Dengue Outbreak News since 18 Aug 2022

Collier County reports first case of dengue fever by locally infected mosquitoes [Naples Daily News, 25 Aug 2022]

by Liz Freeman

A human case of dengue fever that was locally acquired has been confirmed in Collier County and it is causing heightened concern of more infection, according to health officials.

"The Florida Department of Health in Collier County has not reported a case of locally acquired dengue fever in over 20 years," according to Kristine Hollingsworth, spokesperson for the state Department of Health in Collier.

The discovery prompted the department to issue an advisory.

“The risk of transmission to humans has increased,” the Collier health department said in a news release. “Collier County Mosquito Control and the (health department) continue surveillance and prevention efforts.”

Hollingsworth said residents should be on alert.

"It is mosquito borne and cannot be transmitted through person to person contact," she said. "The last locally acquired case was before 2000. We reported a case acquired outside of the United States in July."

As a result, Collier residents can expect to see more treatments and increased data gathering activities by the Collier Mosquito Control.

Specifically, the mosquito that transmits dengue fever lives in urban and highly populated environments because it prefers to feed on humans, according to Mosquito Control officials.

It is a day-time biter and breeds in containers holding water around homes and businesses.

“A mosquito picks up dengue fever in its salivary glands when biting a person infected with the virus,” Patrick Linn, the district's executive director, said in a news release. “The mosquito then passes the virus to each human she bites."

Linn said the district tests area mosquitoes for disease in its laboratory weekly, and currently none have tested positive for any mosquito-borne diseases, including dengue.

Dengue fever: The state reported the first local case of 2022 in Miami-Dade

Last month, the state reported the first local case of 2022 in Miami-Dade. A second case was identified in Miami-Dade on Aug. 1.

Last week, the state health department in Lee County reported detecting the West Nile virus in chickens.

Nationwide there have been 183 cases reported, acording to the U.S. Centers for Disease Control and Prevention. The CDC reported that Florida far outpaces any other states with cases 96 travel-related cases and two cases acquired within the state sd of Aug. 4. No other states have cases that were acquired locally.

In 2020, dengue transmission was detected in Key Largo and Marion County experienced an outbreak in 2013. In 2010, there were 66 cases of locally acquired dengue in Key West were reported from March through November of that year. In the fall of 2009, there were 22 cases in Key West.

Four human cases of West Nile infection in Collier County; no new cases in Lee

What is dengue fever?
Mild dengue fever causes a high fever and flu-like symptoms. The severe form that is also called dengue hemorrhagic fever can cause serious bleeding, a sudden drop in blood pressure, shock and death, according to the Mayo Clinic.

There is no treatment for dengue fever or dengue hemorrhagic fever, but quick recognition of symptoms and complications is effective at preventing deaths, according to the state health department.

Symptoms appear as early as three days but can take as long as two weeks after the bite of an infected mosquito and include sudden onset of fever, severe headache, eye pain, muscle and joint pain.

Gastrointestinal symptoms like vomiting and diarrhea may also be present in some cases. Dengue fever symptoms usually lasts 4-7 days. The disease is often diagnosed incorrectly because the symptoms are similar to influenza and other viruses.

There is currently no vaccine for dengue and the research has been challenging due to variation in the four viral types, but multiple vaccine candidates are currently in development.

“(Y)ou can get immunity to a version of dengue virus once you’ve been infected with it,” according to Cleveland Clinic. “Your immune system has tools it can use to recognize infections and get better at fighting them off. As your body fights a virus, it looks through its toolbox to find out which tool (antibody) it has that can destroy that specific threat.”

Dengue is spread from bites of the Aedes mosquitoes that also spread the chikungunya and Zika virus.

Millions of cases of dengue infection occur worldwide each year in tropical and subtropical areas. It is most common in Southeast Asia, the western Pacific islands, Latin America and Africa. But the disease has been spreading to new areas, including local outbreaks in Europe and southern parts of the United States.

Tips to be safe
Here are tips from the health department that involve outdoor activity, use of repellent, clothing and safety for children:
• Drain standing water to stop mosquitoes from multiplying, which includes water from garbage cans, house gutters, buckets, pool covers, coolers, toys, flower pots or any other containers where sprinkler or rain water has collected.
• Discard old tires, drums, bottles, cans, pots and pans, broken appliances and other items that aren't being used.
• Empty and clean birdbaths and pet's water bowls at least once or twice a week.
• Protect boats and vehicles from rain with tarps that don’t accumulate water.
• Maintain swimming pools in good condition and appropriately chlorinated. Empty plastic swimming pools when not in use.
• Cover doors and windows with screens to keep mosquitoes out of your house, and repair broken screening on windows, doors, porches, and patios.
• Cover skin with clothing by wearing shoes, socks, long pants and long-sleeves. This type of protection may be necessary for people who must work in areas where mosquitoes are present.
• Use repellent and use it according to the label. Apply insect repellent to exposed skin, or onto clothing, but not under clothing.
• Repellents with DEET, picaridin, oil of lemon eucalyptus, para-menthane-diol, 2-undecanone and IR3535 are effective.
• Use mosquito netting to protect children younger than 2 months old. Always read label directions carefully for the approved usage before you apply a repellent. Some repellents are not suitable for children.
• Products with concentrations of up to 30 percent DEET (N, N-diethyl-m-toluamide) are generally recommended. Other U.S. Environmental Protection Agency-approved repellents contain picaridin, oil of lemon eucalyptus, para-menthane-diol, 2-undecanone or IR3535. These products are generally available at local pharmacies. Look for active ingredients to be listed on the product label.

Dengue fever outbreaks in Hazara [Associated Press of Pakistan, 23 Aug 2022]

ABBOTTABAD, Aug 23 (APP): Dengue Fever has hit back all over Hazara division where dozens of the people were admitted to various hospitals in the region.

