The deadly hemorrhagic form of dengue fever is increasing drastically in Mexico, and experts predict a surge throughout Latin America fueled by climate change, migration and faltering mosquito eradication efforts.
Overall dengue cases have increased by more than 600 percent in Mexico since 2001, and worried officials are sending special teams to tourist resorts to spray pesticides and remove garbage and standing water where mosquitoes breed ahead of the peak Easter Week vacation season.
Even classic dengue — known as “bonebreak fever” — can cause severe flulike symptoms, excruciating joint pain, high fever, nausea and rashes.
More alarming is that a deadly hemorrhagic form of the disease, which adds internal and external bleeding to the symptoms — is becoming more common. It accounts for one in four cases in Mexico, compared with one in 50 seven years ago, according to Mexico’s Public Health Department.
While hemorrhagic dengue is increasing around the developing world, the problem is most drastic in the Americas, according to the Centers for Disease Control and Prevention.
Like a poster child for the downside of humanity’s impact on the planet, dengue is driven by longer rainy seasons some blame on climate change, as well as disposable plastic packaging and other trash that collects water. Migrants and tourists — including the many thousands of Americans expected for spring break this year — carry new strains of the virus across national borders, where mosquitoes can spread the disease.
The CDC says there’s no drug to treat hemorrhagic dengue, but proper treatment, including rest, fluids and pain relief, can reduce death rates to about 1 percent.
Virus may grow deadlier
Latin America’s hospitals are ill-equipped to handle major outbreaks, and officials say the virus is likely to grow deadlier, in part because tourism and migration are circulating four different strains across the region. A person exposed to one strain may develop immunity to that strain — but subsequent exposure to another strain makes it more likely the person will develop the hemorrhagic form.
This dengue spread “is one of the primordial public health problems the country faces,” said Mexico’s Public Health Department, which has sent hundreds of workers to the resorts of Puerto Vallarta, Cancun and Acapulco to try to avert outbreaks ahead of the Easter week vacation.
“We are working intensively, both the federal and state governments, on (these) three sites that we want to keep under control, so that it doesn’t become a risk for tourists,” said Pablo Kuri, head of Mexico’s National Center for Epidemiology and Disease Control.
The Canadian Embassy in Mexico City issued an alert about dengue after five Canadians were sickened in Puerto Vallarta earlier this year. Acapulco, a city of 700,000, has documented 549 cases of classic and hemorrhagic dengue in the first two months of 2007, up from just 86 for the same period last year.
Dengue is mostly a problem in tropical slums, where trash collection and sanitation are not as good as in tourist areas.
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U.S. not immune
In January and February, Mexico’s dry season, there were 1,589 cases of both types of dengue nationwide, up 380 percent from the same period in 2006, Kuri said. And last year was also bad for dengue: Mexico documented 27,000 infections overall — including 4,477 hemorrhagic cases and 20 deaths — compared with 1,781 cases overall in 2001.
Dengue has been found along the U.S.-Mexico border, where 151 classic and 46 hemorrhagic cases were recorded last year in the Gulf state of Tamaulipas, south of Texas.
Historically, the United States hasn’t been immune from dengue — a 1922 outbreak in Texas infected a half-million people. And according to the CDC, dengue returned to southern Texas in 1980 after a 35-year absence. Occasional cases since then have included hemorrhagic dengue.
The Intergovernmental Panel on Climate Change, made up of the world’s leading climate scientists, predicted in March that global warming and climate change would cause an upsurge in dengue. In Mexico, officials say longer rainy seasons already are leading to more cases.
“It used to be seasonal, in the hottest, wettest months, and now in some regions we are seeing it practically all year,” said Joel Navarrete, an epidemiologist with the Mexican Social Security Institute.
Solution is mosquito control
The global solution to dengue outbreaks is mosquito control, and faltering eradication efforts, together with climate change, probably share blame for dengue’s rise in the Americas, Kuri said.
A successful eradication program in Latin America in the 1960s sent the disease into remission, but economic crises and government downsizing sapped those efforts over the next two decades. Some countries reported severe outbreaks in the 1980s, and by the 1990s, dengue began a regional resurgence.
Paraguay declared a state of emergency in March after 17 people died of hemorrhagic dengue and an estimated 400,000 were infected with the milder “classic” form of the disease. The government sent soldiers into the streets in an emergency campaign to spray insecticides and clean up stagnant water.
At least 24 people died of hemorrhagic dengue in the Dominican Republic last year.
“It’s part of globalization,” Kuri said. “Someone can be in Paraguay, where there is a big outbreak, with type-one virus, and six hours later be in Mexico.”
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