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Dengue in the Americas: Honduras' worst outbreak

2019; Elsevier BV; Volume: 394; Issue: 10215 Linguagem: Inglês

10.1016/s0140-6736(19)32531-0

1474-547X

Thais Helena dos Santos, José Luis San Martín, Luis Gerardo Castellanos, Marcos Espinal,

Global Maternal and Child Health

In November, 2018, the Pan American Health Organization (PAHO) alerted countries of the Americas to enhance preparedness and response efforts, including case management, laboratory diagnosis, integrated vector management, and risk communication, in preparation for a more intense dengue season.1Regional Office for the Americas of the World Health Organization21 November 2018: dengue - epidemiological alert. Regional Office for the Americas of the World Health Organization, Washington, DC2018Google Scholar A World Report2Alves L Honduras's worst dengue outbreak in 50 years.Lancet. 2019; 394: 371Summary Full Text Full Text PDF PubMed Scopus (4) Google Scholar on Honduras's worst dengue outbreak in 50 years contained mischaracterised data obtained from PAHO. As of July, 2019, 2 029 342 cases of dengue had been reported in the Americas, of which 12 268 were classified as severe.3Regional Office for the Americas of the World Health Organization9 August 2019: dengue - epidemiological update. Regional Office for the Americas of the World Health Organization, Washington, DC2019Google Scholar 42 346 cases were reported from Honduras, which accounts for 2% of the total dengue incidence in the region. Honduras was incorrectly reported to have most of the cases of dengue in the Americas, but most of the cases in 2019 were reported by Brazil. The confusion might be caused by reports from Honduras that suggested that 9793 cases of severe dengue occurred in Honduras, representing 79% of all severe dengue cases in the Americas. Of note, Honduras has a case fatality rate of 0·146%, and, although this is the highest reported in the country for many years and led to the declaration of a national emergency, this fatality rate is not the highest in the region. As a reference, the regional dengue case fatality rate target is 0·05%. The Americas have experienced atypically intense dengue activity in 2019. The number of dengue cases decreased by more than 70% in 2017–18;4Perez F Llau A Gutierrez G et al.The decline of dengue in the Americas in 2017: discussion of multiple hypotheses.Trop Med Int Health. 2019; 24: 442-453Crossref PubMed Scopus (38) Google Scholar however, as of Nov 11, 2019, 2 919 414 cases of dengue have been reported to PAHO, marking the highest number of cases ever reported in the Americas Region since case records have been maintained starting in 1980.5Pan American Health OrganizationPLISA Health Information Platform for the Americas: Dengue.http://www.paho.org/data/index.php/en/mnu-topics/indicadores-dengue-en.htmlDate: Sept 9, 2015Date accessed: December 5, 2019Google Scholar Additional findings for 2019 include a greater proportion of severe dengue cases, shifts in epidemic seasons, and younger age groups (5–9 years) most affected by death. Shifts to younger populations are expected following decades of transmission and depletion of susceptible older individuals. However, the driving force behind the changes observed in 2019 are still unclear. Possible answers include the effect of climate change on seasonality, and the predominant circulation of dengue virus type 2, which is known to cause severe disease. 2019 is also the first intense dengue transmission period following the Zika epidemic. PAHO monitors dengue in the region and collaborates with countries to mitigate its effect. Early and appropriate clinical management of dengue cases, destruction of mosquito breeding sites, and tackling the social and environmental determinants associated with dengue and other arboviral diseases can slow down disease transmission and prevent deaths. Nevertheless, until new vector control tools and effective dengue vaccines are fully incorporated into the preventive arsenal, dengue will continue harming populations worldwide. We declare no competing interests. 2020: a crucial year for neglected tropical diseasesThe inaugural World Neglected Tropical Diseases Day will be marked on Jan 30, 2020. “#BeatNTDs: For good. For all” is the slogan aiming to gather support and build momentum for a decisive year of action against neglected tropical diseases (NTDs). Jan 30 is the anniversary of the 2012 London Declaration on NTDs, which did much to bring together policy makers across countries and to encourage investment to commit to control and elimination of NTDs. Full-Text PDF