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Re-emergence of Dengue Fever IN THE FLORIDA KEYS

Re-emergence of Dengue Fever IN THE FLORIDA KEYS. Lucy Danso - Odei , MPH student Walden University PUBH 6165-2. Environmental Health Instructor: Dr. Howard Rubin Summer Term, 2010. Presentation is for Residents and Visitors of the Florida Keys. Agenda. Introduction The Florida Keys

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Re-emergence of Dengue Fever IN THE FLORIDA KEYS

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  1. Re-emergence of Dengue Fever IN THE FLORIDA KEYS Lucy Danso- Odei, MPH student Walden University PUBH 6165-2. Environmental Health Instructor: Dr. Howard Rubin Summer Term, 2010

  2. Presentation is for Residents and Visitors of the Florida Keys

  3. Agenda Introduction The Florida Keys The Dengue Virus -serotypes -mode of transmission -re-emergence of disease Prevalence Dengue Fever

  4. Agenda Dengue Hemorrhagic Fever (DHF) Dengue Shock Syndrome (DSS) Preventive Methods Treatment Conclusion References Further reading

  5. I. Introduction to Dengue Fever • Affects at least 50 million people every year. (WHO, 2008). • Endemic in over 100 countries. (Teo, Ng & Lam, 2009, p.66). • 2.5% of 500,000 hospitalized, die yearly. (WHO, • 2008). • Over 2.5 billion people worldwide at risk. (CDC, 2008).

  6. II. The Florida Keys Climate is similar to that of the Carribean Islands. Superb weather conditions offer a tropical vacation. Florida has an abundance of mosquitoes. Mosquito spraying programs are not popular. Reference: NPR NEWS (2010). Dengue Fever in Florida Portends A Growing Problem. Retrieved from http://www.npr.org/blogs/health/2010/05/20/127016467/dengue-fever-outbreak-in-florida-portends-a-growing-problem

  7. II. Cont’d: The Florida Keys • Abundance of mosquito breeding sites . With permission from Joe Raedle, Getty Images Lawrence Smart from Miami-Dade Mosquito Control looks for mosquito larvae in vehicle tires where water has collected so he can eradicate them on July 16 in Miami Beach, Fla. Cases of dengue fever have been found in Key West and other parts of the state. Reference: NPR NEWS, (2010). Dengue Fever in Florida Portends A Growing Problem. Retrieved from http://www.npr.org/blogs/health/2010/05/20/127016467/dengue-fever-outbreak-in-florida-portends-a-growing-problem

  8. III. The Dengue Virus Definition • A Flaviviridaevirus • Small and lipid-enveloped • A positive-stranded RNA virus.

  9. III. Cont’d: The Dengue Virus Serotypes • DEN-1 • DEN-2 • DEN-3 • DEN-4 Picture, courtesy of Google Images Reference: Teo, D., Ng, L., & Lam, S. (2009). Is dengue a threat to the blood supply?. Transfusion Medicine, 19(2), 66-77. doi:10.1111/j.1365-3148.2009.00916.x.

  10. III. Cont’d: The Dengue Virus Mode of Transmission Through • mosquito bites. • blood transfusion • organ transplantation.

  11. III. Cont’d: The Dengue Virus Re-emergence is due to: • Increased Aedes mosquito population • Expanding geographic distribution of mosquito vectors • Multiple serotypes • A viremic returning traveler Reference: Center for Disease Control, (2008). Retrieved September 2008 fromhttp://www.cdc.gov/NCIDOD/DVBID/DENGUE/. Accessed September 2008.

  12. IV. Prevalence • At least 50 million people affected every year. (WHO, 2008). • Dengue hemorrhagic fever (DHF) is endemic in over 100 countries. (Teo, Ng & Lam, 2009). • 100 million cases of Dengue Fever (DF) reported annually. (WHO, 2008). • Over 2.5 billion people worldwide live in areas potentially at risk for dengue. (CDC, 2008). Reference: • Centre for Disease Control, (2008) Retrieved September, 2008 from http://www.cdc.gov/NCIDOD/DVBID/DENGUE/. • Teo, D., Ng, L., & Lam, S. (2009). Is dengue a threat to the blood supply?. Transfusion Medicine, 19(2), 66-77. doi:10.1111/j.1365-3148.2009.00916.x.  • World Health Organization, (2008). Dengue and Dengue Hemorrhagic Fever. WHO Fact Sheet. WHO, Geneva.

  13. V. Dengue Fever • Incubation period - between 3-8 days . • Full recovery generally after 7-10 days. • Age determines clinical symptoms. • Fever ≥ 39 degrees Celsius. • Retro-orbital pain, myalgia, arthralgia, nausea, vomiting. Reference: World Health Organization. (2004). Dengue fever in Indonesia. Accessed October 12, 2004 from http://www.who.int/csr/don/2004_02_26a/en;

  14. VI. Dengue Hemorrhagic Fever (DHF) • An acute febrile illness • Bleeding is characteristic. • Results in thrombocytopenia and plasma leakage. Reference: World Health Organization. (2004). Dengue fever in Indonesia. AccessedOctober 12, 2004 from http://www.who.int/csr/don/2004_02_26a/en;

  15. VII. Dengue Shock Syndrome (DSS) • DHF may result in DSS. • Characterized by circulatory failure. • Death can occur within 12 to 24 hours Reference: World Health Organization. (2004). Dengue fever in Indonesia. Accessed October 12, 2004 from http://www.who.int/csr/don/2004_02_26a/en;

  16. VIII. Dengue And Blood Donor Availability • Infected people cannot donate blood. • Screening tests for dengue are available. • Effective pathogen reduction processes for blood supply also available. Reference: Teo, D., Ng, L., & Lam, S. (2009). Is dengue a threat to the blood supply? Transfusion Medicine, 19(2), 66-77. doi:10.1111/j.1365-3148.2009.00916.x.

