An outbreak of dengue fever has been reported, seven months into 2019, and the number of cases so far is already more than twice the figures for the entire 2018. The highest number of persons affected is up north. In the Orange and Corozal Districts, there are over three hundred and fifty laboratory confirmed cases and there is reason to believe that it is a trans-border health issue. The Ministry of Health also confirms cases in Cayo and the Stann Creek Districts, but the spike up north is cause for alarm. Dengue fever is painful and debilitating, it is spread through the bite of an infected Aedes species mosquito. The Ministry of Health today provided details of the outbreak. Here is Duane Moody.
Duane Moody, Reporting
There is a major dengue outbreak in Belize. According to the statistics, there have been an increased number of infections: two hundred and thirty cases in Orange Walk District; one hundred and twenty-four in Corozal, ninety-eight in Cayo and one hundred and five in Stann Creek. Belize and Toledo have recorded less than twenty laboratory confirmed cases. Those figures combined, not to mention the undocumented cases, are twenty times higher than the numbers up to this time last year. To break it down even further, there are over six hundred confirmed cases of dengue in Belize so far; this is two times the amount recorded for the entire of 2018 and more than the numbers when combining the figures from the past two years. It has thrown the Ministry of Health into a frenzy as they try to contain the spread.
Lorna Perez, Surveillance Officer, Ministry of Health
"We are looking at laboratory surveillance, looking at confirmed cases. We had seen an increase of more than usual at the beginning of the year, but it had been a gradual increase. However, in the past five to six weeks, we have noticed a drastic increase in the number of cases. As mentioned earlier, it was mostly concentrated in the north; started in Orange Walk and then it started spreading to Corozal. We had some small numbers in the cayes. However, since we have noticed this increase in the past five to six weeks, we have seen an increase in southern part of the country, Stann Creek District to be more specific and also in the Cayo District. There are communities that have higher number than others."
The statistics show that children between the ages of five and nine and adults up to thirty-nine years contribute to the bulk of those reported with dengue fever. Surveillance Officer of the Ministry of Health, Lorna Perez, says that across the region, there have been outbreaks in dengue fever and the deadlier dengue hemorrhagic fever. The increased cases in the south are expected, but the rise in the north and west is transboundary.
Lorna Perez
"We need to look first at the impact of what is really happening in our neighbouring countries. If you look at cases coming in from the north, which is where we actually started noticing the increase in cases; you look a bit further out to Quintana Roo and actually the state of Quintana Roo is reporting the highest incidents of dengue for the entire Mexico. So we know we have a lot of movement between the border towns there. And then if you look at the reports coming out of Guatemala and Salvador and Honduras, they are also experiencing a major outbreak at the moment, with Honduras having a high fatality rate related to dengue."
Now there are four different types of dengue that affect humans, and in any given year, there are two types circulating. But within the region this year, all four stereotypes have been detecting, which Vector Control Chief of Operations, Kim Bautista says can result in the likelihood of having a severe episode of dengue, with hemorrhagic manifestation. Considering that the rainy season is upon us, the ministry is expecting that the figures will increase.
Kim Bautista, Chief of Operations, Vector Control Unit
"Through disease modelling and looking at trends that they had started to seeing late in fourth quarter of 2018. So the region on a whole was seeing an increase in cases, so based on those forecasting, they alerted us and told us look we are going to see several outbreaks or we expect several outbreaks. And so back then we started doing some media rounds in March. Since that period we have been seeing an increase in cases, but what the ministry did at that time was to put the regional programmes in country on alert. We have in place whereby our surveillance and management committees within the different districts have developed their dengue preparedness and response plan."
Kim Bautista is stressing on prevention measures. The Ministry of Health is in high alert and the vector control unit across the country has been spraying and carrying our awareness campaigns on best practices for residents in vulnerable communities.
Kim Bautista
"Dengue is one of those diseases; socioeconomic factors are a big contributing factors. So areas where there is poor infrastructure, drainage, poor housing and these persons being in those areas, it increases the likelihood of coming in contact with the Aedes Egypti vector. We have six district surveillance committees led by various professionals with public health and vector control and nursing background and medical background and what they have done is prepared a preparedness and response plan for their district so that has a component that has to do with vector control, with clinical management, with lab, with education. And so I'll give you an example, last week in the north, in Corozal, they met with eighteen village leaders to sensitize them on what has been going on and basically engage and start planning things like clean up campaigns."
The last time Belize has recorded over six hundred cases was back in 2015, but the ministry is concerned about the fact that seven months into 2019, those numbers have already been surpassed.
