Migrant caravan limps north through Mexico, despite dengue and exhaustion

By Lizbeth Diaz and Jose Torres

MAPASTEPEC, Mexico (Reuters) – A caravan of thousands of migrants and asylum seekers from Central America and the Caribbean resumed its trek through southern Mexico on Monday, despite concerns that half of them could be injured or sick, including some from dengue fever.

Over the past week, the approximately 3,000 migrants, mostly women and children, have trekked over 100 km (60 miles) from the city of Tapachula on the Guatemalan border, struggling through sweltering heat and evening rains.

Kabir Sanchez, a volunteer doctor helping to look after injured caravan members, said he and his colleagues treated dozens of people on Saturday with foot injuries, respiratory problems, infections and pregnant women at risk of miscarrying.

“More than 50% of the people in the caravan are sick,” he told Reuters by telephone.

He said other caravan members had possible cases of coronavirus, but that the government had not provided COVID-19 tests.

The government’s National Migration Institute (INM) did not immediately reply to a request for comment on COVID-19 testing.

The INM did say in a statement that six people in the caravan, including five children, had contracted dengue.

On Sunday night, the caravan members slept outside in the rain having paused their trek during the day due to the health concerns.

Most of the migrants are fleeing poverty, violence and the impact of adverse environmental conditions linked to climate change in their homelands. Many hope to make it to the U.S. border.

Leaders of the caravan last week rejected the Mexican government’s offer of visas that are meant to grant migrants access to healthcare and regular work, arguing it had failed to keep promises to help them in the past.

(Reporting by Lizbeth Diaz in Mexico City and Jose Torres in Mapastepec; Additional reporting by Daniel Becerril; Writing by Laura Gottesdiener; Editing by Alison Williams)

Paraguay’s President Abdo contracts dengue fever amid outbreak

Paraguay’s President Abdo contracts dengue fever amid outbreak
By Mariel Cristaldo

ASUNCION (Reuters) – A dengue fever outbreak that has affected thousands of Paraguayans in recent weeks has reached as far as the presidential palace, with the country’s leader Mario Abdo confirmed as having been struck by the disease.

The country’s Health Minister Julio Mazzoleni said on Wednesday that the 48-year-old president fell unwell during an trip to the east of the country and returned to the capital Asunción where the diagnosis was confirmed. He has been ordered to rest.

“The result of the blood test effectively confirms that the President has dengue,” Mazzoleni said at a press conference.

“He will fulfill his agenda in Mburuvicha Roga (the presidential residence) with some restrictions,” he said, adding the President was in a “good general condition”.

The diagnosis underscores the potential severity of the outbreak of the disease in Paraguay, which has the second highest incidence of dengue in South American after Brazil. A severe out break in 2013 led to 250 deaths in the country.

The World Health Organization says the incidence of dengue, which causes high fever and joint pain, has been growing rapidly in recent decades. There is no specific treatment, but early detection and care reduces risks associated with the disease.

The minister said Abdo must complete a rest period of at least 48 hours and will be evaluated day by day in order “to discharge him when appropriate”. He added that the rest time could last three to seven days.

Dengue is an endemic disease in Paraguay, with cases peaking in the summer months when the transmitting Aedes Aegypti mosquito proliferates. The government announced days ago that it is preparing for a strong epidemic that would peak in February.

The health ministry has also confirmed that so far this year two people have died due to the disease and another 14 deaths are being investigated. In addition 1,800 cases of dengue have been confirmed and about 10,000 suspected cases reported.

(Reporting by Mariel Cristaldo; Writing by Adam Jourdan; Editing by Chizu Nomiyama)

Philippines says anti-dengue vaccine may be connected to three deaths

Dr. Rolando Enrique Domingo (R), Undersecretary of the Department of Health (DOH), with Dr. Gerardo Legaspi, Director of the Philippine General Hospital (PGH), answer questions during a news conference at the DOH headquarter in metro Manila, Philippines February 2, 2018.

By Manuel Mogato

MANILA (Reuters) – The Philippines said on Friday the anti-dengue vaccine Dengvaxia may be connected to three deaths in the country, according to a government-ordered inquiry, and that the drug is not ready for mass immunisation.

