Steve Drouin PUBH-61651/20/2013

This presentation is generated to educate the frequent international traveler and anyone that wishes to know more about Dengue Fever.

If used for educational purpose, the scholar is offered many different resources to aid in the direction to locate various information.

Introduction Disease Causes for Reemergence of Infectious

Disease Research and Prevention Public Health Policy

Statistics Increases of Infectious Disease causing rapid emergence of

epidemics

Vector borne disease infecting an estimated 100 million annually

DF is endemic in over 100 countries.

First reported as epidemic in 1950s in South Asia

Believed to originate in Africa and migrate during the slave trade

http://www.who.int/denguecontrol/en/

Causes- The primary culprit being the female Aedes

aegypti (Ae aegypti) and infection can also be transmitted to a much lesser extent by the species Aedes albopictus aka the Tigris mosquito (NIAID, 2006).

Ae aegypti is well adapted to the environment it can breed in small amounts of water

http://www3.niaid.nih.gov/topics/DengueFever/

Locations Dengue Fever (DF) is found in areas of urban

poverty and more commonly occurred during and shortly after the rainy seasons in tropical regions

Tropical Regions include Africa, Southeast Asia, The Caribbean, South/Central Americas, and the South/Central Pacific (NIAID, 2006).

http://www3.niaid.nih.gov/topics/DengueFever/

• Other names:– O’nyong-nyong fever– Break-bone fever

• Flu-like in nature• Sudden onset

– Headaches– Severe joint and muscle pains*– Nausea/vomiting– Swollen glands– Fever up to 105°F– 2 separate appearing rashes**

• Diagnosis with: CBC, serology studies, antibody titer

Behavior Prevention

centered on education of travelers use of Personal Protective Equipment (PPE)

Use of PPE repellents for skin and clothing avoiding of heavily polluted areas staying in air conditioned/screened areas use of bed/mosquito netting.

Education to local population for the recognition of potential breeding sites and regularly changing

Environment Pesticides increasing incidence of malaria and dengue

fever found Regions have not harbored either of the 2 viral

illnesses the disease vectors are still found indigenously in

those regions

(Reiter, 1998)(Patz, Daszak, Tabor, Aguirre, Pearl, Epstein & Bradley, 2004)

As global temperatures fluctuate, this can also cause frequent droughts and flooding.

Deforestation leading cause of increases in many zoonotic diseases

Large emergence of epidemics is due to areas of disasters

(Gubler, Reiter, Ebi, Yap, Nasci & Patz, 2001).

Repellent DEET-

Gold standard, Registered for use by public in 1957 Can use over the age of 2 months. No other compound available to public has the

same effect/spectrum Permethrin

Only recommended for use on clothing, equipment and netting.

Highly effective and can kill mosquitoes

http://www.mosquito.org/repellents

Oil of citronella Less effective of the repellents Can only be used outdoors with no wind

Oil of lemon-eucalyptus Not able to be used on children under the age of 3

yrs Less irritant to the skin but higher concentrations

needed to repel ticks

Newly registered available repellents Metofluthrin (OFF Clip ON repellents)

Efficacy to the public limited, good signs in lab vs. vectors

Mosquito coils/Thermacell devices Synthetic pyrethroid insecticides

http://www.mosquito.org/repellents

Wear long sleeves/pants during peak activity periods

Application of repellents sparingly to exposed skin. Apply to skin under clothes if clothes can be easily penetrated by mosquito

Avoid DEET concentrations greater than 50% to the skin, do not apply to children’s hands

Nursing women should minimize repellent use Repellent saturation does not increase efficacy.

10% DEET approx 90 min coverage. 30% offers approx 5-6 hours protection

http://www.mosquito.org/repellents

Presently no vaccinations Less focus on the production of vaccines the current research trends are directed

toward the use of weakened or harmless viruses as potential candidates

Education Government involvement to control breeding

grounds

This method has been referred to as “sterile-insect technique” (WHO, 2009) currently being used in the agriculture industry for a

number of years to control the population of various species of fruit flies and parasitic screw worms

Successful countries include the United States, Mexico and throughout Central America.

Originally the technique began with the radiation of males, but this left the specimens in a weakened state and decreased the overall drive to reproduce. The newest approach is directed at the insertion of a single gene so that males produce non-viable offspring.

http://www.who.int/bulletin/volumes/87/3/09-020309/en/

Unhealthy Landscapes is a biennial meeting that was established in 2002 in Washington to discuss how the destruction of land affects the landscape and ultimately the ecology and Public Health.

The meeting advises on policies adaptation to evaluate the risk/benefits of landscape modification and the impact on Public Health and Safety.

http://www.ncbi.nlm.nih.gov/pmc/articles/pmc1247383/

Either traveling or learning, know what is endemic

One of many diseases transmitted by mosquitoes

Reemergence of many diseases can be linked to behaviors

Personal prevention and environmental changes

Learn the new

American Mosquito Control Association (No date). Repellents. Retrieved from http://www.mosquito.org/repellents

National Institute for Allergy and Infectious Disease (2006). Dengue Fever. Retrieved fromhttp://www3.niaid.nih.gov/topics/DengueFever/

Phillips, Melissa Lee (2008). Dengue Reborn. Environmental Health Perspectives, 116; 382-88. Retrieved 04/04/2009 from EBSCO

World Health Organization (2009). Mosquito Wars. Bulletin of the World Health Organization, 87, 167-68. Retrieved from http://www.who.int/bulletin/volumes/87/3/09-020309/en/

World Health Organization (2013). Dengue. Retrieved from http://www.who.int/denguecontrol/en/ Khansnis, A &Nettleman, M (2005). Global Warming and Infectious Diseases. Archives of Medical Research, 36(6), Nov-Dec, 689-696. Retrieved from

http://linksource.ebsco.com.ezp.waldenulibrary.org/FullText.aspx?linkout=http%3a%2f%2fezp.waldenulibrary.org%2flogin%3furl%3dhttp%3a%2f%2fdx.doi.org%2f10.1016%2fj.arcmed.2005.03.041

Reiter, P (1998). Global-Warming and vector-borne disease in temperate regions and high altitude. The Lancet, 351 (9105), 839-840. Retrieved from http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2805%2978979-0/fulltext Gubler,D., Reiter, P., Ebi, K., Yap, W., Nasci, R. & Patz, J. ( 2001). Climate Variability and Change in the United States: Potential Impact on Vector-Borne and Rodent-Borne Diseases. EnvironmentalHealth

Perspectives, 109(supplement 2): 223-233. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1240669/pdf/ehp109s-000223.pdf

Patz, J., Daszak, P., Tabor, G., Aguirre, A., Pearl, M., Epstein, J., & ... Bradley, D. (2004). Unhealthy landscapes: Policy recommendations on land use change and infectious disease emergence. Environmental Health Perspectives, 112(10), 1092-1098. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/pmc1247383/

Ahern, M., Kovats, R., Wilkinson, P., Few, R. & Matthies, F. (2005). Global Health Impacts of Flood: Epidemiologic Evidence. Oxford Journals: Epidemiologic Reviews: vol. 27(1); pp. 36-46. doi: 10.1093/epirev/mxi004. Retrieved from http://epirev.oxfordjournals.org/content/27/1/36.full