United States Consulate General Guadalajara
PLEASE CIRCULATE THIS IMPORTANT ANNOUNCEMENT TO AS MANY AMERICAN CITIZENS AS POSSIBLE
 
Warden Message #03 FY2009
 
Warden Message: Dengue Fever Outbreak
 
U.S. citizens should be aware of the recent dengue fever outbreak in Jalisco,
concentrated in the Guadalajara suburb of Zapopan.  In the past year, 276
cases have been reported in Jalisco state, including five cases of the more
severe dengue hemorrhagic fever.  No deaths in Jalisco have been attributed
to dengue fever since 2006, and the number of reported cases has dropped
significantly in recent weeks.  
 
The 271 reported cases of dengue fever by municipality are as follows:
 
Zapopan 191, Guadalajara 22, Puerto Vallarta 16, Tequila 13, Tlaquepaque 9,
Jilotlan 7, Pihuamo 3, Tomatlan 2, Zapotlan El Grande 2, Cihuatlan 1, Sayula
1, Tamazula 1, Tecalitlan 1, Tuxpan 1, Hostotipaquillo 1.  Most of these
cases occurred in six neighborhoods within the Zapopan municipality: El
Batan, Victor Hugo, Constitucion, Mesa de los Octoes, La Martinaca, and
Balcones de la Cantera.  
 
The five reported cases of dengue hemorrhagic fever by municipality are as
follows:  Zapopan 4, Puerto Vallarta 1.  Only one of these patients remains
hospitalized, while the remaining four have recovered.
 
According to local media and Consulate sources, one U.S. citizen living in
the Jocotepec municipality of Ajijic was infected with the dengue virus in
September 2008.  Jalisco's Health Department, however, has not received
official notification of any confirmed dengue cases in the Chapala/Ajijic
basin area.  The Consulate is not aware of any other affected U.S. citizens
at this time.
 
Local media attributed the death of an 18-year old female resident of the
Victor Hugo neighborhood in Zapopan to dengue hemorrhagic fever; however, the
Jalisco Health Department confirmed that her death was not a result of
dengue, 
 
The local government is working to combat this outbreak through a public
information campaign to raise public awareness of the dengue and the
importance of mosquito control.  Local government is also procuring more
mosquito control equipment, such as spraying equipment to eradicate mosquito
breeding areas
 
Residents should report any suspected or confirmed cases of dengue fever by
calling the Jalisco Health Department (Secretaria de Salud, Gobierno de
Jalisco) at 33-3030-5065.
 
What is Dengue Fever?
 
Overview
 
Dengue fever is an infectious disease carried by mosquitoes and caused by any
of four related dengue viruses. This disease used to be called "break-bone"
fever because it sometimes causes severe joint and muscle pain that feels
like bones are breaking. Health experts have known about dengue fever for
more than 200 years. 
 
Dengue fever is found mostly during and shortly after the rainy season in
tropical and subtropical areas of: 
 
*       Africa 
 
*       Southeast Asia and China 
 
*       India 
 
*       Middle East 
 
*       Caribbean and Central and South America 
 
*       Australia and the South and Central Pacific 
 
An epidemic in Hawaii in 2001 is a reminder that many locations in the United
States are susceptible to dengue epidemics because they harbor the particular
types of mosquitoes that transmit dengue virus. 
 
Worldwide, 50 to 100 million cases of dengue infection occur each year. This
includes 100 to 200 cases in the United States, mostly in people who have
recently traveled abroad. Many more cases likely go unreported because some
health care providers do not recognize the disease. 
 
During the last part of the 20th century, many tropical regions of the world
saw an increase in dengue cases. Epidemics also occurred more frequently and
with more severity. In addition to typical dengue, dengue hemorrhagic fever
(DHF) and dengue shock syndrome also have increased in many parts of the
world. Globally, there are an estimated several hundred thousand cases of DHF
per year.
 
Cause
 
Dengue fever can be caused by any one of four types of dengue virus: DEN-1,
DEN-2, DEN-3, and DEN-4. You can be infected by at least two if not all four
types at different times during your lifetime, but only once by the same
type. 
 
