EID Updates:

Emerging and Reemerging Infectious Diseases,
Region of the Americas

Vol. 3, No. 2 (31 October 2006)                             Main Updates index

Dengue Outbreak in El Salvador, 2006

San Salvador: The government of El Salvador declared a state of emergency in several regions of the country, including San Salvador, in their response to dealing with the dengue epidemic that has already taken the lives of two children. As of 22 August 2006, a 'yellow alert' remained in force in the departments of San Salvador, La Libertad and Sonsonete, where 70% of the cases have been concentrated.

The Ministry of Public Health and Social Welfare (Ministerio de Salud Pública y Asistencia Social / MSPAS) of El Salvador reported that over US$ 4,246,000 have been allocated from the Health Solidarity Fund (Fondo Solidario para la Salud / FOSALUD) for clinical care, vector-control activities, purchasing ovitraps, mass communication and information-dissemination campaigns, and hiring 149 contractors for related field operations.

Support is being provided by the Ministry of the Defense, through the Armed Forces, where 180 soldiers are involved in distributing supplies and fumigating. Their base of operations is located at the Metropolitan Area Technical Team facilities.

Overcrowding, problems with public provision of drinking water, and the absence of good hygiene practices—coupled with the presence of a large number of vector breeding sites in domiciliary and peridomiciliary areas—all characterize those places where the most cases have been reported, according to experts.

Authorities from the Ministry of Health (MSPAS) emphasized once more that the population should play a more active role in preventing dengue, eliminating mosquito breeding sites, and practicing good hygiene at home, in addition to helping health workers do their job by willingly providing them access to their home and having somebody there who can let them in.

In fact, the entire Department of Sonsonete has become a concern for the Ministry of Health, since it once again stands out as one of the areas "most affected by dengue." The municipalities of Sonzacate, San Antonio del Monte, and their county seats—along with their shared border area—monopolized the case toll for the department, with 37 of the 55 cases.

Of the six Basic Integrated Health Systems (Sistemas Básicos de Salud Integral / SIBASI), Sonsonete is one department with a rate of over 50 cases per every 100,000 inhabitants. Also falling into this category are the municipalities of Nueva Concepción in Chalatenango Department, Centro and Soyapango in San Salvador, Suchitoto in Cuscatlán, and San Vicente.

Up to 4 October 2006 (during Epidemiological Week / EW 40), continual measures were taken to fight dengue, progressing from yellow to red alert in three departments. There were 1,032 suspected cases of dengue during the week of 20–26 August (EW 34), rising to 1,175 during the first week of September (EW 35) and falling to 722 during the week of 24–30 September (EW 39).

The cases confirmed over the past three weeks have fallen by 33%, dropping from 579 to 387 cases and then to 352 at national level. Two weeks ago, the reported percentage of samples testing positive for dengue was 53%; this week, it dropped to 43%. The 4 dengue serotypes are still circulating in San Salvador, with serotypes 1 and 2 circulating in Sonsonate and Santa Ana, and serotype 2 circulating in La Libertad.

The investment in vector-control activities, as well as in clinical care and social communication, has amounted to US$ 6.2 million. Interinstitutional collaboration has intensified in the departments under red alert, as well as in the cities of San Vicente, Cojutepeque, Santa Ana, and Chalchuapa, where activities have been carried out to enable the authorities to bring the outbreak under control in the most populated urban areas.

In 2005, National Dengue Day (Día Nacional contra el Dengue), held every 26 August, was proclaimed by the Legislative Assembly to "raise the level of awareness of the population as to the danger that such a disease represents, as well as to implement preventive government activities in the fight against dengue in El Salvador."

For EW 36/2006, 16,364 cumulative cases of dengue (D) and dengue hemorrhagic fever (DHF) were reported, with 186 cases of DHF and 3 deaths. For EW 38, 18,087 cumulative cases of D and DHF were reported—almost double that reported for the same epidemiological week in 2005, when there were 9,839 cases and no reports of deaths up to that week.

For EW 40/2006 (ending on 7 October), 19,443 cases were reported, of which 204 were dengue hemorrhagic fever, followed by 3 deaths.

Follow-up is being done on the implementation of the Integrated Strategy for Dengue Prevention and Control throughout the country.

Source: Ministry of Public Health and Social Welfare (MSPAS) of El Salvador: Press release of 4 October 2006 on the continuous activities being carried out within the framework of the red alert in effect in three departments (Acciones contra el dengue continua en el marco de alerta roja en tres departamentos); official epidemiological report; and a newsbrief published on National Dengue Day (Día Nacional contra el Dengue) (all documents in Spanish). Above text submitted by the PAHO Regional Program on Dengue based at PAHO-Panama and translated at PAHO Headquarters in Washington, DC.