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Americas act to combat dengue outbreaks
NEWS
WHO puts effort into
Americas act to combat dengue outbreaks
tackling epidemics
Health Ministers from all nations of the Americas meeting in Washington this week agreed on an "emergency action plan" to combat the epidemic of dengue fever that has affected at least 140 000 persons in Brazil, Venezuela, Central America, the Caribbean, and Mexico since January. The action was taken during the Pan American Health Organization’s 38th conference of the Directing Council, which focused this year on emerging infectious diseases. Dengue cases in the region rose from 63 000 in 1993 to 150 700 in 1994. 3600 cases of dengue haemorrhagic fever-with 38 deaths-have been reported this year. The epidemic has been caused by all four dengue serotypes, including type 3, which only recently reappeared in the region (Nicaragua and Panama) after an absence of 16 years. Officials fear that this may become the worst dengue epidemic in the Americas since 1981, when Cuba reported 344 000 cases, of which at least 10 300 had signs of dengue haemorrhagic fever
eradication, and appealed to the international community for technical and In its current restructuring financial support. : "doing the same, or a better, job processwith fewAlthough no cost for the plan was specer people"-WHO’s communicable disified, a similar appeal issued from PAHO eases division has become the Division of on Sept 10 estimated that immediate conEmerging, Viral and Bacterial Diseases trol of the epidemic in Central America ’., Surveillance and Control (EMC). Its puralone will cost US$4-6 million and is to national and interpose strengthen PAHO expects that$1-9million of that national in surveillance and capabilities sum must come as donations. So far, the control of infectious diseases, including appeals have raised promises of$400 000 those that are new, emerging, and refrom the United Kingdom and$50 000 emerging public health problems. It will from Norway. The price of long-term also promote research on diagnosis, Aedes eradication would be far higher. A epidemiology, prevention, and control. PAHO report released this June estimated With the on quick deployment, emphasis that a successful campaign for Central the EMC can, it is intended, intervene America would require 5 years and about more effectively in situations such as the $144 million. (Alternatives para la prevenc : current outbreaks of dengue in Latin ion y control del dengue y del dengue hemor- : America and the Caribbean. ragico en los paises de centroamerica. : The EMC’s mandate, drawn up on OPS/HCP/CHT/ 95.049, Rev, 1). : assessment of WHO’s performance in Officials blame the epidemic on urbanirecent epidemics-eg, plague (India), sation, poverty, the demise of Aedesebola (Zaire), and yellow fever (Kenya)eradication programmes in the 1970s, was considered at a WHO headquarters and the increased use of non-biodegradmeeting on Sept 25-27. There was : able containers and old tyres, which can unanimity on the fact that, given national (WHO grades I-IV,figure). The plan is similar to one proposed serve as small and undetected breeding will, closer permanent collaboration and earlier this month in Guatemala at an grounds for the mosquito. The role of a fuller exchange of information would international travel and trade also seem emergency session sponsored by PAHO provide far more complete immediate and UNICEF, and follows a series of crucial. Using viral envelope-geneappraisal of what had to be done. This recent national and regional conferences sequencing, researchers have found that was in the context of a set of recommenmeant to stem the epidemic. It is to be the newly arrived American dengue dations on strengthening WHO’s capacity over 6 and calls on months, implemented serotype 3 is identical to the virus responfor epidemic response, and particularly local governments to form "national sible for dengue haemorrhagic fever epion thinking through different scenarios committees" to coordinate demics in India and Sri Lanka in the emergency in advance, including the equipment medical services, improve facilities for 1980s. The first reported cases of dengue required. Basic was a government’s will worldwide occurred almost simultaneousdisease surveillance and laboratory diagto recognise that it was facing an epidemic nosis, and organise activities for the ly in 1779-80 in the port cities of Cairo, and to allow international agencies, "elimination or reduction of breeding Jakarta, and Philadelphia. especially their key specialists, to sites" of Aedes aegypti, the vector. In addienter and help without being delayed by tion, Ministers at the meeting asked formalities. David H Frankel PAHO to study the "feasibility" of Aedes Skills required for investigating an out: break can be more difficult to mobilise than formerly, said Dr Jim LeDuc, of the EMC programme on bacterial and viral diseases and immunology. The difficulty of maintaining a pool of readily available people is, he said "in part a generational problem, in as much as the people who were initially trained in field work are ageing. The generation coming behind is more molecular-laboratory orientated. They can sequence genes and they can purify proteins. But if you tell them that we have sick people and we need to control rats and the fleas on those ratsthat’s not frequently taught. "This is an aspect we’re very concerned about. Continuing medical education is in some degree a balancing act; scientific and technical knowledge continues to grow so that clinicians and public health people need to know more technical things just to keep properly informed. In medical school, giving more time to major new problems, such as HIV, means less time spectrum or aengue rever naemorrnagic tever for classical parisitology and other things". Grades 3 and 4 dengue shock syndrome. Source: Dengue & Dengue Haemorrhagic Fever in the Americas (PAHO, SP 548), with permission. Alan McGregor ‘
