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Dengue in the Americas and Caribbean (Update 2)

30 August 2017

An update from the Pan American Health Organisation/World Health Organisation Link on 28 August 2017 shows dengue remains widespread in the Americas and Caribbean. The countries with the highest number of probable cases (including confirmed) are Brazil (210 627), Peru (71 447), Nicaragua (43 956), Colombia (18 526) and Ecuador (9 713).

Incidence (cases per 100 000 population) is highest in Nicaragua (702.51), Aruba (590.18) and Saint Barthélemy (331.13), Turks & Caicos Islands (314.00) and St Martin (278.05).

PAHO/WHO probable case numbers for dengue include confirmed cases. Area headings are those used by PAHO/WHO.

North America

United States: 93 probable cases, 93 confirmed (incidence 0.03/100 000)

Central America & Mexico

Belize: 4 probable, 4 confirmed (incidence 1.15/100 000)

Costa Rica: 3 458 probable, 0 confirmed (incidence 69.13/100 000)

El Salvador: 2 539 probable, 104 confirmed (incidence 39.51/100 000)

Guatemala: 2 061 probable, 386 confirmed (incidence 12.68/100 000)

Honduras: 3 877 probable, 0 confirmed (incidence 44.46/100 000)

Mexico: 7 073 probable, 3 014 confirmed (incidence 5.65/100 000)

Nicaragua: 43 956 probable, 1 665 confirmed (incidence 702.51/100 000)

Andean

Panama: 4 232 probable, 1 943 confirmed (incidence 106.12/100 000)

Bolivia: 7 910 probable, 0 confirmed (incidence 71.75/100 000)

Colombia: 18 526 probable, 8 357 confirmed (incidence 37.4/100 000)

Ecuador: 9 713 probable, 9 713 confirmed (incidence 59.86/100 000)

Peru: 71 447 probable, 23 358 confirmed (incidence 229.28/100 000)

Venezuela: 2 722 probable, 309 confirmed (incidence 8.77/100 000)

Southern Cone

Argentina: 7 618 probable, 254 confirmed (incidence 121/100 000)

Brazil: 210 627 probable, 0 confirmed (incidence 103.42/100 000)

Chile: 5 probable, 5 confirmed (incidence 0.03/100 000)

Paraguay: 1 327 probable, 305 confirmed (incidence 18.87/100 000)

Hispanic Caribbean

Cuba: 270 probable, 0 confirmed (incidence 2.4/100 000)

Dominican Republic: 729 probable, 0 confirmed (incidence 6.84/100 000)

Puerto Rico: 9 probable, 9 confirmed (incidence 0.24/100 000)

English, French & Dutch Caribbean

American Virgin Islands: 1 probable, 1 confirmed (incidence 0.96/100 000)

Anguilla: 15 probable, 2 confirmed (incidence 93.75/100 000)

Antigua & Barbuda: 1 probable, 0 confirmed (incidence 1.09/100 000)

Aruba: 661 probable, 8 confirmed (incidence 590.18/100 000)

Bahamas: 4 probable, 0 confirmed (incidence 1.03/100 000)

Barbados: 151 probable, 29 confirmed (incidence 51.89/100 000)

British Virgin Islands: 28 probable, 28 confirmed (incidence 84.85/100 000)

Cayman Islands: 12 probable, 0 confirmed (incidence 21.43/100 000)

Dominica: 22 probable, 0 confirmed (incidence 29.73/100 000)

French Guiana: 165 probable, 0 confirmed (incidence 69.04/100 000)

Grenada: 59 probable, 59 confirmed (incidence 53.15/100 000)

Guadaloupe: 83 probable, 0 confirmed (incidence 20.19/100 000)

Jamaica: 64 probable,11 confirmed (incidence 2.28/100 000)

Martinique: 73 probable, 1 confirmed (incidence 18.34/100 000)

Saint Barthélemy: 30 probable, 0 confirmed (incidence 331.13/100 000)

St. Kitts & Nevis: 4 probable, 0 confirmed (incidence 7.69/100 000)

St. Lucia: 14 probable,14 confirmed (incidence 8.54/100 000)

St. Martin: 114 probable, 0 confirmed (incidence 278.05/100 000)

St. Vincent & the Grenadines: 2 probable, 1 confirmed (1.94/100 000)

Trinidad & Tobago: 61 probable, 0 confirmed (incidence 4.53/100 000)

Turks & Caicos Islands: 157 probable, 157 confirmed (incidence 314/100 000)

Advice for Travellers

Dengue is the second most common identified cause of febrile illness in returning travellers and the number of cases in travellers continues to increase. All travellers to endemic regions are potentially at risk of dengue fever and should be aware of this infection. Prevention relies on avoiding mosquito bites.

Aedes mosquitoes are particularly persistent and aggressive and bite between dawn and dusk.
Methods of bite avoidance include:

• Wearing long, loose, lightly coloured clothing to cover up the skin during the day.
• The use of insect repellent containing DEET applied to any exposed skin between dawn and dusk.
• When sunscreen and DEET are used together, DEET should be applied after sunscreen. The effectiveness of repellent reduces more rapidly than sunscreen, therefore, repellent may have to be reapplied on top of sunscreen.
• The use of permethrin, impregnated mosquito nets protects against early morning bites and should also be used when sleeping during the day.
• The use of air conditioning if available and/or mesh screening of windows and doors.
• Eradication of mosquito breeding sites around accommodation/home (e.g. open containers, old tyres or flower pots that may collect water).

Vaccine

There is no vaccine against dengue fever licensed in the UK.

At present the World Health Organisation (WHO) is trialling several candidate vaccines against dengue fever.

  • Dengvaxia®, developed by Sanofi Pasteur MSD, is the first vaccine to be licensed for the prevention of dengue.
    • It is a live, attenuated, recombinant, tetravalent vaccine approved for use in people 9–45 years of age living in highly endemic regions on a 3 dose schedule.
    • Prior dengue infection increases the efficacy of the vaccine; efficacy is reduced in populations with low previous exposure to dengue and may lead to increased rates of hospitalisation due to severe dengue.
    • Mexico, Costa Rica, the Phillippines and Brazil are the first countries to have granted marketing authorization for Dengvaxia®

For further information see Dengue Fever.