Dengue Fever in Burkina Faso
Dengue is a viral infection transmitted by the Aedes Aegypti and Aedes Albopictus female mosquitos. There are four different types of the virus currently known as DENV-1, DENV-2, DENV-3 and DENV-4.

Almost half of the people infected with dengue exhibit no specific symptoms, especially since the virus causes flu-like symptoms such as high fever and muscle pain. When left untreated, these symptoms progress to the deadly dengue hemorrhagic fever and cause vomiting, abdominal pain, uncontrolled bleeding, convulsions and circulatory system failure. Dengue is diagnosed by serological or molecular tests. Early and accurate diagnosis is crucial to saving lives and preventing the progression of the infection.

As in most tropical regions with prolonged rainy seasons, the climate of Burkina Faso makes it an optimal breeding ground for mosquitos. Dengue is considered an endemic illness. In recent years, the country has faced outbreaks of this disease in 2016 and 2017. In 2016, there were almost 2,000 suspected cases with 86 percent of cases concentrated in the central region of the country. In the 2017 outbreak, the number of suspected cases jumped to almost 7,000 with 64 percent of infections, again, concentrated in the central region.

Urbanization and Dengue

The central region of Burkina Faso includes the capital city of Ouagadougou. Ouagadougou’s rapid urbanization over the last 30 years has contributed to increased cases of dengue fever in Burkina Faso. From 2000 to 2010, the city’s population grew from 800,000 to 1.9 million. This growth is expected to rise by 81 percent to a staggering population of 3.4 million by 2020.

Increased migration to Ouagadougou from rural regions and nearby countries led to spontaneous settlements uncontrolled by the authorities. Between 2004 and 2009, unplanned residential areas grew by 60 percent. These settlements are prone to overcrowding and poor sanitation infrastructure. Stagnant water from the rainy season also makes the settlements more susceptible to mosquitos and dengue.

Response to Dengue Outbreaks

During both the 2016 and 2017 outbreaks, the Burkina Faso Ministry of Health declared a state of emergency that allowed for assistance from The Alliance for International Medical Action (ALIMA) and World Health Organization (WHO).

In 2016, ALIMA provided 2,100 Rapid Diagnosis Tests (RDTs) to help doctors to accurately diagnose dengue and begin surveillance of the outbreak. The more widespread outbreak of 2017 required a greater response from WHO. The organization provided 15,000 RDTs and 1,500 insecticidal nets to hospitals. WHO also trained 5,500 community volunteers that worked to destroy mosquito-breeding sites in Ouagadougou. These interventions allowed for the slow decline of cases and the continued spread of dengue infections.

Future of Dengue in Burkina Faso

In both outbreak years mentioned above, the financial burden of the outbreak response was shouldered by WHO and ALIMA. The Ministry of Health has identified the importance of strengthening the health care surveillance system so that there are early warnings of future outbreaks of dengue fever in the country.

Vector control methods such as the destruction of mosquito-breeding sites and proper sanitation infrastructure in susceptible areas of Ouagadougou are necessary to prevent continued outbreaks. Finally, early and accurate diagnosis of dengue will save lives through timely treatment and medication.

These targets are the core focus of the Integrated Research Program for the Control of Dengue Fever in Burkina Faso. This program began in 2015 as a five-year collaborative research effort between medical schools in Ouagadougou and Japan. The Japanese Agency for Medical Research and Development plans to invest more than $650 thousand each year to reach the targets by 2020.

As of September 2017, the research program has developed a new detection device that allows for easy virus inspection of mosquitos. This technology will assist detect potential infections and avoid outbreaks. The program is currently working to develop a strategy to limit the replication of dengue in mosquitos which will also help to prevent outbreaks.

The dengue fever has been a very serious problem in Burkina Faso in the past years. The joint effort of various nongovernmental organizations and the country’s government has helped eliminate the crisis in the past two virus outbreaks. This effort will help change the future of dengue fever in Burkina Faso and allow the country to equip itself to properly respond to any new potential outbreaks.

