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Dengue - Madeira and World outbreaks (ECDC/CDTR, February 12 2013, edited)
[Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Edited.]
COMMUNICABLE DISEASE THREATS REPORT
Week 6, 3-9 February 2013 ? CDTR
(?)
Dengue - Portugal - Madeira outbreak
Opening date: 10 October 2012 Latest update: 8 February 2013
Epidemiological summary
On 3 October 2012, the Portuguese public health authorities reported two cases of dengue infection confirmed in patients residing on the island of Madeira in the Autonomous Region of Madeira located around 400 km from the Canary Islands, 650 km from the African coast, and 1 000 km from the European continent. The autonomous region has 268 000 inhabitants.
As of 6 January 2013, 2 144 cases of dengue infection have been reported from the public health sector in Madeira.
The sequence analysis of viral genomes (600 nucleotides) from several positive human samples indicates high sequence similarity with DENV-1 circulating in Venezuela and Colombia, strongly suggesting a Latin American origin.
The vast majority of confirmed cases are from the city of Funchal, which is the main port on Madeira island. The island of Madeira has an established mosquito population of Aedes aegypti, the main vector of dengue in tropical and subtropical countries.
Seventy-seven patients have been diagnosed in European countries with dengue infection after returning from Madeira:
(?)
ECDC assessment
This is the first known occurrence of locally transmitted dengue infection in the Autonomous Region of Madeira, and consequently a new geographical area reporting autochthonous cases in the EU. This is a significant public health event but not entirely unexpected because of the known presence of Aedes aegypti, a competent vector for dengue.
The updated figures indicate that the outbreak has peaked, with a decrease in the number of cases being reported since mid-November.
Entomological surveillance has shown a decrease in mosquito activity as well.
The cases of dengue among returning travellers from the island highlight the need for travellers to Madeira to take measures in order to reduce mosquito bites.
Travellers experiencing febrile symptoms with severe headache, retro-orbital pain, myalgia, arthralgia and maculo-papular rash within 21 days of visiting the island of Madeira are advised to seek medical advice.
Neighbouring geographical areas (e.g. Canary Islands) and other EU Member States need to assess the risk of establishment of Aedes mosquito populations and the introduction of dengue.
The epidemiological situation does not imply the need for any trade or travel restriction beyond the disinfestation policies currently implemented.
Actions
ECDC published an updated rapid risk assessment concerning the autochthonous dengue cases in Madeira.
Portuguese authorities published recommendations regarding personal protective measures, and measures for the safety of blood, cells, tissues and organ donations within the region.
Blood donor deferral for 28 days from day of departure for travellers returning from the Autonomous region of Madeira is now recommended in other EU countries.
(?)
Dengue - Multistate (world) - Monitoring seasonal epidemics
Opening date: 20 April 2006 Latest update: 7 February 2013
Epidemiological summary
Europe: There have been no reports of confirmed autochthonous dengue infections in Europe in 2013, besides the on-going dengue outbreak in Madeira.
Asia: There is no new update from WHO Western Pacific Region this week.
Latin America: A notable dengue activity is reported across Central America this week. In Mexico, overall dengue activity remains high but there has been a recent declining trend across some states. For South America, an overall high dengue activity is reported across Brazil, Colombia, Bolivia, Ecuador and Paraguay. Uruguay has reported a limited number of cases this week.
According to media reports in Montevideo, Uruguay, local health authorities have confirmed that all suspected cases of indigenous dengue in the country have proven to be negative following analysis. There is relatively strong dengue activity reported this week in French Guyana (French Overseas Department). The two main serotypes co-circulating are DENV-2 and DENV-4, but predominantly DENV-2.
The Caribbean: There is no new update from the CDC on the dengue situation in Puerto Rico. The Cayman Islands is experiencing increased dengue activity with 23 suspected cases so far this year. An epidemiological update from InVS this week indicates an elevated risk of a dengue epidemic in St. Martin.
(?)
ECDC assessment
ECDC monitors individual outbreaks, seasonal transmission patterns and inter-annual epidemic cycles of dengue through epidemic intelligence activities in order to identify significant changes in disease epidemiology.
Of particular concern is the potential for the establishment of dengue transmission in Europe. Before the current outbreak in the Autonomous Region of Madeira, local transmission of dengue was reported for the first time in France and Croatia in 2010.
Imported cases are detected in European countries highlighting the risk of locally acquired cases occurring in countries where the competent vectors are present.
Actions
ECDC has published a technical report on the climatic suitability for dengue transmission in continental Europe and guidance for invasive mosquitoes? surveillance.
(?)
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COMMUNICABLE DISEASE THREATS REPORT
Week 6, 3-9 February 2013 ? CDTR
(?)
