DENGUE IN EL SALVADOR

In recent months dengue has gotten worse in El Salvador, a trend that has turned combating the disease into a national priority. According to the PAHO/WHO Representative in El Salvador, by June 15, the number of clinical cases of Dengue reached 1301 (an incidence rate of 20.28 per 100 thousand population), 92% (1200) of which are the classical type and 8% (101) are of dengue hemorrhagic fever (DHF). Children between the ages of 5 and 9 years are most affected. To date, six children have died, four of whom have been confirmed, while the status of the other two is currently under study.

During the last 7 years, only dengue serotype DEN-2 has been reported in El Salvador; now DEN-1 has been detected, a development that increases the risk of DHF. The country has not reported DEN serotype in three years, nor have they reported serotype DEN-4 in the past six years.

In light of this situation, the President of El Salvador has declared a state of emergency in the departments of San Salvador, Libertad, Santa Ana, and Cabañas, and a yellow alert in the rest of the country. A field Command Post has been established, incorporating Ministries of Health, Education, Government, National Police and representatives of Municipalities. It has implemented CONADENGUE as an example of the authorities' important effort in the struggle against Dengue.

Activities aimed at control include day and night sprayings, which are being intensified by army personnel, while brigades from schools, universities and communities help with the mechanical destruction of larval breeding sites. Additional activities have focused on the dissemination of information, increased communication, and face to face education, with the participation of radio and television networks. Furthermore, support has been received from Mexico. A contingent of three experts has arrived, and seven vehicles equipped with ULV (Ultra-low volume) equipment are on the way.

The PAHO/WHO Office in El Salvador is helping with these efforts and has offered public educational information on the disease and suggestions on how to combat the outbreak. Moreover, PAHO is offering support in the purchase of larvicide, and is coordinating with the Mexican cooperation.

El Salvador has a significant susceptible population, particularly among children under five years of age, who have been exposed the DEN-2 serotype over the past few years. The Aedes aegypti infestation indices (which were very high the last time reported) and rains (we are entering the wet season) may affect the severity of the problem in the near future.