– Chinanu Chi-Ukpai
Photo: Flickr

Dengue Track: How Mapping the Spread of Disease May Help to Stop It
Dengue is a notoriously malicious mosquito-borne virus that has seen an uptick in recent decades with the expansion of urban environments. But a new tool called Dengue Track is trying to change that.

Dengue fever causes flu-like symptoms, minor bleeding and a characteristic full-body rash. The disease used to be confined primarily to tropical regions, but the World Health Organization estimates that about half the global population is now at risk. It is rarely fatal but nonetheless constitutes a leading cause of illness and death among children in some developing countries. Though a vaccine has been developed, its use has only been approved in three countries so far, and it is not yet widely available anywhere.

Dengue is a disease that is uncommonly hard to fight. Because it has an incubation period of four to 10 days, mosquitos can be spreading it in an area for weeks before officials start to realize that they have an epidemic on their hands. What’s more, as globalization intensifies and people and goods travel more broadly than ever, it’s nearly impossible to keep infections localized or to judge where they might develop next.

Illnesses that, like dengue, are transmitted by blood-sucking insects are called “vector-borne” diseases, and when vaccines are not available, the only way to protect human populations is through methods known collectively as “vector control.” These include strategies for reducing the insects’ breeding areas, creating tools like nets to keep them away from vulnerable people or killing them with pesticides.

Vector control, however, is most effective when the movement of the disease can be plotted on a map. The trouble is that dengue, which is most prevalent in developing countries around the equator, is dramatically underdiagnosed and underreported, and systems to share what little information there is are inefficient, unstandardized, or nonexistent.

Dengue Track, a crowdsourced tool that tries to map the epidemiology of the disease, is an initiative from an organization called Break Dengue. Drawing information from cell phone conversations, social media, and an online chat system, it plots cases of the illness across the globe to try to predict where it may surface next.

It is a low-cost method that relies on tools common in developing countries, where only one-third have access to the internet but over 95 percent own mobile phones. This means that it is particularly well-suited to places where the national health system does not have the ability to track outbreaks itself.

“Thousands of lives are lost every year in developing countries for failing to detect epidemics early because of the lack of real-time data on reported cases,” said Lakshminarayanan Subramanian, a professor at New York University who helped to develop Dengue Track. This app might prove a useful model for identifying such epidemics early in the game and taking the appropriate steps to head them off.

Madeleine Read

Photo: Flickr

Dengue Epidemic in India
The dengue epidemic in India is a reoccurring plight — new hoards of mosquitoes hatch during the wet monsoon season. These insects carry a number of diseases that citizens have been unable to protect themselves against. From this yearly mosquito infestation, dengue is one of the most commonly contracted. It manifests as a harsh influenza, but can quickly turn into severe dengue, and will sometimes result in death.

There are four different strains of dengue, meaning that one individual can get dengue up to four times before building an immunity to each strain. That is only if the person makes it that far; every time an individual contracts more than one strain, there is a greater risk of severe dengue.

The problem with eliminating mosquito-borne diseases is that the insect is highly adaptable. It thrives wherever water is available; eggs can lay dormant for more than a year and hatch immediately when exposed to water. Mosquitos themselves are evolving as well, and have begun to prefer the taste of human blood more than the blood of other mammals. They are also becoming intelligent enough to hide in homes during the day to bite unsuspecting sleepers at night.

The World Health Organization (WHO) claims that the best way to prevent mosquito-borne illnesses is to kill mosquitos in all stages of life. As it stands now, citizens in India can only stunt the spread of the dengue epidemic through fogging, disposing of standing water and maintaining a clean living space.

However, citizens alone cannot destroy all mosquitoes. Hence, the best tactic to approach the dengue epidemic in India is to supplement individual actions with other means of mosquito prevention. Thankfully, the elimination of mosquitos is a mission that researchers are working hard to accomplish.

