ABSTRACT
Dengue is a viral disease usually transmitted by Aedes aegypti mosquitoes. Dengue outbreaks in the Americas reported in medical literature and to the Pan American Health Organization are described. The outbreak history from 1600 to 2010 was categorized into four phases: Introduction of dengue in the Americas (1600-1946); Continental plan for the eradication of the Ae. aegypti (1947-1970) marked by a successful eradication of the mosquito in 18 continental countries by 1962; Ae. aegypti reinfestation (1971-1999) caused by the failure of the mosquito eradication program; Increased dispersion of Ae. aegypti and dengue virus circulation (2000-2010) characterized by a marked increase in the number of outbreaks. During 2010 > 1.7 million dengue cases were reported, with 50,235 severe cases and 1,185 deaths. A dramatic increase in the number of outbreaks has been reported in recent years. Urgent global action is needed to avoid further disease spread.
Subject(s)
Dengue/history , Disease Outbreaks/history , Severe Dengue/history , Aedes/virology , Americas/epidemiology , Animals , Dengue/epidemiology , Dengue Virus , History, 17th Century , History, 18th Century , History, 19th Century , History, 20th Century , History, 21st Century , Humans , Insect Vectors/virology , Severe Dengue/epidemiologyABSTRACT
During the last 22 years, the Region of the Americas has seen an upward trend in dengue incidence, with epidemics peaking ever higher and recurring every 3-5 years, almost regularly. A major factor in the spread of the disease has been the diminished capacity of national programs to respond with dengue prevention and control. This paper evaluates the Integrated Strategy for Dengue Prevention and Control-approved by the 44th Directing Council of the Pan American Health Organization in September 2003- and its preliminary results. The Integrated Strategy for Dengue is a management model designed to strengthen national programs, with a focus on reducing morbidity, mortality, and the societal and economic burdens produced by outbreaks and epidemics. Currently, 11 of the countries in the Region have developed a plan for or implemented a national strategy. In addition, a sub-Regional plan has been developed for Central America and the Dominican Republic. The Integrated Strategy for Dengue is expected to produce a qualitative leap forward in prevention and control through stronger partnerships among the State, its various ministries, and governing bodies, at all levels; private companies; and the range of community and civil groups. Once implemented, this strategy will reduce risk factors for dengue transmission, establish an integrated epidemiological surveillance system, decrease Aedes aegypti mosquito populations, prepare laboratories to better detect and identify the virus, optimize diagnosis and treatment, and, as a result, decrease the frequency, magnitude, and severity of dengue outbreaks and epidemics.
