Barbados Doctors Battling Dengue Fever Outbreak.

Photo credit: PAHO. Standing water can provide a breeding ground for mosquitos that transmit dengue fever.
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Barbados, along with other Caribbean islands, is currently experiencing an outbreak of Dengue fever, with the number of suspected cases increasing on a daily basis according to a report from the Barbados Ministry of Health.

The Ministry of Health and Wellness is warning Barbadians to be aware of the signs of severe dengue as cases of dengue fever continue to rise–although the ministry has not published any numbers other than the number of deaths, which is zero.

However on October 7th the Chief Medical Officer, Dr. Kenneth George, said that the threshold was reached at the end of September, where 518 cases were recorded compared to the same period in 2022, when there were 241 cases.

The Ministry of Health and Wellness classifies both suspected and confirmed reports of dengue fever as “cases” for statistical purposes.

The mosquito-borne illness  is transmitted by the Aedes Aegypti mosquito.

The Pan American Health Organization (PAHO) has also advised that there have been outbreaks in Martinique and Guadeloupe in the Eastern Caribbean, with dengue virus serotype 2 resulting in some hospitalisations. There have also been recorded rising cases in the OECS, including Grenada.

The World Health Organization recently indicated that increased cases of mosquito-borne disease were likely in Europe, the United States of America and Africa, as a result of climate change (warmer, wetter and less reliable climate).

However, health authorities in Barbados are advising members of the public to implement routine measures to avoid contracting the illness, such as wearing repellent and protective clothing; eliminating breeding sites by keeping surroundings clean and removing standing water; and using protective window and door screens as well as mosquito nets in the home.

Dengue fever is caused by any one of four dengue virus (DENV) serotypes or strains. Each DENV strain could produce mild to severe illness.  According to research, persons with healthy immune systems can only get each strain once.

Senior Medical Officer of Health, Dr. Leslie Rollock, who is responsible for infectious diseases, environmental matters and surveillance, said dengue infection, regardless of the type, is indistinguishable.

According to her, it may be asymptomatic, which means the person has no symptoms.

But if it is symptomatic, most people would experience in the initial phase high fever, headache, pain, especially behind the eyes and on movement of the eyes; joint pains; skin rash, either all over the body or just over the joints; and upset stomach, which could lead to vomiting or diarrhoea. Symptoms usually last two to seven days.

If individuals continue to deteriorate after that, it is critical to look for the warning signs of severe dengue. Although less than one per cent of persons with severe dengue will die, Dr. Rollock emphasised that early detection and access to proper supportive medical care could save lives.

“When the fever starts to go down [in the initial phase], then the person feels worse. They get abdominal pain; if they had vomiting, it gets worse, and they may notice that their gums are bleeding. Their appetite may not return and they may get evidence that fluid is collecting in areas of the body; those are signs to go to your doctor and for your doctor to take note of, for admission because the warning signs may predict severe disease,” she explained.

The Senior Medical Officer of Health added that while anyone could get severe dengue, children and young persons were usually most affected during an outbreak.

“Even though a person may get the severe disease, they may not die if they are managed through that period, which is 24 to 48 hours in a hospital,” she said.

Persons with severe dengue may experience dehydration and excessive bleeding for which they would need urgent clinical care.

There is a vaccination for Dengue fever,  however the United States Center for Disease Control recommends dengue vaccination for children 9 through 16 years old, but only when they have been previously infected with dengue and living in areas where dengue is common.

This previous infection should be confirmed by laboratory testing.  This vaccine is different from other vaccines in that it is only recommended for people who have already been infected with dengue virus.

The reason is that children without previous dengue infection are at increased risk for severe dengue disease and hospitalization if they get dengue after they are vaccinated with Dengvaxia.  Therefore, evidence of a laboratory-confirmed previous dengue infection is required before vaccination.

Sources: Barbados Government Information Services, reliefweb.int, CDC.
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