French drug maker Sanofi said in November that Dengvaxia – the world’s first dengue vaccine – might increase the risk of severe disease in people who had never been exposed to the virus.

The news prompted an uproar in the Philippines, where more than 800,000 school-age children had been vaccinated in 2016.

“We sympathise with all the families who have suffered the loss of a child. Sanofi Pasteur’s mission is to reduce or eliminate suffering for millions around the world through vaccination, including in the Philippines,” a spokesman for Sanofi said in an emailed statement.

“Dengue fever is one of the most pressing public health issues facing the Philippines today. Sanofi Pasteur remains committed to working with the Philippines government and all organisations to address this urgent public health challenge.”

The Philippine Health Ministry halted Dengvaxia immunisations in November. It formed a 10-member panel of experts to determine if the drug was directly connected to the deaths of 14 children after they were given the vaccine.

It found it may have been connected to the deaths of three.

“Three cases were found to have causal association. They died of dengue even (though) they were given Dengvaxia. Two of them may have died because of vaccine failure,” Health Undersecretary Enrique Domingo told a news conference.

“These findings strengthen the decision of the Department of Health to stop the vaccine. It has failed in some children. Dengvaxia is not ready for mass vaccinations and we would need three to five more years to watch and monitor if there would be other adverse reactions from the vaccine.”

Mosquito-borne dengue is the world’s fastest-growing infectious disease, afflicting up to 100 million people worldwide, causing half a million life-threatening infections and killing about 20,000 people, mostly children, each year.

Domingo said the panel’s findings would be shared with the justice department, which is considering cases against those responsible for the mass immunisation programme.

Paediatrician and panel member Juliet Sio-Aguilar, from the University of the Philippines-Philippine General Hospital, said the team was recommending further studies as it was difficult to directly connect the three deaths to Dengvaxia.

No vaccine has a 100 percent success rate, she said. The dengue death rate in the Philippines was 60 times higher than global rate, Sio-Aguilar said.

The Philippines spent 3.5 billion pesos ($68 million) on the Dengvaxia programme to reduce the 200,000 dengue cases reported every year.

The Philippines has already fined Sanofi a symbolic $2,000, citing violations in product registration and marketing.

(Additional reporting by Ben Hirshler in London, Matthias Blamont in Paris; Editing by Nick Macfie and David Evans)

Dengue outbreak kills 300 in Sri Lanka, hospitals at limit

A mosquito landing on a person. Courtesy of Pixabay

COLOMBO (Reuters) – An outbreak of dengue virus has killed around 300 people so far this year in Sri Lanka and hospitals are stretched to capacity, health officials said on Monday.

They blamed recent monsoon rains and floods that have left pools of stagnant water and rotting rain-soaked trash — ideal breeding sites for mosquitoes that carry the virus.

The International Federation of Red Cross and Red Crescent Societies is scaling up emergency assistance to Sri Lanka with the Sri Lanka Red Cross to help contain the outbreak.

“Dengue patients are streaming into overcrowded hospitals that are stretched beyond capacity and struggling to cope, particularly in the country’s hardest hit western province,” Red Cross/Red Crescent said in a statement.

According to the World Health Organization, dengue is one of the world’s fastest growing diseases, endemic in 100 countries, with as many as 390 million infections annually. Early detection and treatment save lives when infections are severe, particularly for young children.

The Sri Lankan government is struggling to control the virus, which causes flu-like symptoms and can develop into the deadly hemorrhagic dengue fever.

The ministry of health said the number of dengue infections has climbed above 100,000 since the start of 2017, with 296 deaths.

“Ongoing downpours and worsening sanitation conditions raise concerns the disease will continue to spread,” Red Cross/Red Crescent said.

Its assistance comes a week after Australia announced programs to help control dengue fever in Sri Lanka.

“Dengue is endemic here, but one reason for the dramatic rise in cases is that the virus currently spreading has evolved and people lack the immunity to fight off the new strain,” Novil Wijesekara, head of health at the Sri Lanka Red Cross said in a statement.

(Reporting by Ranga Sirilal and Shihar Aneez Editing by Jeremy Gaunt.)

Hawaii County declares state of emergency over dengue fever outbreak

The growing number of dengue fever cases in Hawaii County has prompted the county’s mayor to declare a state of emergency, a measure that aims to reduce the spread of the disease.

