Outbreak of dengue fever and health alert in Iquitos

Peruvian health authorities have reported that a fast-growing outbreak of dengue fever, aggravated by heavy rain and torrid heat, might lead to the reappearance of the more serious dengue hemorrhagic fever in Iquitos, a city of approximately 300,000 residents in Peru’s northern Amazon region.

According to Loreto’s Regional Health Office, 4,348 people have contracted dengue fever since January 2008. Extreme heat and heavy rain showers are being held responsible for the sudden outbreak. Dengue is a mosquito-borne infection that causes a severe flu-like illness, and sometimes a potentially lethal complication called dengue hemorrhagic fever.

Climate change may influence the transmission of dengue fever, the world’s most widespread vector-borne virus, by extending the mosquito-borne disease transmission season, reports Loreto’s Regional Health Office.

There is a very high probability that hemorrhaging will occur in cases of the disease, said Carlos Coral Gonzales, the head of the region’s epidemiology department.

Symptoms of dengue range from a mild fever, to incapacitating high fever, with severe headache, pain behind the eyes, muscle and joint pain, and rash. Dengue haemorrhagic fever, however, is a potentially lethal complication including symptoms such as fever, abdominal pain, vomiting and bleeding.

As there are no specific antiviral medicines for dengue, the only way to prevent transmission is to combat the disease-carrying mosquitoes.

The Regional Health Office plans to fumigate 85,000 homes in Iquitos during the month of November.

“We have the necessary equipment for the fumigations,” said Coral. “And we have 60 people carrying out sanitary inspections, home by home, to verify if water storage containers meet health regulation standards, in order to prevent the growth of disease-transmitting mosquito larvae.”

From March to July 1990, an epidemic of dengue occurred in Iquitos and the surrounding area. A smaller outbreak was reported in Tarapoto, in the neighboring department of San Martin.

Although cases were reported in Peru from 1953-1955 and in 1958, the 1990 epidemic was the first laboratory confirmation of indigenous transmission of dengue in the Andean country.

Hemorrhagic manifestations, such as bleeding gums, were noted in 6.5 percent of patients with clinical dengue.

A second outbreak occured in the same area from May 2000 to May 2001.

The disease is mostly found in tropical and sub-tropical regions around the world, predominantly in urban and semi-urban areas, such as the city of Iquitos.

Many people would be increasingly affected by dengue in Latin America and Peru if, as expected, global warming aggravates disease and mosquito transmission processes. According to the World Health Organization, “current evidence suggests that inter-annual and inter-decadal climate variability have a direct influence on the epidemiology of vector-borne diseases.”

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