After reporting of dengue virus case in Khalabat Chhohar Colony Sector No. 2 district Haripur, District Health Officer (DHO) Haripur Dr. Manoor Khan Afridi ordered spray in the Khalabat township, the spray campaign for the prevention of dengue virus was completed in Chhohar Colony.

Health department has also started fog spray in several areas of Haripur including GT road, Circular road and inside the city areas. The department also issued directives for precautionary measures against dengue fever.

The situation of Dengue fever in district Mansehra is alarming as more than 20 patients including 5 women of the same village Phagla caught by the virus and have been admitted to King Abdullah Hospital Mansehra.

The dengue fever patients have the facility of Sehat Insaf Card for treatment. During the last few years district Mansehra is the worst hit by dengue fever where hundreds of patients had been registered from almost every union council.

People have complained that in the affected areas of Mansehra district administration and health department have sprayed only once or twice despite the outbreak of the disease.
They claimed that during the incubation period of the larva through August health department did nothing for the eradication and now Dengue is on the peak.

In Abbottabad, mostly the dengue fever cases have been registered from Sherwan circle while 4-5 case of Tehsil Havelian has been reported.

Takeda gets first approval for its dengue vaccine - [pharmaphorum, 23 Aug 2022]

by Phil Taylor

Japan’s Takeda has secured its first regulatory approval – in Indonesia – for its dengue fever vaccine TAK-003, which has been tipped as a potential blockbuster product.

Indonesia’s National Agency for Drug and Food Control (BPOM) has approved the vaccine as Qdenga to protect against the virus in people aged six to 45, on the back of data showing that it can cut dengue-related hospitalisations by 84%, with 61% protective efficacy against symptomatic illness seen up to three years after vaccination.

It isn’t the first dengue vaccine to reach the market, but is free of the severe restrictions that have held back its only predecessor, Sanofi’s Dengvaxia, which was cleared for marketing in 2015.

Dengvaxia can however only be used in seropositive children aged 9 to 16, after it emerged that it could cause more serious illness in those who were seronegative – i.e. they have not been infected with the virus before – relegating it to niche status.

Dengue fever is unusual in that a first infection is rarely serious, but a second can lead to much more serious disease. Shortly after launch Sanofi was forced to pull Dengvaxia off the market in the Philippines, where publicly-funded rollout of the shot had been started, after deaths were seen in vaccinated children.

Qdenga has been approved for use regardless of prior dengue exposure, so can be prescribed without the need for pre-vaccination testing, said Takeda.

Indonesia has experienced almost half of the dengue disease burden within Southeast Asia and continues to suffer from one of the highest burdens of dengue in the world, according to the drugmaker.

In the first half of this year, the country reported over 63,000 dengue cases and nearly 600 deaths from the virus. Dengue makes most people it infects seriously ill. Symptoms often include severe joint pain, vomiting, severe rashes, and a high fever.

Takeda has also filed for approval of TAK-003 in the EU and some other markets where the potentially deadly mosquito-borne disease is endemic, and is due to submit it to the US FDA in the coming months.

“Dengue can affect anyone living in or traveling to endemic areas – regardless of age, health and socio-economic circumstances,” said Gary Dubin, president of Takeda’s vaccines business unit.

“Developing this innovative dengue vaccine has been an exciting challenge, and its approval in Indonesia is an important achievement for Takeda and for public health,” he added.

Qdenga is also the first of the company’s vaccine products to be marketed outside Japan.

Takeda's dengue fever vaccine picks up first global nod in Indonesia [FiercePharma, 22 Aug 2022]

by Zoey Becker

For years, Takeda has been working hard to bring the first travel vaccine for dengue fever to the market. Now, the company can breathe a sigh of relief as the program snagged an approval from the Indonesia National Agency for Drug and Food Control⁠—its first anywhere in the world.

The vaccine, called Qdenga, is approved in the country for use in people 6 to 45 years of age regardless of prior dengue exposure. The country's regulator granted the approval based on results from the company’s ongoing phase 3 Tetravalent Immunization against Dengue Efficacy Study (TIDES), which enrolled more than 20,000 healthy children aged 4 to 16 living in dengue-endemic areas in Asia and Latin America.

Takeda's dengue vaccine efficacy slips between 12- and 18-month analyses Three years after vaccination, the vaccine delivered efficacy of 62% and was “generally well tolerated,” Takeda said in a statement. The vaccine prevented hospitalization from dengue fever by 83.6%.

Four and a half years after the second dose, Qdenga showed efficacy of 61.2% against virologically confirmed dengue and 84.1% efficacy against hospitalization from dengue.

Qdenga is based on a live-attenuated dengue serotype 2 virus that “provides the genetic backbone” for all four dengue virus serotypes. It's designed to protect against any and all of the serotypes, Takeda says, and is a 0.5-mL dose in a two-dose series.

Takeda's dengue shot 80% effective in massive phase 3 test
Dengue fever is a mosquito-borne viral disease that’s prevalent in over 125 countries.
Recently, Indonesia has experienced “almost half” of the dengue disease burden in Southeast Asia and continues to suffer from one of the “highest burdens of dengue in the world,” the company said in a statement. In the first half of 2022, the country reported more than 63,000 dengue cases and nearly 600 deaths across 455 cities in 34 provinces.

Takeda said last December that the vaccine could reach up to $1.6 billion in peak sales.

Dengue claims one more life, infects 66 so far [The Express Tribune, 21 Aug 2022]

Surveillance, spraying increased in some neighbourhoods

RAWALPINDI:
Forty-six year-old Naseer Khan died of the dengue virus at the District Headquarters Hospital on Saturday.