William P. Kenoi issued the declaration on Monday as the state Department of Health reported that there have been confirmed 251 cases of the mosquito-borne illness since last September.

All of the confirmed cases have been in Hawaii County, which is the state’s largest island.

Kenoi’s declaration allows people to dump tires at county landfills, which had been outlawed. The Centers for Disease Control and Prevention (CDC) says used tires can collect rain, making them a good place for mosquitos to lay eggs, and mosquito control is key to combating dengue.

Hawaii Governor David Y. Ige issued a statement saying he supported Kenoi’s emergency proclamation, but he would only declare a statewide emergency if certain conditions were met.

According to the World Health Organization (WHO), dengue fever usually triggers a flu-like illness that lasts up to a week. Symptoms include headaches, vomiting, muscle pains and rashes. In some cases, however, dengue can become severe and lead to potentially fatal complications.

The WHO says severe dengue causes about 500,000 hospitalizations and 12,500 deaths every year, though access to proper medical care significantly lowers the disease’s mortality rate.

Hawaii health officials have not reported any deaths as a result of this outbreak.

The Hawaii Department of Health says dengue isn’t usually found in Hawaii, but there have been some cases of infected travelers coming to Hawaii from areas where the disease is spread. But it says this outbreak is of locally-acquired dengue, the state’s first such event since 2011.

Dengue is different than the Zika virus, another mosquito-borne illness. However, both dengue and Zika can be transmitted by the Aedes aegypti mosquito and both have spread to new areas.

The WHO says dengue has reached more than 100 countries over the past 50 years, recording a 30-fold increase in its incidence. About half the world’s population is now at risk of infection.

The CDC has issued numerous travel warnings about the Zika virus, and the WHO recently deemed Zika an international public health concern as scientists investigate its potential connection to a rare birth defect called microcephaly that affects head size.

The Hawaii Department of Health has said that one Oahu child who was born with microcephaly had been infected with Zika, though his mother likely got infected when she was living in Brazil. The country saw a substantial rise in microcephaly last year.

Only about 20 percent of those infected with Zika show any symptoms, according to the CDC. Those symptoms include fever, rash and joint pain and most people fully recover within a week.

Hawaii Reports Additional Cases of Dengue Fever

The number of people infected with dengue fever in Hawaii is climbing, officials said Monday.

The Hawaii Department of Health reported that it was investigating 167 total cases of the mosquito-borne illness, which can lead to fatal consequences in extreme cases. There were 122 confirmed dengue cases as of Dec. 2, signifying 45 additional infections in about three weeks.

State health officials said only three of the 167 cases are currently infectious. The other people got sick between Sept. 11 and Dec. 10, so they are no longer at risk of transmitting the disease.

The health department also reported there were 659 additional potential dengue infections that had been ruled out, either through test results or the illnesses failing to meet the case criteria.

Dengue isn’t endemic (regularly found) in Hawaii, though health officials said it can occasionally be brought in from travelers who got infected in endemic regions. But this latest outbreak on the Big Island is unique because it’s the first cluster of locally acquired cases since 2011, when Centers for Disease Control and Prevention (CDC) records indicate five people got sick in Oahu.

According to the World Health Organization (WHO), an arm of the United Nations, dengue is transmitted when an infected mosquito bites a human. The infection generates a flu-like illness — from which most people usually recover within a week — though it sometimes progresses to severe dengue. In those instances, people can suffer organ impairment and severe bleeding.

The WHO estimates severe dengue hospitalizes about 500,000 people per year, and about 2.5 percent of them die. Dengue is much more common, with some estimates indicating as many as 136 million people falling ill every year, but non-severe cases of the disease are rarely ever fatal. Symptoms can include severe headaches, swollen glands, joint and muscle pain and a high fever.

The Hawaii outbreak reflects a global trend in which dengue is spreading to new locales.

The WHO reports the disease was traditionally found in the tropics and subtropics, but it’s now endemic in more than 100 countries and about half the world’s population is at risk of infection. Still, early detection and access to good medical care keeps the mortality rate below 1 percent. Without those, the WHO says severe dengue can be fatal in more than 20 percent of cases.

