Vitals: A quarterly report of the Ministry of Health and Wellness, Jamaica April 2022

This document looks at dengue statistics for the period January 2018 to December 2021. It focuses on symptoms and signs, history, suspected and confirmed cases and mapping of cases in each parish for the period January 2018 to December 2019.

Dengue deaths: length of hospital stay, haematological parameters and presence of co-morbidities

OBJECTIVE: To review the characteristics of the patients who died from dengue in Trinidad to determine if there was any association between length of hospital stay, haematological parameters and ethnicity and any association with gender and the presence of co-morbidities. DESIGN AND METHODS: A descriptive study was undertaken via a review of case notes. Four major public hospitals were included in the study to locate patients who died from dengue between 2001 and 2010. RESULTS: The duration of hospital stay until death was characterised by a mode of 3 days and a median of 4 days. Eleven patients (47.8%) had a history of diabetes and 7 (30.4%) a history of hypertension recorded in the notes. A falling platelet count was observed in 69.5% of patients. A low normal haematocrit was observed in 78.2% of cases. Analyses did not reveal a significant association between length of hospital stay and platelet levels, nor with ethnicity; neither was a significant association found between gender and the presence of co- morbidities. CONCLUSION: Morbidity and mortality from dengue continue to pose a public health problem globally. Most patients had a history of diabetes with low platelets on admission, but low to normal haematocrit throughout their stay in hospital (mode 3 days). A prospective comparison study would better explore the significance of co- morbidities and the meaning of low to normal haematocrit levels.

Exploratory space-time analysis of dengue incidence in Trinidad: a retrospective study, 1998-2004

OBJECTIVE: To obtain an understanding of the space and time dynamics of dengue and provide health agencies with important clues for reducing its impact. DESIGN AND METHODS: Dengue Haemorrhagic Fever (DHF) cases observed for the period 1998-2004 were georeferenced using Geographic Information System software. Spatial clustering was calculated for individual years and for the entire study period using the Nearest Neighbor Index. Space and time interaction between DHF cases was determined using the Knox Test while the Nearest Neighbor Hierarchical method was used to extract DHF hot spots. All space and time distances calculated were validated using the Pearson r significance test. RESULTS: Results shows that (1) a decrease in mean distance between DHF cases correlates with activity leading up to an outbreak, (2) a decrease in temporal distance between DHF cases leads to increased geographic spread of the disease, with an outbreak occurrence about every 2 years, and (3) a general pattern in the movement of dengue incidents from more rural to urban settings leading up to an outbreak with hotspot areas associated with transportation hubs. CONCLUSION: The results of this study can be used by public health officers to help visualize and understand the spatial and temporal patterns of dengue, and to prepare warnings for the public. Dengue space-time patterns and hotspot detection will provide useful information to support public health officers in their efforts to control and predict dengue spread over critical hotspots allowing better allocation of resources.

Dengue clinical cases by epi week & district 2009

The document is a compilation of the clinical cases recorded by the Epidemiology Unit of the Ministry of Health, Belize for 2009. This information has been captured, collated and reported according to district, sex, and age group.

Impact of vector control on a dengue fever outbreak in Trinidad, West Indies, in 1998

In 1998, Trinidad experienced its first major outbreak of dengue haemorrhagic fever. Data from the Trindad Public Health Laboratory, the National Surveillance Unit and Insect Vector Control Division, Ministry of Health, Trinidad and Tobago were analysed to determine the impact of vector control measures on the dengue outbreak. Geographical Information Systems (GIS)/Global Positioning Systems (GPS) were used to map cases and to distinguish epidemiological clusters. The Aedes aegypti population densities were higher than the 5 percent transmission threshold in all countries. The spatial distribution of dengue fever cases was significantly correlated with the heavily populated east-west corridor in the north and several distinctly separate clusters in the western part of the island. The temporal distribution patterns showed significantly more dengue fever cases occurring during the rainy season than during the dry season. The study documents the importance of vector control in the prevention of dengue transmission since no vaccine is curently available, and emphasizes the urgent need to understand better the environmental factors which contribute to the proliferation of this disease vector Ae. aegypti(AU)

Impact of vector control on a dengue fever outbreak in Trinidad, West Indies, in 1998

In 1998, Trinidad experienced its first major outbreak of dengue haemorrhagic fever. Data from the Trinidad Public Health Laboratory, the National Surveillance Unit and Insect Vector Control Division, Ministry of Health, Trinidad and Tobago were analysed to determine the impact of vector control measures on the dengue outbreak. Geographical Information Systems (GIS)/Global Positioning Systems (GPS) were used to map cases and to distinguish epidemiological clusters. The Aedes aegypti population densities were higher than the 5% transmission threshold in all counties. The spatial distribution of dengue fever cases was significantly correlated with the heavily populated east-west corridor in the north and several distinctly separate clusters in the western part of the island. The temporal distribution patterns showed significantly more dengue fever cases occurring during the rainy season than during the dry season. This study documents the importance of vector control in the prevention of dengue transmission since no vaccine is currently available, and emphasizes the urgent need to understand better the environmental factors which contribute to the proliferation of this disease vector Ae. aegypti.

