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Florida woman dies of dengue fever


By Denise Mann
Health Day reporter

THURSDAY, June 10, 2021 (HealthDay News) – The death of a Miami woman in her 30s from locally acquired dengue fever highlights the need to be aware of a potentially fatal mosquito-borne virus now found in United States.

Once seen only in warm and humid tropics or subtropics, dengue fever is on the increase in parts of the southern United States due to global warming, travel and other factors. While most Americans still contract the disease while traveling to areas of the world where dengue is endemic, there have also been cases of locally acquired dengue in the United States, including a 2019 outbreak in Miami.

This can happen when a local mosquito feeds on a person infected with dengue fever and then spreads the disease to others.

Spread by a bite from an infected person Aedes mosquito, dengue fever can cause a high fever, rash, and muscle or joint pain. In severe cases, dengue can cause bleeding and potentially fatal shock. Each year, up to 400 million people will be infected with dengue fever and about 22,000 will die from the disease, according to the United States Centers for Disease Control and Prevention.

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In 2019, Florida saw 413 people diagnosed with dengue, most of whom had recently traveled to Cuba. This epidemic spawned 18 locally acquired cases, including one that resulted in the death of the young woman from Miami. To determine the source of the infection, doctors looked at the woman’s travel history and performed genetic sequencing of the virus, which confirmed that it had been acquired locally.

His story is the basis of a letter in the June 10 issue of the New England Journal of Medicine. That should serve as an edifying tale, said co-author Dr Stephen Morris, an infectious disease specialist at Jackson Memorial Hospital in Miami.

“Florida is sort of a near-endemic area for dengue fever now,” he said. “We should expect this to be a risk for the future, and doctors in the southern United States should know that dengue is on the table as a possible diagnosis.”

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There is no widely available vaccine to prevent dengue, Morris said. To avoid infection, “use a good insect repellent, cover your skin, and avoid areas with a lot of standing water,” he said. Mosquitoes like to lay their eggs near standing water in buckets, bowls, flowerpots, and vases.

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Screens on doors and windows can also keep mosquitoes out, Morris said.

Delayed diagnosis

There’s also no rapid test for dengue, so it can take several days to make a diagnosis, said study co-author Tyler Sharp, an epidemiologist at the CDC’s dengue branch in San Juan, Porto Rico.

A delay in diagnosis played a role in the death of the Miami woman. “If you think it could be dengue, treat it like they have it, and if it’s negative, it’s okay,” Sharp said.

Treatment involves hydration and close monitoring of vital signs. “Tell your doctor if you’ve been to an area where dengue is endemic or if someone you know has recently been diagnosed with dengue, as this may not be a concern for many doctors,” he said. -he declares.

Mosquito control at the community level has been more difficult, Sharp said.

“We need to raise awareness and develop, evaluate and ultimately implement tools to tackle dengue fever in South Florida and elsewhere,” he said.

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There are ways to reduce the mosquito population that are currently being explored. For example, in a controversial study, Florida released genetically engineered male mosquitoes that pass a gene that kills female offspring before they mature. Only female Aedes aegypti mosquitoes can bite and spread dengue fever.

Unless and until the mosquito population is reduced, “it is very important to be aware of dengue fever in Florida, Texas and Hawaii because we know the mosquito vector is there,” Yesim said. Tozan, assistant professor of global health at the NYU School of Global Public Health in New York.

Fortunately, most local outbreaks in the United States have been contained because mosquitoes cannot fly too far, she said.

“We need to be vigilant against fever and disease, especially when we know mosquitoes are active,” Tozan said. Mosquito season runs from spring to fall.

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“Climate change makes us see severe weather like unexpected rains and fluctuating temperatures and mosquitoes are very sensitive to it, so all of a sudden we have breeding activity when we wouldn’t normally,” said explained Tozan, who was not involved in the new report. .

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“Be an educated traveler,” she said. “If you are returning from areas where dengue fever and other mosquito-borne illnesses are prevalent, share your travel history with your doctor.”

More information

The United States Centers for Disease Control and Prevention offers more information on dengue prevention.

SOURCES: Stephen Morris, MD, infectious disease specialist, Jackson Memorial Hospital, Miami; Tyler Sharp, PhD, epidemiologist, CDC Dengue Branch, San Juan, Puerto Rico; Yesim Tozan, PhD, assistant professor, global health, NYU School of Global Public, New York; New England Journal of Medicine, June 10, 2021

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