Description of the current epidemiological trends of dengue in the Americas
In 2013, dengue behaved like a classic epidemic for the Americas region, with the largest historical cases reported. In total, countries in the Americas reported more than 2.3 million cases of dengue, with 37,692 cases of severe dengue and 1,280 deaths, for a mortality rate of about 0.05%. The average incidence rate of dengue for the year was 430.8 per 100,000 inhabitants. Circulation of all four serotypes was reported in the region with the simultaneous movement of all of four in 11 countries and / or territories.
Up to the 8th epidemiological week in 2014, a total of 73,763 dengue cases have been reported across the continent. The Andean subregion reported 29,727 cases of dengue, the highest number reported in 2014 with an incidence rate of 27.6 per 100,000 inhabitants, followed by 22,714 cases in South Cone, and 18,988 cases in North America, Mexico and Central America. The number of reported cases follow a similar pattern seen in the first half of previous years. In the region, 1,264 cases of severe dengue cases with 25 deaths have been reported, with an average of 0.03% mortality. The countries that reported dengue deaths in 2014 included Peru (9), Panama (6), Dominican Republic (5), Brazil (4), and Paraguay (1). The four serotypes of the dengue virus are circulating throughout the continent, and currently Mexico, Nicaragua, Peru and Venezuela have confirmed the simultaneous movement of all four.
:: The Epidemiology of Dengue in the Americas Over the Last Three Decades: A Worrisome Reality Copyright © 2010 by The American Society of Tropical Medicine and Hygiene.
This year, Nicaragua, Panama and Venezuela are the countries in the region that have been affected by large outbreaks of dengue, even before the beginning of the rainy season (May). Nicaragua has reported a total of 8,178 cases and an incidence rate of 157 per 100,000 inhabitants, but has not reported any severe dengue or deaths. Venezuela, meanwhile, has reported a total of 10,883 cases, an incidence rate of 50.4 per 100,000 inhabitants, including 36 severe dengue cases but no deaths from the disease. Panama has reported 2,859 total cases of dengue, an incidence rate of 80.4 per 100,000 inhabitants, with 13 severe dengue cases, 6 deaths, and a mortality rate of 0.21%. These early outbreak situations should alert these countries because they may experience severe epidemics from May –June, the rainy months historical for outbreaks. The rest of the continent should increase surveillance measures and timely response to any unusual increase.
The problems of water supply and an inadequate system of sewage disposal, coupled with the lack of environmental management in homes and surroundings, are problems that greatly facilitate the proliferation of mosquito breeding sites of this disease. Every action taken by the individual, community, public health authorities and regional government to improve the current conditions will have a direct effect on reducing the risk of dengue transmission and morbidity.
PAHO / WHO continues advising all countries to intensify technical measures for prevention and control of dengue, based on the Integrated Strategy (EGI-Dengue) countries implemented. In February 2014 there was meeting in Panama to implement the Model Integrated Epidemiological Surveillance of Dengue, which included the participation of 8 countries in the region, whose in the upcoming months will have responsibility for progress evaluation. This model will standardize surveillance making the data comparable across countries and allowing better analysis of the patterns of the disease.
Finally countries are encourage to make every effort to ensure the implementation of the new PAHO / WHO Patient Care Guide in order to minimize deaths from dengue.