue fever patients identified in this study. However, the incidence of rash was substantially higher than the nondengue, nonrickettsiosis patients. One or more SFG rickettsioses appear to be present in areas of Mexico not previously recognized to harbor these organisms. The etiologic agent or agents are as yet unknown.
              Revue / Journal Title
              The American journal of tropical medicine and hygiene (Am. j. trop. med. hyg.) ISSN 0002-9637 CODEN AJTHAB
              Source / Source
              1996, vol. 55, no2, pp. 157-159 (28 ref.)
              Langue / Language
              Anglais
              Editeur / Publisher
              Allen Press, Lawrence, KS, ETATS-UNIS (1952) (Revue)
              Mots-cl&#233;s anglais / English Keywords
              Rocky mountain spotted fever ; Differential diagnostic ; Dengue ; Clinical form ; Human ; Mexico ; Rickettsial infection ; Rickettsialosis ; Bacteriosis ; Infection ; Arbovirus disease ; Viral disease ; Central America ; America ;
              Mots-cl&#233;s fran&#231;ais / French Keywords
              Fi&#232;vre pourpr&#233;e ; Diagnostic diff&#233;rentiel ; Dengue ; Forme clinique ; Homme ; Mexique ; Rickettsiose ; Rickettsialose ; Bact&#233;riose ; Infection ; Arbovirose ; Virose ; Am&#233;rique Centrale ; Am&#233;rique ;

              002b05b02l8 ; 235 ;
              Mots-cl&#233;s espagnols / Spanish Keywords
              Fiebre purp&#250;rea ; Diagn&#243;stico diferencial ; Dengue ; Forma cl&#237;nica ; Hombre ; M&#233;xico ; Rickettsiosis ; Rickettsialosis ; Bacteriosis ; Infecci&#243;n ; Arbovirosis ; Virosis ; America central ; America ;
              Localisation / Location
              INIST-CNRS, Cote INIST : 6817, 35400006409933.0070

              Comment


              • #8
                Re: Veracruz aún es primer lugar en casos de dengue

                Thank you Joe for the d&#233;j&#224; vu references.

                But from what I can read see on-line, this outbreak has a more virulent strain than in 1999.

                Although this outbreaks appears more violent than the one of 1999, I am not 'so concerned' about it, from the infos I have, tonight.

                Would the creation of a thread 'Focus on Dengue' into wich we insert informative posts on Dengue, previous datas like the ones of 1999 and other elements that keeps the perspective 'relative' be helpful ??

                Should we drive or get dragged ???

                Any opinions ??
                Last edited by Snowy Owl; October 26th, 2006, 10:18 PM.

                Comment


                • #9
                  Re: Veracruz aún es primer lugar en casos de dengue

                  http://cat.inist.fr/?aModele=afficheN&cpsidt=3821344
                  Titre du document / Document title
                  Epidemic dengue 4 in the Yucat&#225;n, M&#233;xico, 1984
                  Auteur(s) / Author(s)
                  LORONO PINO M. A. (1) ; FARFAN ALE J. A. (1) ; ROSADO PAREDES E. DEL P. (1) ; KUNO G. ; GUBLER D. J. ;
                  Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
                  (1) Univ. aut&#243;noma Yucat&#225;n, cent. investigaciones regionales Dr. Hideyo Noguchi, M&#233;rida Yucatan 97240, MEXIQUE
                  R&#233;sum&#233; / Abstract
                  An outbreak of dengue 4 occurred in the Yucatan, M&#233;xico in 1984. During the course of the outbreak, 538 of 5486 reported cases of dengue-like illness were studied; 200 were confirmed as dengue serologically and/or virologically. Dengue 4 virus was isolated from 34 patients and dengue 1 from one. Severe haemorrhagic symptoms were observed in 9 laboratory confirmed patients, including four deaths. Thus, the outbreak in Yucatan is the second dengue epidemic in the Americas after the Cuban epidemic in 1981 in which a number of patients suffered from haemorrhagic complications. It was notable that 5 of 9 hospitalized, severe cases were young adults and that only one met the WHO criteria of DHF, in contrast to primary pediatric nature of DHF in Southeast Asia
                  Revue / Journal Title
                  Revista do Instituto de Medicina Tropical de S&#227;o Paulo (Rev. Inst. Med. Trop. S&#227;o Paulo) ISSN 0036-4665 CODEN RMTSAE
                  Source / Source
                  1993, vol. 35, no5, pp. 449-455 (23 ref.)
                  Langue / Language
                  Anglais
                  Editeur / Publisher
                  Instituto de Medicina Tropical de S&#227;o Paulo, S&#227;o Paulo, BRESIL (1959) (Revue)
                  Mots-cl&#233;s anglais / English Keywords
                  Dengue 4 ; Epidemic ; Mexico ; Epidemiology ; Public health ; Human ; Dengue ; Arbovirus disease ; Viral disease ; Infection ; Central America ; America ;
                  Mots-cl&#233;s fran&#231;ais / French Keywords
                  Dengue 4 ; Epid&#233;mie ; Mexique ; Epid&#233;miologie ; Sant&#233; publique ; Homme ; Yucatan ; Dengue ; Arbovirose ; Virose ; Infection ; Am&#233;rique Centrale ; Am&#233;rique ;