The International Atomic Agency has been able to suppress insect populations extensively in other areas by sterilizing male mosquitos with low doses of radiation, making the eggs they fertilize unviable. Similarly, there has been notable success with a new form of mosquito suppression that uses the Wachovia bacteria, a bacteria that does not infect humans, but prevents eggs fertilized through infected males from hatching.

Surprisingly, the Centers for Disease Control and Prevention (CDC) does not believe that efforts to suppress mosquito population on a large scale will likely be realized through the sterilization of male mosquitos. This is because large numbers of infected mosquitos need to be affected to properly address the problem. However, when it comes to those who have made little to no headway in stemming the growing mosquito population, even some relief is welcome.

As Ila Patnik of the Indian Express points out, the burden to control the mosquito population cannot rest on citizens alone. Suppressing the mosquito population may take time, but at least it is a means to an end. Mosquito sterilization is a worthy course of action in decreasing the dengue epidemic in India, at least until a more effective solution presents itself and more people have access to the newly tested dengue vaccines.

Amy Whitman

Photo: Pixabay

Dengue FeverCountries in tropical climates, including Mexico and the Philippines, have started to approve the usage of a vaccine to prevent dengue fever.

Dengue fever is the most rapidly spreading mosquito-borne virus in the world today. The virus is currently present in 150 countries and over 390 million people are infected per year, with many cases being under-reported.

According to the World Health Organization, half of the world’s population is in danger of developing dengue fever. Patients inflicted with the disease are typically advised to rest, drink plenty of fluids and consume paracetamol, a widely used over-the-counter medicine to reduce fever.

Several tropical countries recently announced their plans to help prevent and reduce the number of dengue fever cases, with the world’s first dengue vaccine. Dengvaxia, a live attenuated version of the virus, will combat all four strains of the disease. The drug is scheduled to go on the market this month.

In the Philippines, health officials have started filing orders for Dengvaxia, aiming to bring the vaccine into its national market as soon as possible. Janette L. Garin, the Secretary of the Philippines Department of Health told GMA News that her country “is the only [location] where three phases of the clinical trial were done… it’s a reflection of how good our researchers are.”

Garin stated that officials will initially administer vaccines to students from eight to 10 years old, since they are the most likely candidates to fall victim to dengue fever. The vaccine is also less effective and more unpredictable in older patients.

“We don’t recommend it to [elder individuals] because there would be other interactions… That is why we want to play on the safe side,” Garin explained.

John Gilmore

Sources: GMA Network, WHO, Impatient Optimists, News Medical
Photo: Scientific American

Fever Outbreak
Delhi, the capital of India, is going through the largest case of dengue fever in five years. There have been more than 1,800 cases of dengue fever recorded in 2015. Nearly 200 more patients were diagnosed with dengue fever than the 1,695 patients in 2010.

Proper treatment reduces the mortality rate of dengue fever to 1 percent, however there is more than a 20 percent mortality rate for untreated dengue fever. Nearly half of the world’s population is at risk of contracting the disease.

There are nearly 25 million people residing in New Delhi and the high population has caused an overflow in hospitals. Although government hospitals are not permitted to refuse dengue patients, the influx of patients has proven to be too much for the public health system to handle.

Patients are sharing beds and queues for dengue fever screenings are out the door. The government has had to issue a temporary three-month registration to 48 new private hospitals and nursing homes to accommodate the overwhelming increase of patients.

It is in this kind of crisis that a strong public healthcare system is shown to be of value. The World Health Organization recommends that there by at least five hospital beds for every 1,000 people but Delhi has a little more than half the number of recommended beds.

With one of the lowest rates of government spending on healthcare, only roughly 1 percent of India’s Gross Domestic Product goes toward public healthcare. Private hospitals are catered to the middle and high class, leaving the public government hospitals overcrowded, understaffed and underfunded.

