203613 Preventive measures against changing epidemiological trends of dengue fever in New Delhi, India

Tuesday, November 10, 2009: 10:45 AM

Thriveni Reddy, MBBS , Department of Health Science, MSC 3HLS, New Mexico State University, Las Cruces, NM
Ashley Graboski-Bauer, MPH, CHES , Department of Health Science, MSC 3HLS, New Mexico State University, Las Cruces, NM
Robert W. Buckingham, Dr PH , Department of Health Science, MSC 3HLS, New Mexico State University, Las Cruces, NM
Kiran Sapkota, MS , Department of Health Science, MSC 3HLS, New Mexico State University, Las Cruces, NM
Saran Kumar Rai, BDS , Department of Health Sciences and Social Services, New Mexico State University, Las Cruces, NM
Sandra Jacquez, MS , Department of Health, New Mexico State University, Las Cruces, NM
  
Introduction:

Dengue fever (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS) are caused by any of the four serotypes (DEN-1, DEN-2, DEN-3, and DEN-4) of dengue virus. DEN-3 has been associated with an increased incidence of DHF and DSS, which carry a mortality rate of 5%. DF has been endemic in both urban and semi-urban areas of India for over two centuries. Several epidemics of DF occurred in India between 1967 and 2006, during which DEN-1 and DEN-2 were most often identified. Recently, however, DEN-3 began emerging as the predominant serotype, leading to increased incidence of cases presenting as DHF/DSS.

Methods:

Published data regarding DF in India was collected from a variety of sources. Data was pooled and analyzed with the objective of determining the epidemiological trends of DF in India and which measures would be effective in preventing future epidemics henceforth decreasing the incidence of cases presenting with DHF/DSS cases.

Results:

Larval indices of the prevalence and distribution of Aedes aegypti, the primary vector of DF are highest during the monsoon and post-monsoon periods (September-November). Case clustering analysis of the 2006 epidemic indicates that at least 90% of cases occurred during the post-monsoon months of October and November. A DF seasonal predilection that coincides with peaks in Aedes aegypti larval indices is demonstrated.

Conclusion:

DF prevention efforts emphasizing the eradication of larval Aedes aegypti, patient education, and adherence to a standardized serological reporting system should revolve around the monsoon and post-monsoon periods.

Learning Objectives:
1) Explain the need for patient education and preventive measures that are heedful of dengue fever seasonal predilection. 2) Describe the correlation between changing epidemiological trends of dengue hemorrhagic fever/dengue shock syndrome and the need for increased efforts to diagnose dengue fever in its initial stages.

Keywords: Epidemiology, Water

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I hold a MBBS (Bachelors of Medicine and Surgery) from India and practiced there for several years; I frequently treated dengue fever cases in the region in which I practiced. I am currently completing my Masters in Public Health degree in the U.S., affording me the background necessary to better plan public health interventions in India.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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