Hawaii health officials say it’s still safe to visit the island. The department encourages travelers to use insect repellant and wear long sleeves and pants to help prevent mosquitos from biting.

Hawaii Dealing with Rare Dengue Fever Outbreak

Health officials in Hawaii are currently investigating more than 100 cases of dengue fever, a mosquito-borne illness that experts say can lead to potentially lethal complications in rare cases.

The Hawaii Department of Health says on its website that there were 122 confirmed dengue cases as of Wednesday. The disease isn’t endemic (regularly found) in Hawaii, it says, but it can occasionally be brought in from someone who traveled to an endemic region and got infected.

However, the department indicates this is a cluster of people who contracted the disease locally.

It’s the first such outbreak since a 2011 cluster of cases in Oahu, the department says. According to Centers for Disease Control (CDC) and Prevention records, only five people fell ill in that outbreak.

This cluster is on Hawaii Island, the big one. CNN reported that CDC officials were traveling to the island on Wednesday and bringing specially designed mosquito traps to help catch the bugs.

Of the 122 confirmed cases, the health department says 106 are residents of the island and 16 were visiting. Ninety three were adults and 29 were children. They began falling ill between Sept. 11 and Nov. 24. No deaths have been reported, but the disease has been known to kill.

The World Health Organization (WHO), an arm of the United Nations, says dengue causes a flu-like illness and is traditionally found in the tropics and subtropics. But it says the disease has rapidly spread to new areas in recent years and roughly half the world’s population is at risk.

The disease is carried by certain types of mosquitos and transmitted to humans through bites. Symptoms can include a high fever, severe headaches, swollen glands and joint and muscle pain.

Dengue itself is seldom deadly, according to the WHO, but in some instances it can lead to severe dengue. That can cause respiratory distress, severe bleeding and organ impairment.

About 500,000 people (most of whom are children) need to be hospitalized for severe dengue treatment every year, according to the WHO, and approximately 2.5 percent of those who develop the disease die. Severe dengue has been a major issue in Asia and Latin America, the organization says, and is one of the top causes of hospitalization and death for children there.

The WHO says detecting the disease early enough and having access to medical care facilities drops the dengue mortality rate below 1 percent. The Hawaii Department of Health says it’s still safe to travel to the state, and a CDC official told CNN that the overall risk of getting infected is low because mosquitos in the United States have not been known to transmit the virus well.

Dengue Fever Outbreak in India

The capital of India is facing a serious outbreak of dengue fever.

Health officials in New Delhi have said the outbreak of the disease is the worst in five years.  They are also putting steps in place to make sure all patients can receive treatment after two children died when hospitals turned them away.

The government said they will be stripping the license of any private hospital that refuses to treat a dengue fever victim.  Also, the government has restricted the cost of tests for the disease to $9 after some private labs were charging more than four times that amount.

The death of one of the boys lead to the suicide of their parent.  The note left behind cited the child’s death and said five private hospitals turned the family away before he was finally admitted at a sixth for treatment, but by then it was too late.

The government confirmed death toll from the disease since the outbreak began has reached 11.  Over 1800 cases have been confirmed by health officials.

The country is experiencing the rainy season and most cases of Dengue Fever happen near the end and in the months right after the rainy season.

Florida On Alert For Mosquito Borne Diseases

Florida health officials are raising the alarm about two mosquito-borne diseases that have shown up in the state.

The Florida Department of Health stated in its latest weekly report that 24 cases of potentially fatal Dengue Fever have been found in the state along with 18 cases of the extremely painful Chikungunya virus.  Both diseases are viral and spread through mosquito bites.

All of the infected people reportedly traveled through the Caribbean or South America and most likely were infected during their travels.  However, the health officials cannot confirm they did not contract the virus from a domestic mosquito bite.

“The threat is greater than I’ve seen in my lifetime,” said Walter Tabachnick, director of the Florida Medical Entomological Laboratory and 30-year veteran of epidemiology.  “Sooner or later, our mosquitoes will pick it up and transmit it to us. That is the imminent threat.”

Health officials are asking residents to work with local governments to eliminate areas where mosquitos breed.  This includes elimination of standing water such as in buckets and rain barrels.

“If there is public apathy and people don’t clean up the yards, we’re going to have a problem,” Tabachnick said.