Friday, July 16, 2010

Florida's newest arrival: Dengue Fever







Here it is only July and in Florida we have already been given enough to worry our heads about for the entire year. We lead the nation in unemployment and housing foreclosures. The prognosticators started warning us early this year that this will be a record hurricane season (State Farm apparently responded to this prediction by promptly canceling my homeowners policy after 31 years!) and we have been told to prepare for the onslaught of oil from the BP disaster that will reach our beaches and estuaries in one or more of several (all heinous) forms that include such names as mousse, tar balls and tar sticks. I kid you not, watching the evening forecast on the Mobile and Pensacola television stations during the weather segment they now announce which (if any) of these disgusting forms of oil can be expected by beachgoers on the following day. Thanks BP. Bastards!

So with all this on our minds perhaps we can be forgiven if we overlooked that little article reporting on observations by the CDC that was tucked in between the latest misbehaving elected officials and the newest examples of corporate criminal activity or unbelievable greed that fill the news. No wonder most of us overlooked the fact that a dozen cases of Dengue Fever were uncovered in Key West, Florida. But as someone who contracted Dengue while working and traveling in Southeast Asia it caught my attention. I learned quickly during my bout why it is called “Breakbone Fever” in much of the world. The persistent high fevers and excruciating joint pains I experienced made it one of the most unpleasant experiences of my life. So when the CDC announced this week that their epidemiological survey has determined that over 5% of all the Key West residents have antibodies to Dengue Fever I realized, “Florida, we got a problem”.

Even if people have heard of it, very few know how to pronounce it (den’ gee). Now is the time to take a few minutes to sit down and learn a few useful facts. The most important of which is “remain calm”. We all know a huge media spin is about to accompany this revelation so a few facts will help head off irrational fear. The CDC tells us over 5% of the people in Key West (over a thousand) were exposed to or infected by the virus that causes Dengue, yet less than 100 have actually sought medical care. That tells us that the majority of the people have very mild infections. That’s the good news part. Still it is of little comfort if you are one of the ones who experience a really bad case of Dengue and right now the reasons around why who gets which type of illness are pretty hypothetical. The illness can range from very mild to some wicked complications that include Dengue Hemorraghic Fever (DHF) to Dengue Shock Syndrome (DSS). With names like that, you know they can’t be good.

I was feeling a bit smug in thinking that since I have previously had Dengue I will just be sitting on the sidelines as this epidemic travels through the parts. Then I did a quick review of those CDC fact sheets and learned there are actually four types of Dengue (named 1 -4) and they are so named because there are 4 different viruses that can cause Dengue and if you contract one you still are vulnerable to the other three. I was not pleased to learn I can theoretically experience this disease 4 times. I was even less pleased to learn that when you have it a second time it ups your chances of experiencing DHF or DSS significantly.

It is important to remember that this disease is transmitted by the bite of an infected mosquito. We don’t give it to each other. It has been shown to be transmitted via donor blood and human organ transplantation so the CDC has already begun taking proper measures with the appropriate industries and agencies to safe guard those practices. Let’s remember we cannot contract the disease directly from each other. It requires the mosquito to bite an infected person, incubate the virus and then transmit it to a healthy person in a subsequent bite. The mosquito vector is the key here. And it is not just any species of mosquito.

What we need to do now is make sure we take proper precautions to avoid mosquito bites. The mosquito that carries this disease is a pesky little mosquito that just loves to live around us, our old friend Aedes aegypti. No it couldn’t be one of those annoying but not usually found in our backyard mosquitoes that you only encounter in the Everglades. It is transmitted by ae. aegypti who has developed a fondness for living in the little splashes of water that we provide around our homes when gutters are not properly cleaned, or empty flower pots accumulate around the back beside the air conditioners, etc. But these days with all the abandoned and foreclosed properties, we have an unprecedented supply of incubators in our communities from small puddles in a low area of an unused patio to an abandoned backyard pool. The conditions are ripe for ae. aegypti in our communities like never before.

The link below to the CDC site contains some excellent information on Dengue including transmission, signs and symptoms and most importantly prevention. Oh, by the way, there is no vaccination for the virus and no specific treatment for the disease. Miami Dade health officials are already investigating the first suspected cases there. Since ae. aegypti is a dominant mosquito throughout urbanized areas of southern Florida we will most likely see the virus spread through our counties here in south Florida if we are not vigilant in reducing the mosquito habit in our yards and communities and if we fail to take proper precautions to avoid being bitten. It will be harder for the virus to establish itself in other parts of the U.S. because the ae. aegypti mosquito has all but been wiped out by the Asian Tiger Mosquito that arrived in the 1980s and began to crowd out ae. aegypti everywhere in the U.S. except south Florida. Lucky us.

So even if the BP oil does manage to avoid our south Florida coasts, the prospects of vacationers returning to their homes with a tropical disease aquired on a jaunt to Florida is not going to do anything to help our tourist industry. In the name of good health and a healthy economy it makes sense to educate ourselves on how to keep this disease at bay and contain its spread.

I encourage you to take a quick read of the CDC fact sheets so that you arm yourself with accurate information so that you can increase your chances of avoiding this unpleasant and possibly serious illness.

http://www.cdc.gov/Dengue/