                  002b05c02i1a ; 235 ;
                  Mots-cl&#233;s espagnols / Spanish Keywords
                  Dengue 4 ; Epidemia ; M&#233;xico ; Epidemiolog&#237;a ; Salud p&#250;blica ; Hombre ; Dengue ; Arbovirosis ; Virosis ; Infecci&#243;n ; America central ; America ;
                  Localisation / Location
                  INIST-CNRS, Cote INIST : 1265, 35400002634179.0110

                  Comment


                  • #10
                    Re: Veracruz aún es primer lugar en casos de dengue

                    Headlines in History: Dengue outbreak threatens Northern Mexico
                    http://www.brownsvilleherald.com/com...d=P73053_0_3_0
                    Oct. 21, 1999 — An outbreak of dengue fever in Northern Mexico threatened the Rio Grande Valley.

                    Reporting from the Mexican city of Monterrey, The Brownsville Herald described how the fever had swept areas near the border, killing at least seven people and swamping hospitals.

                    In the state of Nuevo Leon alone, some 5,500 people had been diagnosed with the painful, mosquito-transmitted disease, The Herald reported. Of this number, about 150 had the serious, sometimes deadly hemorrhagic dengue. The majority of the cases had come about in October.

                    In Tamaulipas, about 500 cases had been reported.

                    Five people died in Nuevo Leon and two in Tamaulipas.

                    Symptoms of dengue fever include headaches, rashes, cramps and severe body and muscle pains. It typically lasts about two weeks after infection. The hemorrhagic variety includes internal bleeding.

                    The Aedis egypti mosquito transmits the disease.

                    Compiled by Herald reporter Jeff Raymond.
                    Thought has a dual purpose in ethics: to affirm life, and to lead from ethical impulses to a rational course of action - Teaching Reverence for Life -Albert Schweitzer. JT

                    Comment


                    • #11
                      Re: Veracruz aún es primer lugar en casos de dengue

                      Snowy, Joe, AnneZ -

                      Aren't we talking about DHF not the "regular" dengue?

                      "The disease itself is rarely fatal, but a more serious complication, dengue hemorrhagic fever (DHF), is far more dangerous.

                      DHF can cause liver enlargement and circulatory failure.

                      Without treatment, DHF can kill 20 percent of its victims. With medical treatment, the fatality rate can drop below one percent.

                      But as the current crush of patients at hospitals in northern India attests, an outbreak in a region with limited access to health care can take a drastic toll on a community.

                      "If you just look at the case fatality rate, then it's not so dangerous," Gubler said.