More than ten people have died from the dengue fever outbreak in Delhi. It is hoped that this recent outbreak will cause for serious reorder of the healthcare system.

Iona Brannon

Sources: BBC, CNN, NDTV, WHO, World Bank
Photo: Live Mint

Malaysia is overwhelmed with its never before seen dengue fever outbreak. According to the Health Ministry, there have been more than 40,000 cases and 201 deaths so far. The deaths have increased from 215 in 2014 total, 92 in 2013, and 35 in 2012.

In six months, deaths increased 100 percent from last year between January and June 6, with 144 deaths compared to 72 last year. From the 21st week to the 22nd week, the numbers of cases increased by 8 percent.

Dengue fever is spread by the female Aedes mosquito, which can lay up to 400 eggs per week and needs very little water to breed. The mosquito typically bites in the morning or at dusk with initial symptoms feeling like the flu.

Those infected realize it’s dengue from the exhaustion, fever and joint pains they get. In the worst-case scenario, victims develop hemorrhagic fever, which can lead to death.

There is growing concern that the virus is changing and becoming more deadly with changes in symptoms and repeat infections. The deputy director general of Health at the Ministry says, “There’s always a chance virus may change.” He does find it strange that the new symptoms are liver failure, meningitis and brain infection.

There is currently no cure for dengue. The most that can be done to treat it is the platelet count with a saline drip.

The disease is common in many Asian countries and costs the economy about $2 billion annually, excluding the cost of fogging and other methods used to kill the Aedes mosquito.

According to the World Health Organization (WHO), dengue cases have increased 30-fold in the last half century, and half of the world population is at risk.

Citizens are combatting the disease with leaflets and insecticide. Citizens like Kau Siew Yoon, a retired librarian, are volunteering with their local anti-dengue squad.

At the government level, workers are sent out to spray fog around the neighborhoods affected and doctors are given rapid detection kits as soon as a doctor reports a case to the Health Ministry.

Doctor Lam Sait Kit, who has been studying dengue for 40 years, doesn’t think fog is very effective, and believes vaccines could prevent outbreaks. Given that WHO is aiming to decrease dengue by 25 percent and its mortality by at least half by 2020, many companies are looking to develop a vaccine.

The most progress has been made by the French pharmaceutical giant Sanofi-Pasteur, which finished its third phase of clinical trials for a vaccine it has been working on for more than 20 years.

The trials were done on thousands of children in Asia and South America, and the vaccine shows protection against all four types of fever with varying results. Those ages 9-16 showed an 80 percent reduction in hospitalization and a 93 percent reduction in the disease becoming more severe.

Malaysia is working with WHO in analyzing the vaccine data. Baptiste De Clarens, GM for Sanofi-Pasteur in Malaysia, Brunei, and Singapore, believes a vaccine isn’t the only solution, with a need for vector control and public awareness.

Given the alarming numbers of this outbreak, the focus needs to be on reducing the current cases and finding solutions that prevent the disease, such as an educational campaign to fight against it.

Paula Acevedo

Sources: IRIN, The Malaysian Insider

After decades of searching, scientists may have finally found a vaccine for dengue, one of the developing world’s most feared infectious diseases.

Researchers released a new report confirming the efficacy of the vaccine after the conclusion of a study lasting four years and involving over 20,000 school-aged children in Colombia, Brazil, Mexico, Puerto Rico and Honduras. The study has proven the new drug to be overwhelmingly effective, and both scientists and doctors around the world are celebrating this monumental achievement. The efficacy of the vaccine against severe dengue was 95.5 percent.

Dengue is a mosquito-borne viral infection that affects nearly 400 million people annually. It is a leading cause of serious illness and death among children in many Latin American and Asian countries, and has been spreading violently throughout the developing world since the late 1950s.

The absence of a dependable treatment for the disease has made dengue a particularly terrifying illness in the global south. The debilitating muscle and joint pains associated with cases of severe dengue have earned the disease its nickname, ‘break-bone fever’. Infected individuals can also suffer crippling headaches, nausea, vomiting and a painful rash across the back and chest. Nearly 500,000 people, most of them children, die from the disease each year.

