Preventing disease Promoting and protecting health

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1 Preventing disease Promoting and protecting health

2 DENGUE IN THE CARIBBEAN: A REGIONAL OVERVIEW Dr Babatunde Olowokure Director Surveillance, Disease Prevention & Control Division CARPHA

3 Dengue and Severe Dengue Dengue is a viral disease transmitted by the bite of infected Aedes aegypti/aedes albopictus mosquitoes. From 1995 to 2013, more than 30 countries in the Americas have reported a total of 14,478,637 cases of dengue The number of cases of severe dengue in the same period was 330,019. The total number of deaths from 1995 to 2013 was 2,865. The four dengue serotypes (DENV-1, 2, 3, and 4) are circulating in the Region Source: PAHO, 2014

4 Dengue: First outbreaks in the Americas : The first dengue epidemics occurred in Martinique and Guadeloupe. 1780: Benjamin Rush described a large outbreak in Philadelphia, Pennsylvania in the United States. 1827: First outbreak multicountry (Virgin Islands, Cuba, Jamaica, Venezuela and cities in the United States.) 1912: Epidemi of dengue fever in Panama, Chile and Argentina North

5 Dengue in the Americas ,000,000 2,500,000 2,000,000 1,500,000 1,000,000 Year 1981 CUBA 344, , Source: Annual country reports to PAHO

6 Dengue in the Caribbean Dengue 140, , ,000 80,000 60,000 40,000 20, DHF Source: PAHO 2014

7 Dengue deaths in Hispanic vs non-hispanic Caribbean countries Non Hispanic countries Hispanic countries

8

9 Circulating dengue serotypes,

10 Reasons for Dengue Spread Dengue continues to spread despite control efforts due to uncontrolled, unplanned urbanization, lack of basic services in communities, poor environmental management, Insufficient resources for national vector control programmes High infestation levels of Aedes aegypti, climate change, among other reasons.

11 Social and economic determinants contribute to situations such as these: Illicit dumping of solid waste No measures available to address disposal of used tyres

12 Social and economic determinants contribute to situations such as these:

13 Other determinants include: Incorrect application of insecticides Few insecticides available for use in public health Insecticide resistance in Aedes aegypti populations

14 Dengue - Surveillance and Response Prevention and response involves the development and implementation of preparedness plans. Plans should include: Epidemiological, entomological and environmental surveillance Early warning systems Laboratory support Clinical case management Environmental controls Risk communication Social mobilization

15 Monitoring and Evaluation! The weakest link! Core indicators! Number of suspected dengue fever cases! Number of severe dengue cases! Number of deaths from suspected and confirmed severe dengue;! Number of cases confirmed by the laboratory! Serotype in circulation! Entomological indicators! Transmission threshold! Container productivity levels

16 Epidemiological surveillance Social communication Integrated vector managmenet Laboratory Environment Case management

17 THANK YOU

Data are presented below for those countries where the magnitude of the outbreak has taken on special importance in recent months.

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