                      "But if you compare [dengue's overall impact] to [that of] Ebola and Marburg—these highly fatal hemorrhagic fever diseases that get a lot of press—they aren't even in the same league. I consider them relatively unimportant compared to dengue." '

                      http://www.flutrackers.com/forum/sho...02&postcount=1


                      Can we get any numbers for DHF alone?
                      Last edited by Snowy Owl; October 26th, 2006, 10:11 PM.
                      "May the long time sun
                      Shine upon you,
                      All love surround you,
                      And the pure light within you
                      Guide your way on."

                      "Where your talents and the needs of the world cross, lies your calling."
                      Aristotle

                      “In a gentle way, you can shake the world.”
                      Mohandas Gandhi

                      Be the light that is within.

                      Comment


                      • #12
                        Re: Veracruz aún es primer lugar en casos de dengue

                        http://www.medscape.com/viewarticle/417334_7

                        Emergence of Dengue Hemorrhagic Fever in the Americas
                        from Infections in Medicine ®

                        Emergence of DHF in the Americas
                        Before 1981, there were no known DHF outbreaks in the Americas despite the circulation of dengue viruses in parts of the region during the 1960s and 1970s. A small number of suspected cases of DHF or severe fatal dengue were reported before then, but only a few of them fulfilled the WHO case definition for DHF/DSS, and the majority lacked laboratory confirmation.[37]

                        Cuba. A milestone in the emergence of DHF in the Americas was the major DHF epidemic that affected Cuba in 1981.[9] This epidemic was first detected in late May 1981 and peaked during July and August; the last cases were diagnosed in October. A total of 344,203 cases of dengue and DHF/DSS were reported, 10,312 of which were determined to be grades II to IV of the WHO classification for DHF severity (Table I). There were 158 fatalities, 101 of which occurred in children younger than 15 years. Over a 3-month period, a total of 116,143 persons were hospitalized. This outbreak was short-lived, thanks to a vigorous and effective A aegypti control program implemented by the Cuban authorities, which virtually eradicated the mosquito from the island. Cuba became free of dengue virus until 1997, when another epidemic occurred in Santiago province. A total of 2946 cases of dengue were reported in that outbreak, including 205 DHF cases and 12 deaths, all of them in adults.[47]

                        Venezuela. Since 1981, DHF cases or epidemics have been reported in 25 countries of the Americas every year except for 1983 (Fig. 1). Small outbreaks were reported in El Salvador, Mexico, Nicaragua, and Puerto Rico between 1982 and 1988.[39] In 1989, however, the second major epidemic of DHF/DSS in the Americas occurred in Venezuela.[11] The first cases were diagnosed in October; the epidemic peaked in January 1990 and then declined sharply. From December 2, 1989, through April 17, 1990, a total of 3108 DHF cases were reported, with 73 deaths. Approximately two thirds of the cases occurred in children under 14 years of age, and a similar age distribution was observed in fatal cases. Cases of DHF were reported from 17 of 20 states, the Federal District, and 1 of the 2 Venezuelan Federal Territories. Most DHF reports originated in the Federal District and from the states of Aragua, Barinas, Carabobo, Falcon, Miranda, and Zulia. Dengue viruses isolated during the epidemic belonged to serotypes 1, 2, and 4, but dengue-2 was predominant. However, none of these isolates came from fatal cases. Immunohistochemical studies with formalin-fixed tissues of fatal cases found dengue-2 antigen in the liver of 4 patients.[11] The end of the epidemic was officially declared in mid-April 1990, but it re-emerged later in the year. Outbreaks of DHF have been reported in Venezuela every year since then. The largest outbreak occurred in 1997, when 6300 cases with 43 deaths were reported.

                        Click to zoom http://www.medscape.com/content/1998...m3365.fig1.jpg
                        Figure 1. (click image to zoom) Dengue hemorrhagic fever in the Americas. Provisional as of February 6, 1998. Data from country reports to PAHO/WHO.