Initial news of the drug’s potential broke in late 2011, when French pharmaceutical company Sanofi Pasteur announced plans to release the new antiviral medication by mid-2015. Since that time, research teams have been working tirelessly in many countries spanning both Asia and Latin America, where the disease is most prevalent. Meticulously testing patients, administering vaccinations and recording their findings, scientists have emerged from the study with new certainty in the drug’s effectiveness.

Relaying the good news on Jan. 8, Sanofi Pasteur reported the overall efficacy of the drug to be 60.8 percent for children between the ages of nine and 16 who received three doses of the vaccine over a 12-month period. Furthermore, the study confirmed 80.3 percent reduction in the risk of hospitalization for dengue-infected individuals. The crowning achievement of the study, however, was the accomplishment of a 95.5 percent protection rate against the most deadly form of the disease, a discovery that is projected to save countless lives in countries from India to Brazil.

Past efforts to control dengue have relied heavily on preventative practices such as destroying mosquito egg-laying habitats and spraying insecticides intended to kill the disease-carrying mosquito vector. Without an effective antiviral medication available to treat infected individuals, however, the fight against dengue has been violent—and often deadly—for economically disadvantaged communities in tropical areas of the world. Because of the mosquito’s ability to adapt to many diverse environments, and its skill for finding hidden deposits of stagnant water in both rural and urban areas, regions affected by dengue quickly find the disease to reach epidemic proportions amongst their populations.

The introduction of the new dengue vaccine serves as a beacon of hope in the world’s fight against deadly pathogens, and will prove to empower millions of people in the developing world in their own fight against poverty.

– Brady Thomas Mott

Sources: New England Journal of Medicine, WHO
Photo: Top News

Dengue Fever Mosquito
Dengue fever has caused mayhem in developing countries, with over 2.5 billion people in the world at risk for infection. The World Health Organization estimates that anywhere from 50-100 million people are affected yearly, showing an increase of incidence rates in the last few decades.

Dengue fever is a mosquito-born viral infection often found in tropical and sub-tropical regions of the world. Today, the disease is endemic in more than 100 countries in Africa, Asia, the Americas and the Western Pacific. In 2010, cases in Southeast Asia, the Americas and Western Pacific accumulated to 2.3 million, and this number is only rising.

Incidence rates are not only going up, but there have been recent outbreaks in Europe, including Croatia, France and Portugal, that are concerning to neighboring countries.

However, there is no region that has been quite affected by dengue fever than Asia. Southern China is experiencing one of the worst outbreaks of dengue fever in the last 20 years, with more than 1,000 reported cases emerging daily. In October, it was reported that there had been six deaths and over 21,000 infections in Guangdong province.

Malaysia and Taiwan have also experienced more deaths in 2014 than previous years, while Japan suffered its first outbreak of dengue since 1945. Twenty-two cases had been confirmed in Japan, with the health ministry believing visitors to Tokyo’s Yoyogi Park were the first to contract the disease.

Another study illustrated that dengue fever rates in India may actually be 300 times more than what has been officially reported, costing the country around $548 million annually.

With no approved vaccine, dengue fever is difficult to treat. The disease causes severe joint and muscle pain, but does not usually result in fatalities. According to WHO, the only way to prevent the transmission of dengue fever is to fight vector mosquitos. Some ways to do so include disposing waste properly, using personal household protection such as window screens and cleaning water storage containers.

The Government of Japan is taking all necessary precautions to combat the disease, especially in Yoyogi Park, by putting up warning signs, spraying insecticide and draining ponds. Japan has also set up a hotline specifically for dengue fever cases. These precautionary methods will hopefully decrease the transmission of dengue fever in Asia.

Leeda Jewayni

Sources: World Health Organization, CNN BBC
Photo: North Jersey