Childhood dengue shock syndrome in Trinidad

Dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS) is a major cause of hospitalisation and mortality among children in South East Asia. We now report, for the first time, the occurrence of DHF/DSS in Trinidadian children. The presence of vomitting, abdominal pain and hepatomegaly in the setting of a dengue epidemic should alert clinicians to the possibility of DHF/DSS. Timely diagnosis and aggressive supportive treatment are essential for a successful outcome. Source reduction, vector control and community participation are also necessary to avert the South East Asian scenario from emerging in the Caribbean (AU)

A preliminary study of neopterin as a potential marker for severe dengue virus infection

Dengue virus cause the non-fatal dengue fever and the life-threating dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS). Early clinical features of DF and DHF/DSS are indistinguishable and it is difficult to identify early DHF/DSS using clinical and laboratory parameters. A prospective observational study (KALAYANAROOJ et al, 1997) of Thai children with fever for less than 72h revealed that, at enrolment, plasma aspartate aminotransferase (AST)levels were significantly raised in children who developed DHF but were of relatively low positive predictive value (PPV=0.27 for AST>40U/mL). MONATH (1997), in his review of the paper by Kalayanaroo et al., noted the lack of 'clear clinical prognostic indicators for DHF' and called for strategies to improve diagnosis (AU)

Absence of impact of aerial malathion treatment on Aedes aegypti during a dengue outbreak in Kingston, Jamaica

During an outbreak of dengue fever in Jamaica from October to December 1995, a study was carried out to determine the impact of aerial ultra-low volume malathion treatment on adult Aedes aegypti. This was done by monitoring oviposition rates of the vector in three urban communities in Kingston and by exposing caged mosquitoes both directly and indirectly to the aerial malathion treatment. The insecticide was delivered at a rate of 219 mL/ha between 7:10 a.m. and 8:45 a.m. The results of the study clearly showed that the insecticide application was ineffective in interfering with Aedes aegypti oviposition, and adult mosquitoes held in cages inside dwellings were largely unaffected. Consequently, this type of intervention seemed to have little significant impact in arresting or abating dengue transmission (AU)

Case reports 2003

This extract presents a summary of a case report containing a diagnosis of dengue hemorrhagic fever, the case report itself, an introduction to dengue viruses, and a discussion on dengue and dengue-like diseases. The case looks at a 7 year old girl who presented with a history of fever, diarrhoea and bleeding from her gums. Treatment for her commenced after a diagnosis of dengue hemorrhagic fever was made. For this young patient a number of complications could have occurred including volume overloading, persistent acidosis, shock, and hyperkalemia or hypocalcaemia. Despite efforts to resuscitate her while in a shock state it did not affect recovery.

Knowledge attitudes and practices contributing to vector proliferation and dengue in Trinidad and Tobago

Aedes aegypti is found breeding on almost every island in the Greater and Lesser Antilles, and is the peri-domestic vector of dengue fever and its clinical sequalae, dengue haemorrhagic fever (DHF) and dengue shock syndrome (DHF) and dengue shock syndrome (DSS). It is also the classic urban vector of yellow fever. Four serotypes of the virus which causes dengue have been isolated and all four have been found in the Caribbean area during the last forty years, beginning in 1952 with a dengue type 2 in Trinidad; dengue type 3 in Puerto Rico (1964); dengue type 1 in Jamaica (1977); and dengue type 4 in St. Maarten (1981). Dengue serotypes 1,2 and 4 are currently circulating in the region. In the last fifteen years there has been a marked increase in the number of reported cases of dengue in the Americas. Recurring epidemics of dengue are causing considerable morbidity and imposing significant financial burdens on the economies of affected countries. Thousands of cases have occured in the Caribbean and have presented mostly as classical dengue (AU)

Dengue fever in Trinidad and Tobago

During the period January 1st through October 31st 1992, four hundred and forty four (444) clinical cases of dengue fever were reported to the National Surveillance Unit of the Ministry of Health. Roughly twenty percent of these notifications were recorded during week number 40, ending October 3rd 1992. Reported morbidity was not confined to any specific geographic area, although the greatest proportion of notified cases originated in County Caroni (AU)

Dengue in the Caribbean

Dengue fever is an acute febrile illness characterized by sudden onset, severe headache, arthralgia, myalgia and fever for 5-7 days. Fair skinned individuals usually have a visible rash. Leukopaenia, thrombocytopaenia and lymphadenopathy are common. The differential diagnosis includes anthropod-borne viral fevers, influenza, rubella and others. The surveillance and epidemiologic data suggest that the disease pattern in the Caribbean is evolving in a manner similiar to that of South-East Asia in the 1960's when DHF originally began occurring sporadically, it is now a leading cause of hospitalization and deaths among children in many countries in South-East Asia. Unless a concentrated effort is made over the coming months and years to substantially reduce vector populations in the Caribbean, there can be little doubt that Dengue occurence will increasae with the risk of DHF (AU)