Conflicting reports about dengue fever in Yemen [Archives:2005/820/Health]

February 28 2005

Mohammed bin Sallam
The Ministry of Public Health and Population and the World Health Organization have denied reports by different media outlets that 30 people have died in Hodeida as a result of dengue fever.

Deputy Minister of Public Health and Population, Dr. Majed al-Junaid says that priority should be given to health care particularly after seven people were reported dead since the emergence of the epidemic.

Al-Junaid pointed out that 90 cases were reported in Zabeed District between December15, 2004 and January 15, 2005, adding that medical tests conducted at the Sana'a Central Laboratory for many samples and reconfirmed at laboratories in Cairo revealed the proliferation of a third-kind dengue fever in the district of Zabeed.

The Ministry of Public Health issued a circulation to all Yemeni governorates to be alert.

The concerned authorities at the Ministry of Health are closely monitoring the possible spread of the so called dengue fever, which was discovered in Dec. 2004 in a number of coastal areas including Tahama and Shabwa, Dr. Majed Al-Junaid Deputy Minister of Health said to the Yemen Times a few days ago.

Dr. al-Junaid added that such fever is a virus disease causing partial fever and then a fatal bleeding, and its symptoms are similar to that of malaria. This disease is new to Yemen.

During the previous period, the Ministry of Health registered the dengue infected cases and dealt with them immediately. The ministry was informed of the existence of the disease in last December as well as some death cases were reported particularly in Zabid.

In return, the Ministry of Health took a quick action and formed teams to observe the epidemic -infected cases in cooperation with the Hodeida Health Office and the local security. A thorough surveillance was carried out by the Ministry of Health all over the Hodeida Governorate and found out certain places where the infection exists, and we are still following up the surveillance in other governorates, the minister said.

It is known that the main carrier of the disease is the mosquito which also carries the infection of malaria. The spray processes have been implemented so far in order to fight the spread of the mosquito and the infected cases have been transferred to hospitals, according to sources at the Ministry of Health.

“We requested technical support from World Health Organization's Representative and he is now on the way to Hodeida,” Dr. al-Junaid noted. “The situation seemed to be stable enough as we controlled the places where the infection is terribly proliferating. The death cases have not exceeded five since the epidemic was first discovered in December, 2004.”

Asked whether the disease has been existing in Yemen for a long time without any action taken by the concerned authorities, Dr. al-Junaid replied: “the epidemic was existing in Yemen and procedures were taken several years ago, and Hodeida along with Shabwa were found to be the severely infected areas. Not even a single case was reported to the concerned authorities”.

We are closely making a survey of the suffering cases to spot the places where the infection spreads in order to take preventive measures and explore the actual reasons behind the epidemic, Dr. al-Junaid added.

Dengue [DEN-ghee] is a flu-like viral disease spread by the bite of infected mosquitoes. Dengue hemorrhagic fever is a severe, often fatal, complication of dengue. Dengue occurs in most tropical areas of the world. Most U.S. cases occur in travelers returning from abroad, but the dengue risk is increasing for persons living along the Texas-Mexico border and in other parts of the southern United States. There is no specific treatment for dengue. Prevention centers on avoiding mosquito bites in areas where dengue occurs or might occur and eliminating breeding sites. Dengue and dengue hemorrhagic fever are caused by any of the dengue family of viruses. Infection with one virus does not protect a person against infection with another.Dengue is spread by the bite of an Aedes mosquito. The mosquito transmits the disease by biting an infected person and then biting someone else.Dengue viruses occur in most tropical areas of the world. Dengue is common in Africa, Asia, the Pacific, Australia, and the Americas. It is widespread in the Caribbean basin. Dengue is most common in cities but can be found in rural areas. It is rarely found in mountainous areas above 4,000 feet.The mosquitoes that transmit dengue live among humans and breed in discarded tires, flower pots, old oil drums, and water storage containers close to human dwellings. Unlike the mosquitoes that cause malaria, dengue mosquitoes bite during the day.

Dengue fever usually starts suddenly with a high fever, rash, severe headache, pain behind the eyes, and muscle and joint pain. The severity of the joint pain has given dengue the name “breakbone fever.” Nausea, vomiting, and loss of appetite are common. A rash usually appears 3 to 4 days after the start of the fever. The illness can last up to 10 days, but complete recovery can take as long as a month. Older children and adults are usually sicker than young children.

Most dengue infections result in relatively mild illness, but some can progress to dengue hemorrhagic fever. With dengue hemorrhagic fever, the blood vessels start to leak and cause bleeding from the nose, mouth, and gums. Bruising can be a sign of bleeding inside the body. Without prompt treatment, the blood vessels can collapse, causing shock (dengue shock syndrome). Dengue hemorrhagic fever is fatal in about 5 percent of cases, mostly among children and young adults.

The time between the bite of a mosquito carrying dengue virus and the start of symptoms averages 4 to 6 days, with a range of 3 to 14 days. An infected person cannot spread the infection to other persons but can be a source of dengue virus for mosquitoes for about 6 days.

Anyone who is bitten by an infected mosquito can get dengue fever. Risk factors for dengue hemorrhagic fever include a person's age and immune status, as well as the type of infecting virus. Persons who were previously infected with one or more types of dengue virus are thought to be at greater risk for developing dengue hemorrhagic fever if infected again.

There is no specific treatment for dengue. Persons with dengue fever should rest and drink plenty of fluids. They should be kept away from mosquitoes for the protection of others. Dengue hemorrhagic fever is treated by replacing lost fluids. Some patients need transfusions to control bleeding.

In tropical countries around the world, dengue is one of the most common viral diseases spread to humans by mosquitoes.

Tens of millions of cases of dengue fever and up to hundreds of thousands of cases of dengue hemorrhagic fever occur each year.All types of dengue virus are re-emerging worldwide and causing larger and more frequent epidemics, especially in cities in the tropics.

The emergence of dengue as a major public health problem has been most dramatic in the western hemisphere. Dengue fever has reached epidemic levels in Central America and is threatening the United States.