                        Brazil. In Brazil, 4 cases of primary infection with dengue-1 virus were identified in 1986-1987.[39] In 1990-1991, the country experienced its first outbreak of DHF in the state of Rio de Janeiro.[12] This outbreak was associated with dengue-2, but it was preceded in 1986-1987 by outbreaks of dengue-1-associated fever.[48] That dengue-1 serotype was introduced into Brazil in 1986 after several decades during which no cases of dengue were reported. This sequence of events was similar to the Cuban outbreak of 1981. However, the number of cases in Rio de Janeiro was much smaller. Only 462 DHF cases and 8 deaths were reported. A second outbreak affected the state of Ceara in 1994.[34,49] This outbreak was also associated with dengue-2 and resulted in 24 DHF cases and 11 deaths.

                        Other countries. During the 1990s, 3 other American countries--Colombia, Mexico, and Nicaragua--reported significant outbreaks of DHF.[8] Between 1990 and 1994, Colombia reported small outbreaks each year, but since 1995 this country has recorded over 1000 DHF cases each year. Prior to 1994, Mexico had reported 14 DHF cases between 1984 and 1991. A small outbreak occurred in 1994, and since 1995 there has been a sharp increase in the incidence of DHF. During the 1995 outbreak in Mexico, dengue-2 virus was isolated from 20 DHF cases and dengue-1 from an additional 5 cases, but dengue-3 and -4, which were also circulating in the country, were recovered only from non-DHF cases.[50] In Nicaragua, outbreaks have occurred since 1992, the 2 largest ones in 1993 and 1995.

                        All cases. As seen in Figure 2, between 1981 and 1997 a total of 54,248 cases of DHF and 689 deaths were reported by 25 countries in the Americas (provisional figures at February 6, 1998). Figure 2 shows that most of the reported cases (28,470, or 52.5%) and deaths (250, or 36%) originated in Venezuela. In addition to Venezuela, 4 other countries--Colombia, Cuba, Mexico, and Nicaragua--reported more than 1000 cases each, and the remaining 20 countries reported between 1 and 706 DHF cases.

                        Click to zoom http://www.medscape.com/content/1998...m3365.fig2.jpg
                        Figure 2. (click image to zoom) Number of reported cases and deaths (indicated in parentheses) of dengue hemorrhagic fever in the Americas by country, 1981-1998. Provisional as of February 6, 1998. Data from country reports to PAHO/WHO.

                        The age distribution observed for DHF cases in the Americas is different from that in Asia. During the outbreaks that occurred in Cuba in 1981 and in Venezuela in 1989, about one third of the deaths were among children over 14 years of age, whereas in Asia, cases of DHF/DSS and associated deaths occurred among children aged under 14 years. In the 1997 Cuban outbreak, however, all of the deaths were among adults. In Brazil, an age range of 31 to 45 years was seen in patients who fulfilled the WHO criteria.[51] In Puerto Rico, two thirds of the cases reported in 1986 were in children under 15 years old,[52] but in 1990-91 the mean age of the patients was 38 years.[31] In contrast, in Southeast Asia, young children are predominantly affected. However, a marked increase in the number of DHF cases in individuals over 15 years of age has been seen in Malaysia and the Philippines during recent years.[53] In Asia, females are at higher risk than males for developing DHF/DSS. During the 1981 Cuban outbreak of DHF/DSS, the frequency of DHF/DSS was higher in female adults,[41] but no significant female predominance was evident among fatal cases.[9] This observation contrasts with findings reported in Asian countries.

                        DHF/DSS in the Americas continues to occur in both children and adults, but it is not clear if this is due to the genetic background of populations, epidemiological events, or other unknown factors.

                        The overall case-fatality rate (CFR) of DHF/DSS in the Americas is 1.4%,[8] but a large variation among countries has been observed. In countries reporting over 100 cases, the CFR ranged from below 1.0% (Colombia, Nicaragua, and Venezuela) to 11.9% (Puerto Rico). The reasons for this variation are not clear, but could be due to reporting criteria, viral virulence, host genetic factors, case management, or other unidentified factors.

