August 1, 2021

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Fertile ground for a dengue outbreak | government


As infections, hospitalizations and deaths from Covid-19 increase, cases of the dengue virus also increase in Puerto Rico, so doctors begin to warn of a possible outbreak parallel to the coronavirus pandemic, at a time when it is confirms an increase in the number of female Aedes aegypti mosquitoes.

To this is added that due to the coronavirus pandemic, fumigation efforts in municipalities have been limited, which is necessary to attack mosquito breeding sites. If the rainy days of the last week are taken into account, the medical alert is greater, especially in October, which is one of the months of most concern for dengue.

Dr. Marianyoly Ortiz, associate director of the Puerto Rico Vector Control Unit, told EL VOCERO that the increase in the number of female mosquitoes per trap is sustained and remains above the acceptable level, which is three female mosquitoes. per trap per week.

“In the first quarter of the year we obtained an average of eight female mosquitoes per trap per week, in the second (quarter) nine and in this last quarter we have obtained an average of 13 female mosquitoes per trap per week. Which indicates an increase of 45% to 65% on average ”, he added.

The number of mosquitoes is the factor that impacts the increase in dengue cases as long as the virus is present, Ortiz explained, noting that last March the Vector Control Unit reported that female Aedes aegypti mosquitoes – the main vector that transmits dengue, zika and chikungunya viruses – were carrying dengue in the metropolitan area. In fact, in May the Centers for Disease Control and Prevention (CDC, for its acronym in English) alerted travelers to the island about precautions to avoid contracting dengue.

“As we have previously reported, having a number of mosquitoes greater than three female mosquitoes per trap per week, and having the dengue virus circulating on the Island, presents a risk factor for a dengue outbreak to occur in Puerto Rico”, Ortiz warned.

Yesterday at the Department of Health there was no official available to discuss the matter. However, related sources indicated that in effect “there are all the factors” for a dengue outbreak to develop if further measures are not taken.

Concern at the College of Physicians

The president of the College of Surgeons, Víctor Ramos, warned this week about the increase in dengue cases and emphasized that the level of use of intensive care beds in hospitals exceeded 70%, and not only because of Covid-19 cases .

Ramos said Tuesday that “dengue cases are increasing dramatically in Puerto Rico.” He explained that in two or three weeks the Department of Health will be able to have clear numbers of this increasing trend, because it is already what doctors are experiencing in their offices and hospital facilities.

He mentioned that “one who is in the hospital every day, basically dengue and Covid-19 are admitted in hospitals, that there was not much dengue since (hurricane) Maria.”

Mosquito resistant

In the past, Aedes aegypti has been reported to have become resistant to insecticides. Yesterday Ortiz stressed that such resistance is sustained, according to a recent study by the Vector Control Unit.

“This has not changed. In Puerto Rico there are more than 40 species of mosquitoes and this resistance has been observed only in Aedes aegypti, ”he said.

According to the analysis carried out by THE SPOKESMAN Based on the weekly reports of arboviral diseases published by Salud, the increase in dengue cases has been sustained.

From the last published report —which includes the period from August 26 to September 1— it can be inferred that there were 88 suspected cases with symptoms and / or clinical signs compatible with dengue, chikungunya and / or Zika infection, reported to the Epidemiological Surveillance System of Arboviral Diseases. However, in that period, seven additional cases of dengue were confirmed and there were none of probable or confirmed Zika or chikungunya.

However, during this year there have been 3,543 suspected cases, of which 384 have been confirmed as positive for dengue after a molecular test, and 28 are probable after a positive serological test. From the data published by Health, the types of dengue viral serotypes —DENV-1, DENV-2, DENV-3 and DENV-4— that can produce serious forms of the disease, as well as cause the death of the person .

For example, 254 cases corresponding to DENV-1 and a DENV-2 case associated with a trip are detailed. In addition, 132 hospitalized cases, 11 severe cases and zero fatalities were identified. There were also 63 probable cases of the Zika virus.

The municipalities with the most suspected cases of arboviral diseases are Peñuelas, Ponce, Juana Díaz, Carolina, San Juan and Bayamón, with more than 100 cases. When comparing these data with those published by Health —corresponding to the week of August 19 to 25— an increase of 89 cases can be observed, since for this period there were 3,454 suspected cases.

Alerts in hospitals

The executive president of the Puerto Rico Hospital Association, Jaime Plá, commented that the number of admissions to hospitals has remained stable, and that situations such as dengue outbreaks and other viruses are pending.

Plá said that as long as there is no rebound in Covid-19 cases from at least 1,500 to 2,000 cases a day, hospitals will be able to handle the infections, as long as no other viral outbreaks develop.

He mentioned that for now “the use of Covid-19 in intensive units has not exceeded 9%”, which are also occupied by patients with other diseases. He added that “we are close to 300 patients and that number has remained stable in recent months.”

“In addition to that, hospitals have built or remodeled rooms that can turn them into intensive areas if they need to,” said Plá.

Mild dengue symptoms can be confused with other illnesses that cause fever, aches and pains, or a rash. Dengue symptoms generally last two to seven days. Most people recover in about a week.



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