According to District Health Authority Chief Executive Dr Ishaq, the patient was brought to the hospital suffering from cirrhosis of the liver upon tests he was confirmed to be dengue positive as well. Unfortunately, the patient died while the treatment was in progress.

Khan was the resident of Chongi No.22 and his residence was sprayed against dengue larvae, said Dr Ishaq. He added that after his death the health department began dengue surveillance spray in the area.

Despite several warnings, a large number of dengue larvae spots are being found in the district. It has also been revealed during anti-dengue surveillance that around 1,263 dengue spots were left out while 374 houses were found to be dengue positive.

Moreover, fines have been increased and buildings are being sealed to restrict the spread of dengue.

Moreover, a formal warning was issued again to ensure that the breeding of dengue larvae is restricted in such localities.

So far, 66 dengue patients have been reported across the district, out of which 10 were confirmed patients and 42 were suspected patients, and 11 showed symptoms of dengue virus.

Similarly, a fine of Rs3,079,500 was fined during the surveillance of the anti-dengue campaign, 5,231 notices have been issued, 1,123 challans have been issued, 347 buildings have been sealed and 881 FIRs have been registered.

Chief Executive District Health Authority Dr Ansar Ishaq claimed that citizens are being repeatedly informed and warned against the spread of dengue larvae.

Florida: Miami-Dade County dengue local transmission cases now at five - Outbreak News Today [Outbreak News Today, 20 Aug 2022]

The Florida Department of Health in Miami-Dade County (DOH-Miami-Dade) remains under a mosquito-borne illness advisory following the confirmation of two identified cases of dengue in two Miami-Dade residents. This is the fourth and fifth local cases of dengue infection in the county and in the state in 2022.

In addition, the Florida Department of Health has reported one hundred and seventy-two cases with onset in 2022 in individuals with travel history to a dengue endemic area in the two weeks prior to onset.

Counties reporting cases were: Brevard, Broward (10), Collier, Duval (4), Escambia, Hendry, Hillsborough (16), Lee (5), Manatee (2), Miami-Dade (106), Monroe (2), Orange (5), Osceola, Palm Beach (6), Pinellas (4), Polk (3), Sarasota, St. Johns, and St. Lucie (2). Four cases were reported in non-Florida residents.

Of the 172 travel associated cases, Cuba was the country of exposure for 150 cases.

Dengue is a virus spread through mosquito bites by Aedes mosquitoes which also spread the chikungunya and Zika virus. Most people infected with dengue have mild or no symptoms. Those that do develop symptoms typically recover after about one week.

The common symptoms of dengue are fever and one or more of the following symptoms: headache; eye pain (typically behind the eyes); muscle, joint, or bone pain; rash; nausea and vomiting; or unusual bleeding (nose or gum bleed, small red spots under the skin, or unusual bruising). Severe dengue can occur resulting in shock, internal bleeding, and death. If you or a family member develop the mentioned symptoms, visit your health care provider or local clinic.
DOH-Miami-Dade encourages the use of repellent when outdoors.

• Apply mosquito repellent to bare skin and clothing, but not under clothing.

• o Always read label directions carefully for the approved usage before you apply a repellent – Some repellents are not suitable for children.
o Always use repellents according to the label. Repellents with DEET, picaridin, oil of lemon eucalyptus, para-menthane-diol, and IR3535 are effective.
o Use mosquito netting to protect children younger than 2 months old.
Additional Tips on Repellent Use
• In protecting children, read label instructions to be sure the repellent is age-appropriate. According to the Centers for Disease Control and Prevention (CDC), mosquito repellents containing oil of lemon eucalyptus should not be used on children under the age of three years. DEET is not recommended on children younger than two months old.
• Avoid applying repellents to the hands of children. Adults should apply repellent first to their own hands and then transfer it to the child’s skin and clothing.
• If additional protection is necessary, apply a permethrin repellent directly to your clothing. Again, always follow the manufacturer’s directions.

Poor sanitation in Bangladesh's Rohingya camps breeding dengue mosquitos [Anadolu Agency | English, 20 Aug 2022]

By SM Najmus Sakib

About 10,000 Rohingya infected with dengue virus until mid-August, 7 died

DHAKA, Bangladesh
Dengue fever, a virus spread by mosquitos, has infected stateless Rohingya refugees in one of the world's largest and most congested refugee camps in Cox's Bazar, Bangladesh's southeastern coastal district. Health experts say these camps have become a breeding ground for dengue mosquitos that are different from ordinary mosquitoes in both shape and color.

Bangladesh is currently hosting about 1.2 million Rohingya, the majority of whom fled a brutal military crackdown in Myanmar's Rakhine state in August 2017.

An average of seven to eight people live in a 120-square-foot room in a house with a poor sewer system, making the camp a breeding ground for mosquitos, particularly those carrying the dengue virus.

Dengue fever outbreaks are common during the rainy season in many places across the country, notably Dhaka and Cox's Bazar, due to humid conditions.

According to Health Ministry data, nearly 10,000 Rohingya were infected with the dengue virus until mid-August of this year, with seven deaths. This disease killed 105 people last year and infected 28,429 more.

Ansar Ali, a Rohingya community leader, is concerned about the spread of dengue fever in his two-bed house with nine other people after his younger brother became infected with the virus and is treated at a refugee hospital.

"I share a room with my five-member family, while my brother shares a room with four other refugees. We are all worried about contracting dengue and other infections as we cannot maintain privacy and hygiene in such crowded living conditions," he told Anadolu Agency.

- Poor sewer and waste management
Refugees attributed the situation to the unsanitary surroundings and poor waste management in the camps.

Khin Maung, a member of the persecuted Rohingya living in Camp-13, told Anadolu Agency that they are frightened over the rise in dengue cases.

"Waste and garbage are strewn throughout the camps, and waterlogging have grown common as a result of poor waste management and drainage systems. The situation worsens during the rainy season," the refugee explained.