Transmission
 
Dengue virus can be transmitted from the bite of an infected Aedes mosquito.
Mosquitoes become infected when they bite infected humans, and can later
transmit the infection to other people. Two main species of mosquito, Aedes
aegypti and Aedes albopictus, have been responsible for all cases of dengue
transmitted in Mexico. Dengue cannot be transmitted from person to person
without a mosquito as the intermediate vector. 
 
Symptoms
 
Symptoms of typical uncomplicated (classic) dengue usually start with fever
within 4 to 7 days after you have been bitten by an infected mosquito. These
symptoms include: 
 
*       High fever, up to 105ºF 
 
*       Severe headache 
 
*       Retro-orbital (behind the eye) pain 
 
*       Severe joint and muscle pain 
 
*       Nausea and vomiting 
 
*       Rash 
 
The rash may appear over most of the body 3 to 4 days after the fever begins,
and then subsides after 1 to 2 days. There may be a second rash a few days
later. 
 
Symptoms of dengue hemorrhagic fever include all of the symptoms of classic
dengue plus bleeding from the nose, gums, or under the skin, causing purplish
bruises, which results from damage to blood vessels. This form of dengue
disease can cause death. 
 
Symptoms of dengue shock syndrome--the most severe form of dengue
disease-include all of the symptoms of classic dengue and dengue hemorrhagic
fever, plus severe bleeding and 'shock' (very low blood pressure).  This form
of the disease usually occurs in children (sometimes adults) experiencing
their second dengue infection. It is sometimes fatal, especially in children
and young adults. 
 
How is Dengue Diagnosed and Treated?
 
Dengue can be diagnosed by doing two blood tests, 2 to 3 weeks apart. The
tests can show whether a sample of your blood contains antibodies to the
virus. However, in epidemics, a health care provider often diagnoses dengue
"presumptively" by typical signs and symptoms without waiting for lab
results. 
 
Treatment
 
There is no specific treatment for classic dengue fever, and most people
recover within 2 weeks. To help with recovery, health care experts recommend:
 
 
*       Getting plenty of bed rest 
 
*       Drinking lots of fluids 
 
*       Taking medicine to reduce fever 
 
The U.S. Centers for Disease Control advises people with dengue fever not to
take aspirin. Acetaminophen or other over-the-counter pain-reducing medicines
are safe for most people. 
 
For severe dengue symptoms, including shock and coma, early and aggressive
emergency treatment with fluid and electrolyte replacement can be lifesaving.
 
 
Complications
 
Most people who develop dengue fever recover completely within 2 weeks. Some,
especially adults, may be tired and/or depressed for several weeks to months
after being infected with the virus.
 
The more clinically severe dengue hemorrhagic fever and dengue shock
syndromes can result in vascular (blood vessel) and liver damage, and can be
life-threatening. 
 
How Can I Prevent Dengue?
 
The best way to prevent dengue virus infection is to take special precautions
to avoid being bitten by mosquitoes
<https://http:/www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=recs&obj=bu
gs.htm&cssNav=browseoyb> . Several dengue vaccines are being developed, but
none is likely to be licensed by the Food and Drug Administration
<https://www.fda.gov/>  in the next few years. 
 
When outdoors in an area where dengue fever has been found: 
 
*       Use a mosquito repellent containing DEET, Picaridin, and oil of lemon
eucalyptus are less effective than DEET so are not recommended as a
substitute unless there is an allergy or a contraindication to DEET or it is
unavailable.  
 
*       Dress in protective clothing-long-sleeved shirts, long pants, socks,
and shoes 
 
Because Aedes mosquitoes usually bite during the day, be sure to use
precautions especially during early morning hours before daybreak and in the
late afternoon before dark. 
 
Other precautions include: 
 
*       Keeping unscreened windows and doors closed 
 
*       Keeping window and door screens repaired 
 
*       Carefully inspect your environment to detect and eliminate all areas
with standing water where mosquitoes can breed, such as flower pots,
containers, birdbaths, discarded tires, etc.