Caribbean Dengue Force New Measures

Sept. 15, 2010, 9:55 a.m.

The island’s health secretary is requiring all doctors in this U.S. Caribbean territory undergo new training after federal authorities confirmed nearly a dozen more deaths related to the mosquito-born dengue virus, the Associated Press reports. Thousands of doctors ranging from pediatricians to gynecologists will have to take courses on how to prevent, detect, manage and treat dengue, which has killed dozens of people in the Caribbean this year, including 18 in Puerto Rico. Another 14 deaths in the island are under investigation and more than 11,000 cases have been reported. The island’s worse dengue outbreak occurred in 1998, when the virus killed 19 people and sickened 17,000.

“The situation is serious. It is critical,” Health Secretary Lorenzo Gonzalez said Friday at a press conference.

Dengue cases have surged across the Caribbean this year, with more than 80,000 reported in the region as of early September, according to the Pan American Health Organization.

The virus even struck Suriname’s new president, former dictator Desi Bouterse, who recently ceded power to his vice president for a week while he recovered.

Health authorities blame warm weather and an unusually early rainy season, but officials in Puerto Rico also blame doctors for not providing appropriate follow-up care and patients who dismiss symptoms until they are critically ill.

Many patients leave the hospital when their fever drops, but that is when they are most at risk of becoming even sicker, Gonzalez said.

And some patients do not bother to see a doctor when they should, said Kay Tomashek, epidemiology section chief of the Centers for Disease Control and Prevention’s dengue branch in Puerto Rico.

“We encourage adults not to be stoic and to show up when they’re sick,” she said.

Most of Puerto Rico’s dengue cases are concentrated in the island’s northwest and southeast regions, and the government worries more deaths will occur because dengue cases usually peak around October.

Elsewhere in the Caribbean, officials are warning people to protect themselves from mosquitoes as the number of cases keep climbing, especially in Guadeloupe, French Guiana and the Dominican Republic, which is reporting 41 deaths and nearly 9,000 cases. At the same time last year, it had reported only 3,000 cases and 27 deaths.

Nelson Rodriguez, a vice minister within the Dominican Ministry of Health, blamed the deaths on doctors not diagnosing the virus in time.

In Trinidad, health officials have reported 1,200 cases and four deaths. They also have added dozens of new hospital beds to make room for patients. Jamaica, meanwhile, has seen an uptick with 729 suspected cases.

Tomashek, with the CDC, said Central and South America are showing a similar pattern, with Colombia reporting the largest dengue outbreak in the country’s history.

Dengue causes fever, headaches and severe joint and muscle pain. Most victims recover within a week, but it can be life-threatening.

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