The Guam Public Health Laboratory has confirmed the first locally acquired case of dengue fever, health officials said, noting that the patient had no travel history outside Guam.
The virus is type III [DENV 3], the same type of dengue virus causing outbreaks in Yap, Palau, Marshall Islands, and the Philippines.
“This is the first locally acquired dengue case detected and reported on Guam in the last 75 years; all previous cases were imported from off-island,” the Department of Public Health and Social Services said.
In response, the health department is implementing a heightened response in preventing further local transmission of the virus.
The department has activated its Arboviral Disease Response Plan, which includes the following:
1) Activation of the Public Health Incident Command;
2) Enhanced surveillance for dengue fever;
3) Targeted vector control; note that part of normal vector response is to fumigate areas at high risk for mosquito transmission;
4) Update on dengue case management; and
5) Community outreach and awareness.
All health care providers are urged to be on alert for additional cases of dengue fever. A physicians’ alert has been disseminated.
Dengue fever is a disease caused by any one of four closely related dengue viruses (DENV 1, DENV 2, DENV 3, or DENV 4). The viruses are transmitted to humans by the bite of an infected mosquito. Aedes aegypti mosquito is the primary transmitter, or vector, of dengue viruses, and fortunately this particular mosquito is not found on Guam.
According to The History of Health on Guam (2010), edited by Guam’s retired territorial epidemiologist, Dr. Robert Haddock, vector borne diseases were not a problem on Guam prior to World War II. After the U.S. re-occupation of Guam in 1944, there was an epidemic of dengue fever, transmitted by the Aedes aegypti mosquito. As a result, the military launched an intensive eradication program, which temporarily eliminated both the vector and dengue fever from the island until 1970, when the vector, A. aegypti was re-introduced to Guam. However, by this time, the ecological niche of A. aegypti had now been occupied by Aedes albopictus (the Asian tiger mosquito), another good transmission vector of dengue.
While there is no vaccine for dengue fever, the people of Guam should be vigilant about taking precautions and preventing mosquito bites, as well as eliminating the places where mosquitos breed and multiply.
The best preventive measure for residents living in areas infested with mosquitoes is to eliminate the places where the mosquito lays its eggs, which are primarily artificial containers that hold water. Mosquito larvae only need a little bit of standing water to survive. The Department wants to remind residents that breaking the mosquito life cycle starts at the home.
People traveling to the Philippines or Palau, Yap State should also be vigilant about taking precautions and preventing mosquito bites.
The principal symptoms of dengue fever are high fever, severe headache, severe pain behind the eyes, joint pain, muscle and bone pain, rash, and mild bleeding usually around nose or gums. Generally, younger children and those with their first dengue infection have a milder illness than older children and adults. Dengue hemorrhagic fever (DHF), the severe form of the disease, is characterized by a fever that lasts from 2 to 7 days, which can be followed by persistent vomiting, severe abdominal pain, and difficulty breathing. In addition, patients with DHF tend to bruise easily or other skin hemorrhages and possibly even internal bleeding. There is no vaccine for preventing dengue fever.
If you feel sick:
· Talk to your doctor or nurse if you feel seriously ill, especially if you have a fever with other symptoms such as headache and joint pain, or have traveled to a country with locally occurring dengue fever or other mosquito-borne diseases.
· Consult with you doctor about the use of acetaminophen to treat fever and pain.
· Get lots of rest, and drink plenty of liquids.
· Avoid spreading the disease by preventing more mosquito bites.
MOSQUITO PREVENTION MEASURES
The Department of Public Health and Social Services asks residents to do their part to reduce the mosquito population with some simple steps:
• Properly cover or dispose all containers that collect rainwater or water, such as flower pots, garbage cans, recycling containers, wheelbarrows, aluminum cans, boat tarps, old tires, and buckets.
• Flush birdbaths and wading pools weekly.
• Flush ornamental bromeliads with water, or treat with BTI, a biological larvicide available at most home stores.
• Clean roof gutters, which can become clogged and hold water.
• Change the water in outdoor pet dishes regularly.
• Keep pools and spas chlorinated and filtered.
• Stock ornamental ponds with mosquito-eating fish.
• Cover rain barrels with screening.
• Check for standing water under houses, near plumbing drains, under air conditioner drip areas, around septic tanks, and water pumps.
• Take steps to eliminate standing water, improve drainage, and prevent future puddling.