"There are hospitals in and out of the refugee camps," he said, claiming, "but these are insufficient to manage the rising number of dengue patients."

A mosquito naturally bites one person and transmits the dengue virus to others, according to health experts, who, along with rights groups, have urged coordinated efforts to bring the situation under control.

Rezaul Karim Chowdhury, head of Coastal Association for Social Transformation Trust (COAST), a non-profit organization that works for the Rohingya, told Anadolu Agency that Cox’s Bazar city has become one of the most polluted areas in the country, posing serious health risks to its residents.

And, the refugee camps in the area are the worst of it, he added.

The government has begun dozens of development projects in the tourist hub of Cox's Bazar, many of which generate environmental pollution.

“Some old canals that are crucial for normal water flow during the rainy season have been acquired for road construction. Pollution and destruction of water bodies have caused waterlogging in Cox’s Bazar, posing a potential threat of dengue breeding,” he explained.

- Collective efforts needed
Some health experts say the origin and prevalence of dengue fever are increasing due to accumulated water in various areas of the camp, and that collective efforts are required to bring the situation under control.

Chowdhury said they have repeatedly urged the relevant authorities to ban the use of plastic and to develop waste-to-energy mechanisms in refugee camps.

He did, however, emphasize that refugee health care facilities are good, citing COVID-19 as an example, which he believes is less common among refugees in comparison to their vast population.

Dr Abu Toha, a chief health coordinator at the office of the Refugee Relief and Repatriation Commissioner (RRRC), told Anadolu Agency that the dengue infection rate is not alarming given a large number of refugees in the congested camps.

He did, however, admit that the living conditions in so many tents are unclean, which is one of the reasons dengue mosquitos breed. The prevalence of skin diseases in refugee camps has also been exacerbated by overcrowding, he added.

However, medical care is provided to refugees in collaboration with the government, UN agencies, and international non-governmental organizations (INGOs), including a Turkish hospital and health support.

The UNHCR has recently set up an ICU-bed hospital for refugees.

The health and sanitation staff are working hard to keep the camps clean.

"I have worked in various refugee camps across the world, and what I am seeing in Bangladesh is far better than what I have seen in other places," Dr Abu Toha asserted.

World mosquito day 2022: Most dangerous kinds of mosquitoes [Newsd.in, 20 Aug 2022]

Mosquitoes can cause diseases like malaria and dengue fever, but there are other types of mosquitoes that can cause harm too.

World mosquito day 2022: Mosquitoes can be a nuisance, but they can also carry some serious diseases. Mosquitoes in the United States are most commonly mosquito-borne viruses like dengue, Zika and chikungunya. Here are the three types of mosquitoes that pose the most danger to humans in the United States.

Types of Mosquitoes
Mosquitoes can be grouped by the type of vector they use to spread disease. There are four main types of mosquitoes: biting midges, ticks, fleas, and lice. Each mosquito type is more dangerous to humans than the others.

Biting midges are the most common type of mosquito in North America. They spread diseases like Rocky Mountain spotted fever, West Nile virus, and malaria. Biting midges are also responsible for causing a lot of seasonal allergies.

Ticks are the second most common type of mosquito in North America. They spread Lyme disease, Anaplasmosis, and Ehrlichiosis. Ticks can also carry other diseases like Babesiosis and Rocky Mountain spotted fever.

Fleas are the most common type of insect that carries human disease. Fleas spread plague, typhoid fever, bubonic plague, and cat-scratch fever. Fleas are also responsible for causing heartworm disease in dogs and cats.

Lice are the least common type of mosquito but they cause the most human diseases. Lice spread head lice, chickenpox, ringworm, and scabies.

World Mosquito Day 2022: What to do to help prevent mosquito-borne diseases

How Mosquitoes Bite
Mosquitoes can cause diseases like malaria and dengue fever, but there are other types of mosquitoes that can cause harm too. Here are the five most dangerous kinds of mosquitoes:
1. The Asian tiger mosquito is a type of mosquito that is indigenous to parts of Asia. They are known to spread the Zika virus.

2. The Aedes aegypti mosquito is the main carrier of dengue fever. They are found in tropical and subtropical areas all over the world.

3. The Culex tarsalis mosquito is the main carrier of West Nile virus. They are found in North America, South America, and parts of Europe.

4. The Anopheles gambiae mosquito is the primary vector for malaria. They are found in Africa and parts of Asia.

5. The Aedes albopictus mosquito is responsible for spreading chikungunya and yellow fever viruses.

Curious Kids: What would happen if all the mosquitoes in the world disappeared?

What to Do if You Are Bitten by a Mosquito
If you are bitten by a mosquito, the first thing to do is wash the area thoroughly with soap and water. This will help to remove any of the blood or saliva that may have landed on you and can help reduce the risk of infection. You also might want to consider using an anti-itch cream or ointment to relieve any pain or swelling. If the bite starts to itch excessively, apply an over-the-counter antihistamine such as Benadryl. Finally, if you experience any difficulty breathing, seek medical attention.

Ways to Remove Mosquitoes from Your Home
Most people think of mosquitoes when they think of pests in their home, but there are other types of pests that can be harmful. Mosquitoes are only one type of mosquito; the others include chikungunya and dengue viruses.

There are many ways you can remove mosquitoes from your home. You can use insecticides, repellents, or traps. Insecticides kill mosquitoes on contact, repellents keep them away, and traps catch them when they land.

To use an insecticide, you will need to apply it to the area where the mosquitoes are congregating. You should spray it around windows and doors and on surfaces where mosquitoes like to rest, such as flower pots and furniture. Make sure to read the instructions carefully before applying the pesticide.