The Ministry of Health - measures to avoid contracting Dengue
The Ministry of Health wants to help you take precautionary measures to avoid contracting Dengue. There is an outbreak in cases in Central America and the Caribbean Region so the team is providing information for residents to prevent cases in their areas. They talked about how you can keep your home free from Dengue and discussed the national response system and how it's preparing for any eventualities. On our couch:
Dr. Karl Jones - General Practitioner
Kim Bautista - Chief Operations, Vector Control Unit
Lorna Perez - Statistical Officer, Epidemiology Unit
Our message remains the same: protect yourself and your family from mosquito bites. reduce the breeding areas for mosquitoes, reduce the chances of contracting Dengue.
Dateline Dengue
As we told you last week, Belize - along with Mexico and Central America - is in the middle of a Dengue outbreak.
As of July, there have been over 700 confirmed cases of dengue in Belize.
This is 7-times more than the number of cases last year, and the year before that.
The Director of Health Services told us that the disease is cyclical and that given the situation in our neighboring countries, it was expected:
There have been no deaths related to severe dengue in Belize.
Confirmed Dengue Cases Continue to Spike in Belize
Health authorities continue to monitor the cases of dengue as the number of persons affected continues to spike across the country. Today, the Director of Health Services confirmed to the media that in one week, there are approximately one hundred additional cases, bringing the data to seven hundred and nine persons who have tested positive for the disease. Of concern is that the number reflects only those persons who have sought medical attention at public health facilities, but there is likely others who tested through private facilities and have not been recorded into the system as yet. D.H.S. Doctor Marvin Manzanero explains.
Dr. Marvin Manzanero, Director of Health Services
"Up to this time period last year, we only had one hundred and eleven cases so you would say that we have seven times more cases than we had up to this time period last year. And I think in some of the data that we shared last year is that for the years 2017 and 2018 combined, we have doubled the cases this year. So that’s the preliminary data that we have. We update that routinely every Monday and by midday we should have the final tally every week. Of course those are only cases that are captured in the electronic system because you will have a good amount of people who are not going to go to the public facility and also you might have a delay because the private sector, even though they do their reports, those are manual reports which we go and collect routinely every week. We just take a little bit longer to upload into the system. The mathematical modules for the Caribbean had suggested that this was going to happen, so from March of this year, we have been making our rounds in terms of what we can do at the health system. So the surveillance system was activated from March of this year. All the regions have their own specific dengue plans that have been set in place, but in reality this is a prevention measure. It is not really what the Ministry of Health alone is going to do. You don't want people showing up in your health system with complicated cases. Ideally you want people to not get dengue."
Ministry of Health Monitoring Dengue Cases in the Region
There are four stereotypes of dengue in Belize; strains two and three are the more predominant ones being detected. The goal is to prevent a severe case of the disease, which occurs when a person previously affected by dengue is re-infected. The Ministry of Health is also monitoring the region, where there have been a number of mortalities as a result of the dengue spread. Doctor Manzanero says that persons showing symptoms must seek medical attention early.
Dr. Marvin Manzanero, Director of Health Services
"We have been monitoring also what's happening in the region. We know of the rates that were going up in Quintana Roo. We now see the reports coming out of Guatemala. I think last week, they reported twenty-seven deaths; eighteen of those being in the paediatric population. We are seeing what's happening in Honduras that’s close to thirty thousand cases. Nicaragua and El Salvador going through the same situation. So dengue is cyclical so we had anticipated it was going to happen. It is how do you go about and ensure that you can cut the transmission rate. So this is a collective effort. We are also not testing everybody that is coming in with fever and rash; we are assuming that that’s a clinical case of dengue and we are labelling it as such. We are not testing everybody; there are many suspicious cases. It is not that one strain is more violent that the other because in order for you to have a more severe form of dengue, you would have had a previous case of dengue before. So it is when you get a second or third re-infection that you can have a more serious or severe form of dengue. I don't have the data in terms of who is showing up with severe forms of dengue. But also people need to ensure that they are seeking early attention because if you start auto-medicating then you can have more risk of having a severe form of dengue."
The last time there was a death as a result of dengue in Belize was five years ago.
Health authorities on the island report an increase in Dengue fever As cases of Dengue fever continue to increase across Belize, health authorities on the island are closely monitoring the situation after more than 20 cases were confirmed on Ambergris Caye. This is expected to increase, and islanders are urged to take preventative measures and to visit their nearest medical center if they suspect they have dengue symptoms. Dengue causes painful fever, rashes, and is a very debilitating illness. It is transmitted by the bite of an infected Aedes Egypti species of mosquito.
Fight the Bite. Unfortunately Dengue season has arrived before rainy season. If you have the symptoms, make sure you see a doctor immediately. Do NOT take aspirin or ibuprofen. Tylenol/acetaminophen are ok but see a doctor! If in doubt, check it out! Plan to get plenty of rest. These signs were being created outside by volunteers when I passed by town council today. Get educated about this important health issue.
Photo and text by Karen Brodie
Dengue compilations can be deadly. Here is what you need to know about dengue complications.
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