  17. IX. Preventive Methods • Elimination of mosquito-breeding places. • Implementation of good surveillance systems. • Development of effective vaccines. • Live-attenuated tetravalent dengue vaccines also being developed. Reference: World Health Organization. (2004). Dengue fever in Indonesia. AccessedOctober 12, 2004 from http://www.who.int/csr/don/2004_02_26a/en;

  18. X. Treatment • Supportive care. • Fluid volume maintenance. • Electrolyte balance monitoring. • Platelet transfusion. Reference: World Health Organization. (2004). Dengue fever in Indonesia. AccessedOctober 12, 2004 from http://www.who.int/csr/don/2004_02_26a/en;

  19. XI. Conclusion • 5% of Key West population infected in 2009. • Florida Keys has 28 cases of dengue fever. • Absence of mosquito control program. • Florida Keys has abundance of mosquitoes. • Florida – a popular vacation destination.

  20. Questions

  21. References • AOL News, (2010). Dengue Fever Cases Reported in Parts of Florida. Retrieved from http://www.aolnews.com/article/florida-has-new-problem-dengue-fever/19567294 • Center for Disease Control, (2008). Retrieved September 2008 fromhttp://www.cdc.gov/NCIDOD/DVBID/DENGUE/. Accessed September 2008 • Gurugama, P., Garg, P., Perera, J., Wijewickrama, A., & Seneviratne, S. (2010). DENGUE VIRAL INFECTIONS. Indian Journal of Dermatology, 55(1), 68-78. doi:10.4103/0019-5154.60357. NPR NEWS (2010). Dengue Fever in Florida Portends A Growing Problem. Retrieved from http://www.npr.org/blogs/health/2010/05/20/127016467/dengue-fever-outbreak-in-florida-portends-a-growing-problem • Ranjit, S., Kissoon, N., & Shamarao, S. (2009). Dengue viral infections and shock syndromes: An overview. Journal of Pediatric Infectious Diseases, 4(2), 107-117. doi:10.3233/JPI-2009-0164. • Reuters, (2010). More than 1,000 exposed to dengue in Florida: CDC. Retrieved from http://www.reuters.com/article/idUSTRE66C65X20100713

  22. References Cont’d • Sung, V., O'Brien, D., Matchett, E., Brown, G., & Torresi, J. (2003). Dengue Fever in Travelers Returning from Southeast Asia. Journal of Travel Medicine, 10(4), 208-213. Retrieved from Academic Search Complete database. • Teo, D., Ng, L., & Lam, S. (2009). Is dengue a threat to the blood supply? Transfusion Medicine, 19(2), 66-77. doi:10.1111/j.1365-3148.2009.00916.x. • World Health Organization. (2004). Dengue fever in Indonesia. Accessed October 12, 2004 from http://www.who.int/csr/don/2004_02_26a/en; • World Health Organization, (2008). Dengue and Dengue Hemorrhagic Fever. WHO Fact Sheet. WHO, Geneva. • Wilder-Smith, A., Chen, L., Massad, E., & Wilson, M. (2009). Threat of dengue to blood safety in dengue-endemic countries. Emerging Infectious Diseases, 15(1), 8-11. Retrieved from CINAHL Plus with Full Text database

  23. Further Reading For stories about survivors: • 'Indescribable, crazy pain': Surviving dengue fever. Retrieve from http://www.cnn.com/2010/HEALTH/07/22/dengue.fever/?hpt=Sbin For information about Prevention: • Dengue Prevention and Control Activities Receive a Boost, WHO, TDR News, No. 68, June 2002, available online at http://www.who.int/tdr/publications/tdrnews/news68/dengue.htm For general information • Reuters. Dengue fever cases in Singapore nears record level. Accessed October 12, 2004 http://www.reuters.com/printerFriendlyPopup.jhtml?type-healthNews&storyID_6292412. • Chinaview. (2004). Vietnam reports more dengue fever cases. Accessed October 12, 2004 at http://news.xinhuanet.com/english/2004-09/21/content_2001929.htm. • World Health Organization. Dengue. Accessed October 12, 2004 at http://www.who.int/tdr/dw/dengue2004.htm. • World Health Organization. Dengue and dengue haemorrhagic fever. Accessed October 12, 2004 at http://www.who.int/mediacentre/factsheets/fs117/ • Detailed advice on managing patients with DHF can be obtained at http://www.who.int/emc/diseases/ebola/Denguepublication/index.html

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