If you want to use a repellent, make sure to apply it evenly all over your body and clothing. The active ingredient in most repellents is DEET, which is known to be safe if applied correctly. However, be aware that DEET can cause skin irritation in some people. If you experience any problems after using a repellent, contact your doctor.

Higher mosquito blood meals increase malaria transmission
Prevention Tips for the Season
Prevention is the key to reducing your risk of getting mosquito-borne diseases, such as Zika and West Nile. Here are some tips to help keep you and your family safe this season:
1. Use an EPA-registered insect repellent containing DEET, picaridin, or IR3535. Apply it generously and regularly, including when you’re outdoors in mosquitoes’ breeding grounds.

Follow the product instructions for application sites and clothing. Choose a repellent with the right protection level for you and your family.

2. Cover up! Wear long-sleeved shirts and pants, hat, and shoes when outside. Use mosquito netting if available or cover windows and doors with screens.

3. Make sure your water is clean – do not drink water from lakes, rivers, ponds, or standing water. Check for mosquitoes in these places before filling up your jugs or containers. Use a water filter if possible.

4. Avoid being bitten – mosquitoes need blood to reproduce, so avoid being outdoors during evening hours when they’re most active (around dusk and dawn).

DOH reviewing different dengue vaccines; Dengvaxia still need to apply for new license [INQUIRER.net, 19 Aug 2022]

By: John Eric Mendoza

MANILA, Philippines — In light of the continuous rise of dengue cases in the country, the Department of Health (DOH) officer-in-charge Maria Rosario Vergeire on Friday said the agency is reviewing different kinds of vaccines available for dengue.

Dengvaxia, on the other hand, needs to apply for a certificate of product registration (CPR) from the Food and Drug Administration, according to Vergeire.

Dengvaxia’s vaccine license was revoked after being linked to the deaths of several children, according to Vergeire.

“In order for us para magamit ang bakuna na ito, kailangan (to use this vaccine) the manufacturers will undergo or go through these processes of applying for the CPR and then kailangan ma-evaluate ulit ng ating (it has to be evaluated by) health technology council,” Vergeire said of the dengvaxia vaccine.

“But while waiting for that, of course, the Department of Health, together with our experts, are already reviewing the different vaccines available against dengue,” she added.

Vergeire noted that Dengvaxia’s CPR was revoked due to non-compliance with the requirements of the FDA.

In late 2017, the DOH halted its massive anti-dengue immunization program using Dengvaxia after its manufacturer Sanofi Pasteur said patients who got vaccinated but had no prior exposure to the virus could suffer severe symptoms.

The Public Attorney’s Office filed complaints against health officials for the deaths of children allegedly caused by the anti-dengue vaccine, which is being widely used in other countries worldwide.

But in January 2019, DOH said no death was confirmed to have been directly caused by Dengvaxia.

Meanwhile, nine out of 17 regions have reported an increase of dengue cases in the country, according to Vergeire. She didn’t elaborate on which regions were included.

Vergeire also said the country logged 23,414 dengue cases based on reports from July 3, 2022 to July 30, 2022, of whom, 18,208 or 78 percent of the dengue cases have been hospitalized.

Looming dengue outbreak [The Express Tribune, 19 Aug 2022]

Dengue larvae have been breeding on a large scale during the ongoing monsoon season
While the threat of Covid-19 has temporarily dwindled, Pakistan continues to face a host of dangerous diseases that resurge annually and adversely affect the health of citizens. In this regard, health officials in Rawalpindi were baffled to detect large number of dengue mosquito larvae at 16,000 different locations — 15,601 houses and 1,000 other localities — during indoor and outdoor surveillance campaigns. This is indeed an alarming revelation which could lead to a deadly outbreak in the near future.

It is believed that these dengue larvae have been breeding on a large scale during the ongoing monsoon season that saw many places inundated with water. Where there is stagnant water, dengue mosquitoes are bound to increase in number and become a health threat. The district has been carrying out anti-dengue campaigns but unfortunately implementation has been lacking as 99 locations were left out and fake activities were recorded in 377 locations.
Officials have taken timely action by registering FIRs, sealing buildings, issuing challans and enforcing dengue SOPs but a systematic action plan must be carried out to destroy breeding grounds before these larvae mature. The ordeal also indicates the importance of draining rainwater in a timely manner. But with many provinces across Pakistan witnessing unprecedented levels of rain, dengue could very well escalate into a national health crisis. This merits attention from the very top.

Surveillance campaigns must be carried out across flood affected areas to identify and destroy breeding grounds. Urban cities must issue dengue SOPs and work towards draining the remaining water left in affected localities. Abandoned buildings along with ponds, pools and other bodies of water in recreational spaces must not be left unchecked. But most importantly, the healthcare sector must be notified and well-equipped to deal with any outbreak.

Alarming rise in dengue cases: 1,568 hospitalised in August [The Business Standard, 19 Aug 2022]

by Md Jahidul Islam

Alarming rise in dengue cases: 1,568 hospitalised in August

The outbreak of the Aedes mosquito-borne viral disease is increasing across the country at an alarming rate as 1,568 dengue patients were hospitalised in the first 19 days of this month, while 1,571 were hospitalised in the entire month of July.

A total of 4,228 people with dengue were admitted to health facilities across the country since January this year, according to the Health Emergency Operation Centre and control room of the Directorate General of Health Services (DGHS).

Entomologists say the DGHS data about dengue patients does not give a complete or true picture of the dengue outbreak. The organisation collects data from only 47 hospitals in Dhaka and many private clinics in Dhaka remain outside its data collection efforts.

Entomologist Kabirul Bashar told The Business Standard that the data provided by DGHS is not correct as they only provide data of hospitalised patients. However, more dengue patients undergo treatment without hospitalisation.