;
=
957
WHO puts effort into
Americas act to combat dengue outbreaks
tackling epidemics
Health Ministers from all nations of the Americas meeting in Washington this week agreed on an "emergency action plan" to combat the epidemic of dengue fever that has affected at least 140 000 persons in Brazil, Venezuela, Central America, the Caribbean, and Mexico since January. The action was taken during the Pan American Health Organization’s 38th conference of the Directing Council, which focused this year on emerging infectious diseases. Dengue cases in the region rose from 63 000 in 1993 to 150 700 in 1994. 3600 cases of dengue haemorrhagic fever-with 38 deaths-have been reported this year. The epidemic has been caused by all four dengue serotypes, including type 3, which only recently reappeared in the region (Nicaragua and Panama) after an absence of 16 years. Officials fear that this may become the worst dengue epidemic in the Americas since 1981, when Cuba reported 344 000 cases, of which at least 10 300 had signs of dengue haemorrhagic fever
eradication, and appealed to the international community for technical and In its current restructuring financial support. : "doing the same, or a better, job processwith fewAlthough no cost for the plan was specer people"-WHO’s communicable disified, a similar appeal issued from PAHO eases division has become the Division of on Sept 10 estimated that immediate conEmerging, Viral and Bacterial Diseases trol of the epidemic in Central America ’., Surveillance and Control (EMC). Its puralone will cost US$4-6 million and is to national and interpose strengthen PAHO expects that$1-9million of that national in surveillance and capabilities sum must come as donations. So far, the control of infectious diseases, including appeals have raised promises of$400 000 those that are new, emerging, and refrom the United Kingdom and$50 000 emerging public health problems. It will from Norway. The price of long-term also promote research on diagnosis, Aedes eradication would be far higher. A epidemiology, prevention, and control. PAHO report released this June estimated With the on quick deployment, emphasis that a successful campaign for Central the EMC can, it is intended, intervene America would require 5 years and about more effectively in situations such as the $144 million. (Alternatives para la prevenc : current outbreaks of dengue in Latin ion y control del dengue y del dengue hemor- : America and the Caribbean. ragico en los paises de centroamerica. : The EMC’s mandate, drawn up on OPS/HCP/CHT/ 95.049, Rev, 1). : assessment of WHO’s performance in Officials blame the epidemic on urbanirecent epidemics-eg, plague (India), sation, poverty, the demise of Aedesebola (Zaire), and yellow fever (Kenya)eradication programmes in the 1970s, was considered at a WHO headquarters and the increased use of non-biodegradmeeting on Sept 25-27. There was : able containers and old tyres, which can unanimity on the fact that, given national (WHO grades I-IV,figure). The plan is similar to one proposed serve as small and undetected breeding will, closer permanent collaboration and earlier this month in Guatemala at an grounds for the mosquito. The role of a fuller exchange of information would international travel and trade also seem emergency session sponsored by PAHO provide far more complete immediate and UNICEF, and follows a series of crucial. Using viral envelope-geneappraisal of what had to be done. This recent national and regional conferences sequencing, researchers have found that was in the context of a set of recommenmeant to stem the epidemic. It is to be the newly arrived American dengue dations on strengthening WHO’s capacity over 6 and calls on months, implemented serotype 3 is identical to the virus responfor epidemic response, and particularly local governments to form "national sible for dengue haemorrhagic fever epion thinking through different scenarios committees" to coordinate demics in India and Sri Lanka in the emergency in advance, including the equipment medical services, improve facilities for 1980s. The first reported cases of dengue required. Basic was a government’s will worldwide occurred almost simultaneousdisease surveillance and laboratory diagto recognise that it was facing an epidemic nosis, and organise activities for the ly in 1779-80 in the port cities of Cairo, and to allow international agencies, "elimination or reduction of breeding Jakarta, and Philadelphia. especially their key specialists, to sites" of Aedes aegypti, the vector. In addienter and help without being delayed by tion, Ministers at the meeting asked formalities. David H Frankel PAHO to study the "feasibility" of Aedes Skills required for investigating an out: break can be more difficult to mobilise than formerly, said Dr Jim LeDuc, of the EMC programme on bacterial and viral diseases and immunology. The difficulty of maintaining a pool of readily available people is, he said "in part a generational problem, in as much as the people who were initially trained in field work are ageing. The generation coming behind is more molecular-laboratory orientated. They can sequence genes and they can purify proteins. But if you tell them that we have sick people and we need to control rats and the fleas on those ratsthat’s not frequently taught. "This is an aspect we’re very concerned about. Continuing medical education is in some degree a balancing act; scientific and technical knowledge continues to grow so that clinicians and public health people need to know more technical things just to keep properly informed. In medical school, giving more time to major new problems, such as HIV, means less time spectrum or aengue rever naemorrnagic tever for classical parisitology and other things". Grades 3 and 4 dengue shock syndrome. Source: Dengue & Dengue Haemorrhagic Fever in the Americas (PAHO, SP 548), with permission. Alan McGregor ‘
;
=
957