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Dengue and Dengue Hemorrhagic Fever are acute febrile
viral diseases. There are four different dengue viruses (DEN-1, DEN-2,
DEN-3, and DEN-4) that cause illness. Disease is characterized by the
sudden onset of fever, severe headache, joint and muscle pain, GI disturbances,
and rash, and in the hemorrhagic manifestation, bleeding from multiple
sites. The sporadic occurrence of shock and hemorrhage typically results
in death.
Dengue is predominantly a disease of tropical urban areas and maintained
in a human- Aedes aegypti mosquito cycle (a monkey-mosquito cycle
may be important in maintaining the virus in Asia and Africa). There are
an estimated 50 to 100 million cases in the world each year, and although
there has not been an outbreak in the continental United States since
1945 there are approximately 200 suspect cases imported annually to the
U.S. by international travelers. The majority of these imported cases
occur in Florida and Texas; however, Hawaii experienced an outbreak in
2001, which was attributed to local transmission. While the incidence
of dengue is low in the continental U.S. and surveillance is passive based
on reported cases, Puerto Rico and the U.S. Virgin Islands have active,
laboratory-based surveillance programs in place to control the increasing
incidence in the Americas.
Risk Reduction
Effective risk reduction for mosquito-borne diseases within the NPS requires
all employees and visitors to be knowledgeable and proactive in taking
necessary steps to minimize exposure. Primary risk reduction practices
include eliminating man-made mosquito-breeding habitat, avoiding activities
when mosquitoes are most active, and wearing long sleeved shirts and pants.
Many species of mosquito breed in stagnant water, therefore, it is critical
that containers such as tires, buckets, birdbaths, gutters and miscellaneous
debris are either removed or not holding water. The use of an insect repellant
containing DEET, picaridin or oil of lemon eucalyptus (p-menthane or PMD)
are effective against mosquitoes and should be used during periods of
high mosquito activity. DEET should be used with caution on children –
DEET is not recommended for the very young. Products containing oil of
lemon eucalyptus should not be used on the very young.
References
Health Information, National Center for Infectious Diseases, Centers for
Disease Control and Prevention, Department of Health and Human Services.
If you have any questions, please contact a Regional Public Health Consultant, park sanitarian or call WASO Public Health for more information at 202-513-7226.
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