He said, "If we compare Bangladesh with other countries, we find we have fewer dengue cases but more deaths, due to lesser awareness about dengue. Dengue patients can easily be cured if they get proper treatment and care. Delayed admission to hospitals increases the death risk for patients. Besides, data about dengue cases in other countries is more accurate and they act accordingly."

Fifty-four more dengue patients were hospitalised across the country in 24 hours until Friday morning. Of them, 46 patients were in Dhaka hospitals and eight were outside Dhaka, according to the DGHS.

As many as 398 dengue patients, including 335 in the capital, are now receiving treatment at hospitals across the country. Some 3,813 people have so far been discharged from hospitals after being cured.

According to the DGHS, dengue cases have been reported in all the divisions except Sylhet.
After Dhaka, the second highest number of dengue cases was reported in Chattogram division. So far, 542 dengue cases have been reported in the division and 10 dengue patients have died in its Cox's Bazar district. Then there are the Khulna, Barisal, Mymensingh, Rajshahi and Rangpur divisions respectively, with only 136 patients.

The disease control unit of DGHS has started its Monsoon Aedes Survey-2022 from 13 August under the National Malaria Eradication and Aedes-borne Disease Control Program, which will continue until 22 August in 110 places of 98 wards in the two Dhaka city corporations.

The DGHS conducted a 10-day pre-monsoon Aedes Survey-2022 from 23 March when they found 94.09% Culex mosquitoes in their traps, while the remaining 5.01% were Aedes mosquitoes. Of those, 42.11% larvae of mosquitoes were found in under-construction buildings while 31.58% larvae were in high-rise buildings, which was more than in the previous year.

Entomologist Kabirul Bashar, associated with the survey, said that a little less Aedes larva were found in this survey than last year.

He told TBS, "However, it will be possible to ascertain dengue infections this season when the survey is done. We alerted the city corporations following the pre-monsoon survey and they launched mosquito eradication drives, which helped reduce the outbreak. Moreover, it has not been raining much for the past few days, which also helps diminish dengue cases."

From the European Centre for Disease Prevention and Control, the geographical distribution of dengue cases reported worldwide, (May to July 2022) shows that 2,357,301 cases and 1731 deaths were reported worldwide as of 27 July.

Brazil topped with the most cases (1827617), Vietnam (103433), Philippines (64797), Peru (56021) and Indonesia (52313). Brazil saw the most deaths (737), Indonesia (448), Philippines (274), Peru (65) and Timor Leste (56).

Diseases Mosquitoes Can Give to Humans Are Malaria, Zika, West Nile, Dengue, Yellow Fever, chikungunya [The Daily Beast, 19 Aug 2022]

by Jaishree Raman And Shüné Oliver,


Six Diseases Mosquitoes Can Give to Humans
You know about malaria—but there’s more misery these bugs can bring.

Most people instantly associate mosquitoes with malaria. But these tiny flying insects can transmit a number of other diseases too.

Viruses transmitted by insects like mosquitoes are called arthropod-borne or arboviruses. Like malaria, these viruses are transmitted to vertebrate hosts through the bite of a female mosquito when she takes a blood meal to assist with her egg development. Most vertebrate hosts for these arboviruses are non-human. They include birds, primates and agricultural animals. But some arboviruses can be transmitted to humans with severe negative outcomes.
Five of the most important arboviruses affecting communities in Africa include the chikungunya, dengue, West Nile, yellow fever and Zika viruses. It is estimated that half of the world’s population is at risk of being infected by an arbovirus.

Some mosquito-borne diseases—but not all—can be fatal to humans. This confirms that every effort must be made to prevent being bitten by a mosquito and infected using both pharmaceutical and non-pharmaceutical measures.

Chikungunya
The name chikungunya is derived from the Kimakonde language (used in Tanzania and Mozambique) and means “to become contorted”. The symptoms of chikungunya virus include headaches, a rash, fatigue, fever and muscle and joint pain. Generally these symptoms clear within a week. Occasionally, an infection can result in a severe fever and extremely painful joints, which can last for months or years, inducing a hunched, contorted appearance. Unfortunately, there are no antiviral or vaccine treatments available for chikungunya virus.
Deaths from chikungunya are rare and are generally associated with other underlying health problems.

The chikungunya virus was first identified in 1952 during an outbreak in Tanzania. It is transmitted by Aedes aegypti and Aedes albopictus mosquitoes. Over 100 countries across the globe have reported chikungunya virus cases. The risk of outbreaks is extremely high wherever these mosquito species are present around homes and urban areas.

Female Aedes mosquitoes tend to feed just after sunrise and around sunset. They lay eggs that can survive drying out. This makes vector control rather challenging. Current control strategies focus on reducing the number of water containers that these mosquitoes like to breed in, the use of insecticides against adult mosquitoes and personal protection to prevent mosquito bites.

Dengue
The World Health Organization has classified dengue virus as one of the top ten global health threats. It’s one of the fastest spreading mosquito-borne diseases. At least half of the world’s population is at risk of infection.

Like chikungunya virus, dengue is spread by Aedes aegypti and Aedes albopictus mosquitoes. Both viruses share the same control interventions and non-specific symptoms of headaches, a rash, fever and muscle and joint pain, so they are often misdiagnosed.

Most human cases of dengue are asymptomatic or present with mild symptoms, which last for two to seven days. In certain individuals, dengue virus progresses to severe disease and symptoms include persistent vomiting, bleeding gums or nose and enlarged liver. This must be treated as a medical emergency as these complications can be lethal. Dengue virus can be diagnosed using a rapid diagnostic test or a polymerase chain reaction (PCR) test.

But there is no treatment available. A vaccine has been developed and has been approved for use in a few countries—but is not widely available in Africa at present.