                        Comment


                        • #13
                          Re: Veracruz aún es primer lugar en casos de dengue

                          Aren't we talking about DHF not the "regular" dengue?
                          "The disease itself is rarely fatal, but a more serious complication, dengue hemorrhagic fever (DHF), is far more dangerous.
                          Yes, but it is a complex distinction. The subtype DEN-2 is associated with DHF but not absolute. Laboratory testing frequently not available for most cases. Diagnosis for dengue, like influenza, is made based on the presence of illness in the area.

                          See 8 pp article by Navarrette-Espinoza J et al 2005
                          http://www.scielosp.org/pdf/spm/v47n3/a02v47n3.pdf

                          Joe
                          Thought has a dual purpose in ethics: to affirm life, and to lead from ethical impulses to a rational course of action - Teaching Reverence for Life -Albert Schweitzer. JT

                          Comment


                          • #14
                            Dengue and dengue haemorrhagic fever - Lancet

                            Full article at :

                            http://www.flutrackers.com/forum/showthread.php?t=11625


                            Summary

                            The incidence and geographical distribution of dengue have greatly increased in recent years. Dengue is an acute mosquito-transmitted viral disease characterised by fever, headache, muscle and joint pains, rash, nausea, and vomiting. Some infections result in dengue haemorrhagic fever (DHF), a syndrome that in its most severe form can threaten the patient's life, primarily through increased vascular permeability and shock. The case fatality rate in patients with dengue shock syndrome can be as high as 44%. For decades, two distinct hypotheses to explain the mechanism of DHF have been debated—secondary infection or viral virulence. However, a combination of both now seems to be the plausible explanation. The geographical expansion of DHF presents the need for well-documented clinical, epidemiological, and virological descriptions of the syndrome in the Americas. Biological and social research are essential to develop effective mosquito control, medications to reduce capillary leakage, and a safe tetravalent vaccine.
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                            Dengue is the most important human viral disease transmitted by arthropod vectors. Annually there are an estimated 50–100 million cases of dengue fever (DF), and 250,000 to 500,000 cases of dengue haemorrhagic fever (DHF) in the world. Over half of the world's population live in areas at risk of infection, and these are popular tourist destinations too1,2 (figure 1). DF and DHF are caused by the four dengue viruses DEN 1, 2, 3, and 4, which are closely related antigenically. Infection with one serotype provides life-long immunity to that virus but not to the others. Dengue viruses are maintained in an urban transmission cycle in tropical and subtropical areas area by the mosquito Aedes aegypti, a species closely associated with human habitation. In some regions other Aedes species, such as Ae albopictus and Ae polynesiensis are also involved.
                            "May the long time sun
                            Shine upon you,
                            All love surround you,
                            And the pure light within you
                            Guide your way on."

                            "Where your talents and the needs of the world cross, lies your calling."
                            Aristotle

                            “In a gentle way, you can shake the world.”
                            Mohandas Gandhi

                            Be the light that is within.

                            Comment


                            • #15
                              Re: Veracruz aún es primer lugar en casos de dengue

                              Should we drive or get dragged ???
                              Any opinions ?? (SO)
                              Drive.

                              See excellent power point presentation , From Mary Hayden, PhD
                              Dengue along the US/Mexico Border
                              NCAR Climate and Health Colloquium
                              July 19, 2006

                              2005 Outbreak in Matamoras and Brownsville

                              Tamaulipas, Mexico experienced a dengue epidemic in mid-late 2005 with over 4000 dengue cases reported by mid-October, a six-fold increase from 2004. Dengue-2 was the predominant serotype.
                              Between Sept and Dec 2005, 6 people were identified from Brownsville with dengue fever and 6 with DHF, including one case of locally acquired DHF. In December 2005 a binational seroepidemiologic investigation was conducted to define the prevalence of anti-dengue antibodies in both cities.

                              See the Power Point presentation (4mb)
                              http://www.isse.ucar.edu/climateheal...X%20border.ppt

                              Joe
                              Thought has a dual purpose in ethics: to affirm life, and to lead from ethical impulses to a rational course of action - Teaching Reverence for Life -Albert Schweitzer. JT

                              Comment

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