Dengue

[HereOnThePrimalEdge]

“We’re really trying to get the word out to the public,” said Hawaii State Epidemiologist Dr. Sarah Park. “Specifically about the prevention messages … to say, ‘It’s on you.’ It’s not just about waiting for the Department of Health to come spray. Because that’s not going to happen.

If we're on our own, wouldn't it help to tell us which areas to avoid? Where to concentrate our efforts?

Isn't this response from the health department like announcing there's a food-borne e-coli or salmonella outbreak, then not telling us which food to throw out? "Guess wisely. Good luck! It's all up to you!"

[kalakoa]

If we're on our own...

Why do we pay taxes to support State agencies that don't actually do anything for us?

(Yeah, I know.)

[kalakoa]

It just keeps getting better.

http://www.westhawaiitoday.com/news/loca...lmed-calls

We would like to encourage people not to contact the hospital directly. If they believe they are affected, this is an outpatient referral to a PCP (Primary Care Provider).

[HereOnThePrimalEdge]

State agencies that don't actually do anything for us?

Maybe we should just be happy they even told us? Who knows, one of the people who had their position eliminated might have been in charge of press releases and a Not-My-Job-Description worker is doing us a great big favor by picking up the phone for an interview with the HTH?

[kalakoa]

Maybe we should just be happy they even told us?

I assume State would have said nothing -- but once the outbreak reached the media, they had to say something, even if that amounts to "you're on your own" (like we didn't know that already).

[Obie]

quote:

---

Originally posted by HereOnThePrimalEdge

“We’re really trying to get the word out to the public,” said Hawaii State Epidemiologist Dr. Sarah Park. “Specifically about the prevention messages … to say, ‘It’s on you.’ It’s not just about waiting for the Department of Health to come spray. Because that’s not going to happen.

If we're on our own, wouldn't it help to tell us which areas to avoid? Where to concentrate our efforts?

Isn't this response from the health department like announcing there's a food-borne e-coli or salmonella outbreak, then not telling us which food to throw out? "Guess wisely. Good luck! It's all up to you!"

---

It could be anywhere an infected person has traveled !

A tourist on an around the island tour could have spread it island wide a worker at one of the west side resorts who commutes from the east side could spread it on either side.

Clean up standing water around your house and use insect repellent is the message they are trying to get out.

[Bullwinkle]

The world health organization seems to treat dengue as a flu like illness - its the severe version of the disease that causes fatalities (very small percentage become severe less than .01%)

from the WHO:Global burden of dengue
The incidence of dengue has grown dramatically around the world in recent decades. The actual numbers of dengue cases are underreported and many cases are misclassified. One recent estimate indicates 390 million dengue infections per year (95% credible interval 284–528 million), of which 96 million (67–136 million) manifest clinically (with any severity of disease).1 Another study, of the prevalence of dengue, estimates that 3900 million people, in 128 countries, are at risk of infection with dengue viruses.2

Member States in 3 WHO regions regularly report the annual number of cases. In 2010, nearly 2.4 million cases were reported. Although the full global burden of the disease is uncertain, the initiation of activities to record all dengue cases partly explains the sharp increase in the number of cases reported in recent years.

Other features of the disease include its epidemiological patterns, including hyper-endemicity of multiple dengue virus serotypes in many countries and the alarming impact on both human health and the global and national economies.

Before 1970, only 9 countries had experienced severe dengue epidemics. The disease is now endemic in more than 100 countries in the WHO regions of Africa, the Americas, the Eastern Mediterranean, South-East Asia and the Western Pacific. The America, South-East Asia and Western Pacific regions are the most seriously affected.

Cases across the Americas, South-East Asia and Western Pacific exceeded 1.2 million in 2008 and over 3 million in 2013 (based on official data submitted by Member States). Recently the number of reported cases has continued to increase. In 2013, 2.35 million cases of dengue were reported in the Americas alone, of which 37 687 cases were of severe dengue.

Not only is the number of cases increasing as the disease spreads to new areas, but explosive outbreaks are occurring. The threat of a possible outbreak of dengue fever now exists in Europe and local transmission of dengue was reported for the first time in France and Croatia in 2010 and imported cases were detected in 3 other European countries. In 2012, an outbreak of dengue on the Madeira islands of Portugal resulted in over 2000 cases and imported cases were detected in mainland Portugal and 10 other countries in Europe.

In 2013, cases have occurred in Florida (United States of America) and Yunnan province of China. Dengue also continues to affect several South American countries, notably Costa Rica, Honduras and Mexico. In Asia, Singapore has reported an increase in cases after a lapse of several years and outbreaks have also been reported in Laos. In 2014, trends indicate increases in the number of cases in the People's Republic of China, the Cook Islands, Fiji, Malaysia and Vanuatu, with Dengue Type 3 (DEN 3) affecting the Pacific Island countries after a lapse of over 10 years. Dengue was also reported in Japan after a lapse of over 70 years. In 2015 an increase in the number of cases was reported in Brazil and several neighbouring countries. The Pacific island countries of Fiji, Tonga and French Polynesia have continued to record cases.

part 2: he Aedes aegypti mosquito lives in urban habitats and breeds mostly in man-made containers. Unlike other mosquitoes Ae. aegypti is a day-time feeder; its peak biting periods are early in the morning and in the evening before dusk. Female Ae. aegypti bites multiple people during each feeding period.