Dengue - Portugal - Madeira outbreak
Opening date: 10 October 2012 Latest update: 8 February 2013
Epidemiological summary
On 3 October 2012, the Portuguese public health authorities reported two cases of dengue infection confirmed in patients residing on the island of Madeira in the Autonomous Region of Madeira located around 400 km from the Canary Islands, 650 km from the African coast, and 1 000 km from the European continent. The autonomous region has 268 000 inhabitants.
As of 6 January 2013, 2 144 cases of dengue infection have been reported from the public health sector in Madeira.
The sequence analysis of viral genomes (600 nucleotides) from several positive human samples indicates high sequence similarity with DENV-1 circulating in Venezuela and Colombia, strongly suggesting a Latin American origin.
The vast majority of confirmed cases are from the city of Funchal, which is the main port on Madeira island. The island of Madeira has an established mosquito population of Aedes aegypti, the main vector of dengue in tropical and subtropical countries.
Seventy-seven patients have been diagnosed in European countries with dengue infection after returning from Madeira:
- 10 in Portugal,
- 23 in the UK,
- 19 in Germany,
- three in France,
- five in Sweden,
- seven in Finland,
- two in Denmark,
- two in Austria,
- and two in Norway.
- Croatia, Slovenia, Spain and Switzerland have all reported one case each.
(?)
ECDC assessment
This is the first known occurrence of locally transmitted dengue infection in the Autonomous Region of Madeira, and consequently a new geographical area reporting autochthonous cases in the EU. This is a significant public health event but not entirely unexpected because of the known presence of Aedes aegypti, a competent vector for dengue.
The updated figures indicate that the outbreak has peaked, with a decrease in the number of cases being reported since mid-November.
Entomological surveillance has shown a decrease in mosquito activity as well.
The cases of dengue among returning travellers from the island highlight the need for travellers to Madeira to take measures in order to reduce mosquito bites.
Travellers experiencing febrile symptoms with severe headache, retro-orbital pain, myalgia, arthralgia and maculo-papular rash within 21 days of visiting the island of Madeira are advised to seek medical advice.
Neighbouring geographical areas (e.g. Canary Islands) and other EU Member States need to assess the risk of establishment of Aedes mosquito populations and the introduction of dengue.
The epidemiological situation does not imply the need for any trade or travel restriction beyond the disinfestation policies currently implemented.
Actions
ECDC published an updated rapid risk assessment concerning the autochthonous dengue cases in Madeira.
Portuguese authorities published recommendations regarding personal protective measures, and measures for the safety of blood, cells, tissues and organ donations within the region.
Blood donor deferral for 28 days from day of departure for travellers returning from the Autonomous region of Madeira is now recommended in other EU countries.
(?)
Dengue - Multistate (world) - Monitoring seasonal epidemics
Opening date: 20 April 2006 Latest update: 7 February 2013
Epidemiological summary
Europe: There have been no reports of confirmed autochthonous dengue infections in Europe in 2013, besides the on-going dengue outbreak in Madeira.
Asia: There is no new update from WHO Western Pacific Region this week.
Latin America: A notable dengue activity is reported across Central America this week. In Mexico, overall dengue activity remains high but there has been a recent declining trend across some states. For South America, an overall high dengue activity is reported across Brazil, Colombia, Bolivia, Ecuador and Paraguay. Uruguay has reported a limited number of cases this week.
According to media reports in Montevideo, Uruguay, local health authorities have confirmed that all suspected cases of indigenous dengue in the country have proven to be negative following analysis. There is relatively strong dengue activity reported this week in French Guyana (French Overseas Department). The two main serotypes co-circulating are DENV-2 and DENV-4, but predominantly DENV-2.
The Caribbean: There is no new update from the CDC on the dengue situation in Puerto Rico. The Cayman Islands is experiencing increased dengue activity with 23 suspected cases so far this year. An epidemiological update from InVS this week indicates an elevated risk of a dengue epidemic in St. Martin.
(?)
ECDC assessment
ECDC monitors individual outbreaks, seasonal transmission patterns and inter-annual epidemic cycles of dengue through epidemic intelligence activities in order to identify significant changes in disease epidemiology.
Of particular concern is the potential for the establishment of dengue transmission in Europe. Before the current outbreak in the Autonomous Region of Madeira, local transmission of dengue was reported for the first time in France and Croatia in 2010.
Imported cases are detected in European countries highlighting the risk of locally acquired cases occurring in countries where the competent vectors are present.
Actions
ECDC has published a technical report on the climatic suitability for dengue transmission in continental Europe and guidance for invasive mosquitoes? surveillance.
(?)
-
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