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DENGUE FEVER: A WORLDWIDE CRISIS

Abigail JeffersMPH Student

Walden UniversityPUBH 6165-4 Environmental Health

Dr. Robert P. MarinoWinter Quarter 2010

AGENDA Expected learning outcomeI. Understand cost to societyII. Recognize impact on healthIII.Develop effective controlIV.Describe infection routes AudienceI. WHOII. CDCIII.GovernmentIV.General population Purpose of presentation

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WHAT IS IT?

Mosquito-borne viral disease1. DENV-12. DENV-23. DENV-34. DENV-4 Endemic to Tropical regions No cure DHF

Center for Disease Control and Prevention. (2010). Epidemiology. Retrieved from http://www.cdc.gov/dengue/epidemiology/index.html

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CAUSE OF DENGUE FEVER Bite from infected Aedes aegypti mosquito Stagnant water Poor surveillance Poor Control Poorly constructed homes Solid waste disposal

World Health Organization. (2009). Dengue and dengue hemorrhagic fever. Retrieved from http://www.who.int/mediacentre/factsheets/fs117/en/

Used with permission from CDC

LIFECYCLE OF AEDES AEGYPTI

Used with permission from Hopp & Foley, 2001

ENDEMIC REGIONS

Used with permission from World Health Organization. (2009). Dengue and dengue hemorrhagic fever. Retrieved from http://www.who.int/mediacentre/factsheets/fs117/en/

SYMPTOMS TREATMENT Fever 105ºF Rash Headache Backache Petechiae Ecchymoses

Supported careI. AcetaminophenII. RehydrationIII.Blood pressure

controlIV.Transfusions

Gurugama, P., Garg, P., Perera, J., Wijewickrama, A. & Seneviratne, S.L. (2010). Dengue Viral Infections. Indian J Dermatol, 55(1):68-78. DOI: 10.4103/0019-5154.60357

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PREVALENCE 100 million cases per year

Center for Disease Control and Prevention. (2009). Dengue Fact Sheet. Retrieved from http://www.cdc.gov/dengue/faqFacts/fact.html

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INCIDENCE 2.5 billion people 2/5 of the world's population 500,000 DHF cases 120 million travellers

World Health Organization. (2011). Dengue/dengue hemorrhagic fever. Retrieved from http://www.who.int/csr/disease/dengue/en/

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MORBIDITY Children Elderly

Schwartz, E., Weld, L.H., Wilder-Smith, A., von Sonnenburg, F., Keystone, J.S., Kain, K.C., Torresi, J. & Freedman, D.O. (2008). Seasonality, annual trends, and characteristics of dengue in ill returned travelers, 1997–2006. Emerging Infectious Diseases, 14(7):1081-1088. DOI: 10.3201/eid1407.071412

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MORTALITY 2.5% of children >20% w/o proper treatment 22,000 deaths per year

Center for Disease Control and Prevention. (2010). Epidemiology. Retrieved from http://www.cdc.gov/dengue/epidemiology/index.html

Image shows the gut of a mosquito filled with blood during feeding.Used with permission from CDC

OUTBREAKS 2007 Venezuela 2007 Puerto Rico 2008 Brazil 2009 Cape Verde 2010 The Americas Used with permission from Google images

Ribeiro, P. (2009). 2008 Dengue fever outbreak in Rio de Janeiro . Retrieved from http://gobrazil.about.com/od/denguefeverinbrazil/a/denguerio.htm

COST TO SOCIETY Funds availability Decreases GDP Economic strain $1.8 billion annually Loss of income

Center for Disease Control and Prevention. (2009). Dengue Fact Sheet. Retrieved from http://www.cdc.gov/dengue/faqFacts/fact.htmlGubler, D.J. (2006). Dengue/dengue hemorrhagic fever: history and current status. U.S. National Library of Medicine, 277:3-16. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17319151Suaya, J.A., Shepard, D.S., Siqueira, J.B., Martelli, C.T., Lum, L.C., Tan, L.H., Kongsin ,S., Jiamton, S,. Garrido, F., Montoya ,R., Armien, B., Huy, R., Castillo, L., Caram, M., Sah, B.K., Sughayyar ,R., Tyo, KR. & Halstead, S.B. (2009). Cost of dengue cases in eight countries in the Americas and Asia: a prospective study. American Journal of Tropical Medicine Hygiene, 80(5):846-855. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/19407136

