Dengue outbreak confirmed in

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After 19 cases of suspected dengue fever — and at least one death — reported in the St. Thomas-St. John District, the V.I. Health Department issued a statement Friday saying that the district is experiencing a dengue fever outbreak.

In the statement, Health officials urged residents to seek immediate medical care if they become ill and urged doctors to report all suspected dengue fever cases to the department, as required by law.

“If you don’t seek immediate medical care, dengue fever can lead to death,” Health Commissioner Julia Sheen said in the release.

Symptoms of dengue fever include severe headache, particularly behind the eyes; fever; joint and muscle pain; rash; and nausea, vomiting and loss of appetite.

Dengue fever can also develop into dengue hemorrhagic fever, a complication that is characterized by high fever, bleeding and circulatory failure. In rare cases, dengue hemorrhagic fever can cause death.

Health Department Epidemi­ologist Eugene Tull said Friday that blood tests have confirmed that a 47-year-old St. John woman who died Aug. 20 after she was transferred to a Miami Hospital had dengue fever.

He said he did not know whether there had been other deaths from dengue fever in the territory this year.

“I would have to investigate. I haven’t been trying to investigate that,” Tull said. “Our thing is to prevent people from dying. The key with what we do as a public health entity is to focus our attention on doing the things and making the statements to the public relative to what they need to do to prevent getting the disease.”

According to the Health Department statement released Friday, nine of the 19 suspected cases have been laboratory-confirmed as dengue fever in the St. Thomas-St. John District since June. On St. Croix, there have been four suspected cases with no confirmed cases.

There is no requirement in the territory that people with suspected dengue fever undergo testing to confirm whether or not they have the mosquito-borne virus, Tull said.

Because of the expense of testing, and because treatment of dengue fever is supportive care while the body fights off the infection, physicians may not pursue further testing to confirm a dengue diagnosis if a patient is not experiencing some of the more serious complications, Tull said. Some patients with uncomplicated dengue may not go to the doctor at all.

“Physicians who are seeing suspected dengue cases in their offices, however, are not reporting the information to the Department of Health, as required by law,” Tull said in the release.

He noted that information about suspected dengue cases is key for Health officials to assess the extent of the outbreak and track it.

His experience with a 2005 outbreak on St. Croix leads him to believe that the number of dengue cases this year is higher than reported, Tull said, adding that he is now receiving anecdotal information about more cases in the community.

“I have no doubt that there are more cases out there. The more reports we have, the better we can pinpoint areas where it is happening,” he said.

Dengue fever is transmitted to people by the bite of an infected Aedes Aegypti mosquito. There are four strains of the dengue virus.

A person who has been infected with one strain of the virus becomes immune to it but still is vulnerable to the other strains. Someone who already has had dengue fever is more susceptible to the more serious complications if infected again.

According to the release, the strain causing the current outbreak is Type 2, which was responsible for the 2005 outbreak on St. Croix.

Tull said the Health Department will be ramping up its dengue fever outreach and education efforts in the coming weeks.

While the department has been doing mosquito fogging, Tull noted that the mosquitoes that typically transmit dengue tend to breed in and around homes, where fogging will not be effective.

People can take steps to protect themselves in and around their homes by removing standing water, which makes for prime mosquito breeding ground, he said.

“Most dengue transmission activity takes place inside the home,” Tull said. “People need to understand that. If a person is sick and then gets bitten, the mosquito is not going to just fly outside. Eventually, they’re going to bite someone who is well.”

Health care providers can report dengue fever by calling 773-1311, ext. 3241. To report large pools of stagnant water, contact the Envi­ronmental Health Division on St. Croix at 773-1311, ext. 3109 and on St. Thomas at 774-9000, ext. 4641 or dial 715-5111.

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