Zika
The Zika virus was identified in humans in the 1950s. But it only became a pathogen of major public concern in 2016 following the 2015 Zika virus pandemic. The virus is transmitted by Aedes aegypti and Aedes albopictus mosquitoes, and is generally non-lethal in humans. Most people infected with Zika virus do not show any symptoms. A few have non-specific symptoms like fever, rash, headaches, muscle and joint pains and conjunctivitis. These can last two to seven days.

Individuals infected with Zika virus while pregnant are at an increased risk of stillbirth, abortion, neurological disorders or delivering children with birth defects, including microcephaly. PCR testing can be used to diagnose Zika virus, but there is no treatment available.

Yellow fever
Aedes aegypti and Aedes albopictus mosquitoes are also responsible for the transmission of yellow fever, so named because the virus causes jaundice (yellowing of eyes and skin due to impaired liver function).

Symptoms in mild cases include fever, headaches, chills, back pain, fatigue, jaundice, vomiting and bleeding from the mouth, nose, eyes or stomach. These generally clear within five days. Approximately 50 percent of the small number of patients who develop severe symptoms will die within 10 days of becoming infected. Yellow fever can be diagnosed by PCR or enzyme-linked immunosorbent assay (ELISA). Although there is no treatment for yellow fever, a very effective vaccine is widely available. A single vaccine dose provides lifelong immunity, so all individuals living in or traveling to areas endemic for yellow fever should take the vaccine.

West Nile
The West Nile virus was first isolated from a woman in the West Nile region of Uganda. It is transmitted by mosquitoes belonging to the genus Culex. The natural vertebrate hosts are wild birds. But the virus can be transmitted to a number of different animals, including humans, through the bite of an infected mosquito. Approximately 80% of the people infected with West Nile virus will not show any symptoms. Those who do become symptomatic have mild non-specific symptoms that include headaches, fever, tiredness, body aches, nausea, vomiting and, occasionally, a rash. A small proportion of symptomatic patients, however, develop severe disease. This is associated with neurological impairment, and can be fatal in extreme cases.

West Nile virus infection can be diagnosed by PCR or ELISA, with only supportive treatment available for neurological impairment. It has been suggested that people who are older than 50 or immunocompromised are at greater risk of severe infection. An integrated approach comprising water management together with chemical and biological interventions is needed to control the spread of the Culex vectors.

First human case of dengue in Florida spurs mosquito-borne illness advisory [New York Post, 19 Aug 2022]

Health officials in Miami-Dade County issued a mosquito-borne illness advisory on Monday after the first case of dengue was confirmed this year in a Florida resident.

The dengue virus can be spread through Aedes mosquito bites, which also spread the chikungunya and Zika virus, according to the Miami-Dade Department of Health.

Symptoms can include fever, headache, eye pain, muscle, joint and bone pain; nausea, vomiting and unusual bleeding in the nose or gums.

According to the Centers for Disease Control and Prevention, about 1 in 4 people who get dengue will develop symptoms, and 1 in 20 will become seriously ill. Babies and pregnant women are at higher risk for developing severe dengue, according to the CDC.

According to the Department of Health, most people with symptoms recover after about a week.

There is no specific treatment for dengue. However, children between 9 and 16 years old who have previously been infected could be eligible for a new dengue vaccine, according to the CDC.
Just like most pests, the weather influences mosquitoes that carry the virus.

Miami-Dade Mosquito Control Division Manager Dr. Isik Unlu explains mosquitoes do well in warm but not extreme temperatures.

“Mosquitoes, just like the country song ‘Sunny and 75 Day,’ they like sunny and 75. They do not do well with extremes,” Unlu said. “If we talk about temperatures, around the 50s and 86, anything above 86 mosquitoes start struggling.”

Rainfall also affects the mosquito lifecycle because more rain helps create more habitats to lay eggs, according to Unlu. Meanwhile, too much rain can wipe out the eggs.

Miami-Dade Mosquito Control Division crews have been out treating for dengue in a two-block radius where the transmission happened.

As soon as health officials know the location of someone suspected of having a mosquito-borne illness such as dengue, a treatment team is sent out immediately.

“They inspect the property and other surrounding properties. Then spray for mosquitoes and for adult mosquitoes that evening. They continue to do truck-mounted larviciding every week to keep adult mosquitoes from emerging, particularly if there’s standing water lingering around,” Unlu said.

Treatments continue every two days until adult mosquito numbers start declining.

Florida health officials advise the “drain and cover” method to avoid attracting mosquitos that carry the virus.

Standing water from garbage cans, flower pots or other outdoor containers where rainwater collects should be drained regularly. Outside pet bowls and birdbaths should be cleaned at least twice a week. Swimming pools should be kept clean with chlorination.

“This mosquito is not coming from the saltmarsh, not coming from (a) big body of water. It is actually derived in our backyards,” Unlu said. “They may have their eggs and larvae and pupae in those containers, such as flower pots, old tires, bird baths. Anything that you can think of would hold water for seven days or more. So I strongly encourage the residents to be vigilant and drain and cover that.”

The “cover” method includes covering your body to avoid mosquito bites. This is especially necessary for people who work outside where the flies may be present. The health department recommends wearing shoes, socks, long pants and long sleeves. Mosquito repellent should be applied to bare skin and over the clothing.

How common is dengue in Florida?
According to the Florida Department of Health, after dengue was eradicated from the U.S., there were no dengue cases in Florida from 1934 to 2008. In 2009 and 2010, a dengue outbreak was identified in Key West that included 88 people over two years. Another outbreak in Monroe County in 2020 included nearly 50 people, according to the Florida DOH.

Several cases of the disease related to the West Nile Virus are confirmed in the Sunshine State every year. Most of these cases come from people who have traveled to dengue-endemic regions, including the Caribbean, Central and South America and Asia.