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PREVENTION AND CONTROL Eradicating the mosquitoes Eliminating stagnant water Use of mosquito pesticide Testing of blood products

Gurugama, P., Garg, P., Perera, J., Wijewickrama, A. & Seneviratne, S.L. (2010). Dengue Viral Infections. Indian J Dermatol, 55(1):68-78. DOI: 10.4103/0019-5154.60357

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CHALLENGES Community involvement Physicians knowledge Increased air travel Urbanization

Center for Disease Control and Prevention. (2009). Dengue Fact Sheet. Retrieved from http://www.cdc.gov/dengue/faqFacts/fact.html

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REFERENCES Center for Disease Control and Prevention. (2009). Dengue Fact

Sheet. Retrieved from http://www.cdc.gov/dengue/faqFacts/fact.html Center for Disease Control and Prevention. (2010). Epidemiology.

Retrieved from http://www.cdc.gov/dengue/epidemiology/index.html Gubler, D.J. (2006). Dengue/dengue hemorrhagic fever: history and

current status. U.S. National Library of Medicine, 277:3-16. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17319151

Gurugama, P., Garg, P., Perera, J., Wijewickrama, A. & Seneviratne, S.L. (2010). Dengue Viral Infections. Indian J Dermatol, 55(1):68-78. DOI: 10.4103/0019-5154.60357

Ribeiro, P. (2009). 2008 Dengue fever outbreak in Rio de Janeiro . Retrieved from http://gobrazil.about.com/od/denguefeverinbrazil/a/denguerio.htm

Suaya, J.A., Shepard, D.S., Siqueira, J.B., Martelli, C.T., Lum, L.C., Tan, L.H., Kongsin ,S., Jiamton, S,. Garrido, F., Montoya ,R., Armien, B., Huy, R., Castillo, L., Caram, M., Sah, B.K., Sughayyar ,R., Tyo, KR. & Halstead, S.B. (2009). Cost of dengue cases in eight countries in the Americas and Asia: a prospective study. American Journal of Tropical Medicine Hygiene, 80(5):846-855. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/19407136

REFERENCES Schwartz, E., Weld, L.H., Wilder-Smith, A., von Sonnenburg, F.,

Keystone, J.S., Kain, K.C., Torresi, J. & Freedman, D.O.(2008). Seasonality, annual trends, and characteristics of dengue in ill returned travelers, 1997–2006. Emerging Infectious Diseases, 14(7):1081-1088. DOI: 10.3201/eid1407.071412

Ugonabo, N., & Valdovinos, C. (2008). Assessing the impact of treatment of septic tanks with expanded polystyrene beads on Aedes aegypti larval and adult mosquito emergence. Retrieved from http://www.stanford.edu/group/parasites/ParaSites2008/Nkem_Cristina%20Valdoinos/ugonabon_valdovinosc_dengueproposal.htm

World Health Organization. (2009). Dengue and dengue hemorrhagic fever. Retrieved from http://www.who.int/mediacentre/factsheets/fs117/en/

World Health Organization. (2011). Dengue/dengue hemorrhagic fever. Retrieved from http://www.who.int/csr/disease/dengue/en/

SUPPLEMENTAL READING Ballenger-Browning, K.K. & Elder, J.P. (2009). Multi-modal

Aedes aegypti mosquito reduction interventions and dengue fever prevention. Tropical Medicine and International Health, 14(12):1542-1551. doi:10.1111/j.1365-3156.2009.02396.x. Use the Walden Library Academic Search Premier database, and search using the article’s Accession Number: 2010496140

National Institute of Allergy and Infectious Diseases. (2009). Dengue Fever. http://www.niaid.nih.gov/TOPICS/DENGUEFEVER/RESEARCH/Pages/Default.aspx

THANK YOU!!!

I sincerely appreciate the time that I sincerely appreciate the time that you have devoted to my you have devoted to my

presentation. If you have any presentation. If you have any questions, I will be happy toquestions, I will be happy to

answer them.answer them.

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