On Monday, March 25th, Puerto Rico’s health secretary, Carlos Mellado, declared a dengue epidemic following a spike in cases. This decision was made by both the health secretary and epidemiology agency official, Melissa Marzán, mainly because this has been the eighth consecutive week that the agency's surveillance system has reported a number of cases higher than the epidemiological threshold.
Dengue, referred to as "break-bone fever" by the World Health Organization (WHO) is a mosquito-borne viral infection prevalent in tropical and subtropical regions. The virus can cause intense headaches, body aches, high fever, nausea, and rash, among other symptoms. Nevertheless, most infected individuals do not present symptoms. Most will get better in 1-2 weeks, however, some people do develop severe dengue and require immediate hospital care.
Symptoms
If symptoms occur, they usually begin 4-10 days after an infected mosquito has bitten you, and they typically last for 2-7 days. Symptoms may include:
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- High fever (40°C/104°F)
- Severe headache
- Pain behind the eyes
- Muscle and joint pains
- Nausea
- Vomiting
- Swollen glands
- Rash
People who are infected for the second time are at greater risk of severe dengue. Severe dengue symptoms often come 24-48 hours after the fever has gone away:
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- Severe abdominal pain
- Persistent vomiting (more than 3 in 24 hours)
- Rapid breathing
- Bleeding gums or nose
- Fatigue
- Restlessness
- Blood in vomit or stool
- Being very thirsty
- pale and cold skin
- Feeling weak
Prevention and Control
The best way to lower your risk of getting dengue is by protecting yourself from mosquito bites by using the following:
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- Breathable clothes that cover as much of your body as possible
- Window screens
- Mosquito repellents (containing DEET, Picaridian, or IR3535)
- Coils and vaporizers
- Ensure that there is no stagnant/puddled water in your surroundings. Some examples are: water buckets, pools, and empty tires.
The Health Department advises not to apply bug repellent on children’s hands or eyes, or visible cuts or irritated skin.
If you get dengue, it’s important to:
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- Rest
- Hydrate! Hydrate! Hydrate! Drink plenty of liquids
- Use acetaminophen (paracetamol) for pain
- Avoid non-steroidal anti-inflammatory drugs, like ibuprofen and aspirin
- Watch for severe symptoms and, if you're a member, contact us through your Spruce app as soon as they start
Diagnostics and Treatment
Most cases of dengue can be treated at home with pain medicine and fluids because there is no specific treatment for dengue. Remember that Pravan has a variety of intravenous hydration available. There is a vaccine called Dengvaxia for children and adolescents from ages 9 to 16 who have already had the virus. Nevertheless, in Puerto Rico, the vaccine is currently not available to our knowledge. The only way to confirm if you have dengue is through a blood test, however, if there are clear signs, a clinical diagnosis can be made and hospitals will begin treatment before results are received. This is sometimes due to delays (of up to a month or more) in receiving prompt test results.
The island has reported at least 549 cases so far this year, compared with 1,293 cases last year. The majority of cases have been reported in San Juan, the capital.
According to the island's Health Department, more than 340 people have been hospitalized for the mosquito-borne virus. Due to the increasing number of cases, Mellado also signed an emergency public health declaration. The order will enable access to more funds to strengthen all dengue surveillance systems.
Puerto Rico last declared a dengue epidemic in 2012. The Western Hemisphere has reported some 3 million cases so far this year, with health officials noting that higher rainfall along with humidity and heat linked to climate change have contributed to a rise in cases.
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