Dengue Concerns in the Americas Continue [Vax-Before-Travel, 18 Aug 2022]

(Vax Before Travel)
The U.S. Centers for Disease Control and Prevention (CDC) recently updated its Watch - Level 1, Practice Usual Precautions, regarding dengue virus cases in the Americas.

As of August 15, 2022, the CDC says 'dengue is a risk in many parts of Central and South America, Mexico, and the Caribbean. These countries are reporting increased numbers of cases of the disease.

For example, the Florida Department of Health in Miami-Dade County confirmed on August 14, 2022, that it remains under a mosquito-borne illness advisory following the identification of a third local case of dengue infection in 2022.

Travelers to areas of risk should protect themselves by preventing mosquito bites, says the CDC.

Dengue can take up to two weeks to develop, with the illness generally lasting less than a week.
However, dengue can become severe within a few hours and usually requires hospitalization.

In severe cases, health effects can include uncontrolled bleeding, seriously low blood pressure, organ failure, and death.

As of August 2022, the World Health Organization and the U.S. FDA recommend dengue vaccines should be given to persons as-risk for dengue.

The FDA authorized the Dengvaxia vaccine for limited use in May 2019 for people with laboratory-confirmed previous dengue infection and living in dengue-endemic areas.

This FDA recommendation is essential because preexisting cross-reactive antibodies have been implicated in protection and pathogenesis during subsequent infections with different dengue virus serotypes (DENV1-4).

Certified travel vaccination pharmacies in the USA can provide updated insights into dengue provention.

Codagenix wins $4.4M from Defense Dept. for dengue vaccine [Newsday, 18 Aug 2022]

By Ken Schachter

Codagenix Inc. has won a $4.4 million Defense Department award to develop a vaccine against dengue fever, which could pose a risk for soldiers and travelers in Asia, Latin America and elsewhere.

The Farmingdale-based biotechnology company, whose intranasal COVID-19 vaccine is undergoing clinical trials, received the three-year award for the dengue vaccine through the Joint Warfighter Medical Research Program.

Dengue, which is typically spread by Aedes mosquitos that have bitten humans or animals harboring the disease, sickens about a quarter of those infected. A much smaller minority who come down with a severe version of the disease may go into shock, vomit blood, bleed from the nose or gums and feel pain or tenderness in the belly, according to the Centers for Disease Control and Prevention. Those with severe symptoms should seek medical treatment immediately, the agency advises.

Destinations in the Caribbean (including Puerto Rico), Central and South America, Southeast Asia, and the Pacific Islands have reported outbreaks. In the United States, limited spread of dengue occurs sporadically in states with hot, humid climates like Hawaii and Florida. In July, for instance, Florida's Department of Health reported the year's first locally transmitted case of dengue fever in the Miami region.

In a statement, J. Robert Coleman, Codagenix co-founder and chief executive, said the funding will let the company push its vaccine candidate, CodaVax-DENV, toward clinical trials "and assess its potential as a safe and effective option for protecting our troops and high-risk populations across the globe."

U.S. troops seek to avoid mosquito-borne diseases with insect repellent applied to their skin and by wearing specially treated clothing.

There is no medicine to treat severe dengue. The sole vaccine approved by the Food and Drug Administration, Dengvaxia, made by Sanofi Pasteur Inc., only has clearance for children, aged 9-16, who had been previously infected by the disease. The vaccine's limitation to those who had earlier been infected was added after the company found that vaccinated children who had never been infected could come down with a more severe version of dengue.

In addition to Codagenix, several other life sciences companies are working to develop a vaccine to protect against dengue, whose four virus strains make creation of a single vaccine challenging.

Codagenix's software uses a computer algorithm to recode virus genomes and construct a live, but disabled, version that confers immunity.

Closely held Codagenix is funded by Adjuvant Capital, TopSpin Partners and Euclidean Capital.

Taiwan reports first domestic dengue fever case in over a year: CDC [Focus Taiwan, 18 Aug 2022]

By Chen Chieh-ling and William Yen

Taipei, Aug. 18 (CNA) Taiwan reported its first domestic case of dengue fever in over a year in a man from Taichung, who travels around central Taiwan for work, the Taiwan Centers for Disease Control (CDC) said Thursday.

The patient, a salesman in his 50s, lives in Taichung's Tanzi District and started showing symptoms including a fever, fatigue and discomfort on Aug. 9. He sought medical treatment five times from Aug. 10-17, CDC Deputy Director-General Chuang Jen-hsiang (莊人祥) told CNA.

On Aug. 17, the man's NS1 antigen test showed a positive result for the mosquito-borne illness and the CDC was notified, Chuang said.

The man has no recent history of overseas travel, but has visited Taichung and industrial areas in Changhua County, Chuang said, adding that the source of infection is being investigated.

However, investigations have so far showed that the vector mosquito index of places were the man has been is relatively high, and work has been carried out to remove breeding sources, Chuang said.

The man is now resting at home and family members who share the same residence have shown no suspected symptoms, Chuang said.

According to CDC data, Taiwan did not report any dengue fever cases last year.

Chuang said the recent case could be connected to the shortening of the quarantine period for incoming passengers as it was reduced this year from 14 days to three days of home quarantine and four days of self-initiated epidemic prevention.

Since it is possible for an incoming traveler to leave quarantine after three days, imported cases could have led to local transmission in the community, Chuang said.

There have already been 20 imported cases of dengue recorded so far this year, Chuang said.
Neighboring countries that have dengue fever include Vietnam, Indonesia, the Philippines, Singapore and Thailand, according to the CDC.

It urged the public to watch out for areas that may become breeding grounds for mosquitoes, especially after rain.

If individuals develop a fever, headache, pain behind the eyes, muscle and joint pain, red rash or other dengue fever symptoms they are advised to seek medical attention immediately and tell medical staff of their travel history, the CDC added.