Aedes albopictus, a secondary dengue vector in Asia, has spread to North America and Europe largely due to the international trade in used tyres (a breeding habitat) and other goods (e.g. lucky bamboo). Ae. albopictus is highly adaptive and, therefore, can survive in cooler temperate regions of Europe. Its spread is due to its tolerance to temperatures below freezing, hibernation, and ability to shelter in microhabitats.

Characteristics
Dengue fever is a severe, flu-like illness that affects infants, young children and adults, but seldom causes death.

Dengue should be suspected when a high fever (40°C/104°F) is accompanied by 2 of the following symptoms: severe headache, pain behind the eyes, muscle and joint pains, nausea, vomiting, swollen glands or rash. Symptoms usually last for 2–7 days, after an incubation period of 4–10 days after the bite from an infected mosquito.

Severe dengue is a potentially deadly complication due to plasma leaking, fluid accumulation, respiratory distress, severe bleeding, or organ impairment. Warning signs occur 3–7 days after the first symptoms in conjunction with a decrease in temperature (below 38°C/100°F) and include: severe abdominal pain, persistent vomiting, rapid breathing, bleeding gums, fatigue, restlessness and blood in vomit. The next 24–48 hours of the critical stage can be lethal; proper medical care is needed to avoid complications and risk of death.

Treatment
There is no specific treatment for dengue fever.

For severe dengue, medical care by physicians and nurses experienced with the effects and progression of the disease can save lives – decreasing mortality rates from more than 20% to less than 1%. Maintenance of the patient's body fluid volume is critical to severe dengue care.

Immunization
There is no vaccine to protect against dengue. However, major progress has been made in developing a vaccine against dengue/severe dengue. Three tetravalent live-attenuated vaccines are under development in phase II and phase III clinical trials, and 3 other vaccine candidates (based on subunit, DNA and purified inactivated virus platforms) are at earlier stages of clinical development. WHO provides technical advice and guidance to countries and private partners to support vaccine research and evaluation.

Prevention and control: Prevention and control
Havana: A local health worker uses a torch to check for signs of water and mosquito eggs inside tyres in a tyre depot.WHO/TDR/Crump
At present, the only method to control or prevent the transmission of dengue virus is to combat vector mosquitoes through:

preventing mosquitoes from accessing egg-laying habitats by environmental management and modification;
disposing of solid waste properly and removing artificial man-made habitats;
covering, emptying and cleaning of domestic water storage containers on a weekly basis;
applying appropriate insecticides to water storage outdoor containers;
using of personal household protection such as window screens, long-sleeved clothes, insecticide treated materials, coils and vaporizers;
improving community participation and mobilization for sustained vector control;
applying insecticides as space spraying during outbreaks as one of the emergency vector-control measures;
active monitoring and surveillance of vectors should be carried out to determine effectiveness of control interventions.

more info:http://www.who.int/mediacentre/factsheets/fs117/en/

[HereOnThePrimalEdge]

It could be anywhere an infected person has traveled !

That's true, but as any good epidemic or pandemic movie such as 12 Monkeys will tell you, it's important to find Patient Zero. Or Ground Zero for the outbreak. It provides necessary information to control the spread.

I would bet cash money that the dengue patients the Health Department managed to identify before they left the Big Island, are told not to travel until they test negative. "Especially to Oahu. Or Maui. A day trip to Puna this time of year might be nice though. Symptoms like ruby red skin rash and fatigue are kind of autumnal, like the change of colors in the fall (or after you fall as well, from the fatigue). Those Punatics might enjoy a seasonally appropriate malady."

[Bullwinkle]

Or were infected before they arrived .......Jury is still out as to where it came from

"The EIP is generally referenced as being 8–12 days [10], [11], based on two sets of experimental observations [12], [13]. In these experiments, no blood-fed mosquitoes were infectious until 8 days post exposure, but were infectious by 12 days post exposure. These observations have not however been incorporated into explicit statistical models, which have the advantage of being able to include cofactors, such as temperature, and to formally describe expected values, expected variability, and confidence in model parameters."

http://journals.plos.org/plosone/article...ne.0050972

edit EIP info

[shockwave rider]

quote:

---

Originally posted by Obie

Clean up standing water around your house and use insect repellent is the message they are trying to get out.

---

This is fairly useless advice for many living in Puna, within mosquito flying range of our house, but not on our property are: a collapsed catchment tank that hold small and large puddles of water, an abandoned greenhouse with 100s of square yards of puddle holding plastic, two jungle lots that were used as dumping grounds in the past, they probably still have old tires and buckets but it is all overgrown and the terrain is too rough to walk on. These all have off island owners who really don't care what happens here.

Unless public health efforts include measures to allow entry to properties with absent owners, or other measures to force cleanup of mosquito breading areas all over the island, this disease may become a permanent problem like the fire ants.