With the rising incidence of dengue fever in the Americas, especially the Bahamas, Cayman’s public health officials have issued a travel advisory as they closely monitor for local presence of the disease.

There has been no dengue cases reported in the Cayman Islands so far for 2011. However in 2008 and 2009 there were 2 imported cases each year and in 2010 there were a total of 7 cases (two imported and five with no travel history), indicating that from time-to-time some imported cases may cause sporadic localized cases to occur. However the Cayman Islands are still considered not endemic to dengue, as there is no sustained transmission of the disease.

“With the regional outbreak in mind, we are not complacent and medical personnel are on high alert to look for any local cases,” Medical Officer of Health Dr. Kiran Kumar said.

Currently dengue outbreaks are reported in some countries in the region like Aruba, Bahamas, St. Kitts and Nevis, St. Lucia, Mexico, and Trinidad and Tobago.

“Dengue fever is caused by a virus, but a mosquito biting a person with dengue fever can spread the virus to another person. Hence persons, who develop symptoms within two to three weeks of having returned from countries with dengue cases, are advised to consult their physician,” Dr. Kumar explained.

The symptoms of dengue are high fever, severe headache, backache, joint pains, nausea and vomiting, eye pain, and rash.

The incubation period (the time that the infection takes to develop before it shows symptoms) is usually four to seven days; but can be up to three weeks.

There is no vaccine or specific medication to treat dengue infection, and people travelling to known dengue endemic countries should take preventative measures such as using a repellent (DEET etc), wearing protective clothing, using air conditioning indoors or only opening screened windows and doors, and staying indoors during early dawn and dusk when mosquitoes are most active.

Even as there are no local cases of dengue fever, the dengue carrier – the Aedes aegyptii mosquito – is present in the Cayman Islands, making transmission of the disease possible if a case occurs. “The only real protective measure is avoiding mosquito bites,” Dr. Kumar said.

Upon report of a suspected dengue case the Public Health Department would immediately inform its partners in prevention and control the Mosquito Research and Control Unit (MRCU) and the Department of Environmental Health (DEH) of the suspected case, and they would take measures as if it was a case of dengue fever and enhance their mosquito control measures around the residence of the case.

For more information, call the Public Health Department on 244-2648 or 244-2621, or Faith Hospital on 948-2243. For advice on mosquito control measures contact the MRCU on 949-2557 or DEH on 949-6696 in Grand Cayman or 948-2321 in Cayman Brac.

List of countries in our region who reported having dengue fever (Source: Public Health Department)

Argentina, Aruba, Bahamas,  Bolivia, Brazil,  Columbia, El Salvador, Mexico, Panama, Paraguay, Peru, Puerto Rico, St. Kitts and Nevis, St. Lucia, Suriname, Trinidad and Tobago, and Venezuela.

Fact Sheet: Dengue Fever fact sheet (Source: Public Health Department, 21 September 2011)

What is dengue fever?

Dengue fever is an acute illness, caused by a virus that is transmitted by mosquitoes. Symptoms include fever, headache, muscle aches, joint pains, pain behind the eyes, and rash. Some cases can be very mild, while others can show disorders in blood clotting, which can result in internal bleeding. This is called the hemorrhagic form. The hemorrhagic form of dengue fever is more severe and is associated with loss of appetite, vomiting, high fever, headache and abdominal pain.

How prevalent is dengue?

It is estimated that more than 100 million cases occur worldwide each year. It has become a major international public health concern. It is prevalent in many countries in the Caribbean, and Central and South America, including Jamaica; Honduras; Trinidad and Tobago; Barbados; Guyana; and Puerto Rico. There were 2 cases in 2008 and 2009 each year and 7 cases in 2010. Cases in 2008 and 2009 were imported. Of the 7 cases in 2010 five were locally acquired (three cases in January and one in September and one in October with no travel history) indicating the possibility of imported cases as the source for the occurrence of these sporadic local cases. As there is no sustained transmission, the Cayman Islands are not considered endemic to dengue.

How is dengue fever spread?

The aedes aegyptii mosquito gets infected by biting the dengue patient in the first week of illness. It takes about eight to twelve days for the virus to multiply before the infected mosquito can pass it on to others. Aedes aegyptii is a daytime biter, with peak activity in the late afternoon. It cannot be spread directly from one person to another.

How soon do symptoms occur?

After the bite of an infected mosquito, dengue fever usually develops within five to six days. However, it can take as few as three days, or as many as fifteen days. An infected person can be a source of dengue virus for mosquitoes for about five to six days after onset of fever.

How is dengue diagnosed?

Doctors suspect the possibility of dengue based on clinical symptoms and signs. Confirmation is by a blood test. It takes about five to ten days to receive the results from overseas laboratories. Sometimes a repeat test is needed two weeks after the first test.

What is the treatment for dengue fever?

No specific treatment for dengue fever exists. Most people recover without complications using pain relievers and bed rest. Aspirin should be avoided.

How can dengue be prevented?

• Avoid getting bitten by mosquitoes.
• Use mosquito repellents on skin and clothing.
• When outdoors during times that mosquitoes are biting, wear long-sleeved shirts and long pants tucked into socks.
• When indoors, stay in air-conditioned or screened areas.

What should I do if I am diagnosed with dengue fever? Follow the treatment as prescribed by your doctor, and protect yourself from mosquito bites as described above.