The Health Ministry has gone from monitoring status to an official alert following the first confirmed case of dengue fever to be reported on Samoan shores in five years.
In a letter sent out to medical personnel nation wide, it advises the alert will become urgent “if a new serotype is suspected or case/s of severe dengue are identified”.
The letter, penned by Health Ministry C.E.O. Leausa Toleafoa Dr Take Naseri, states that the Ministry now has a lab positive dengue fever case, as was reported in the Weekend Observer last Saturday.
“This is an expatriate gentleman who is based in Samoa, who had recently returned from Fiji where he was believed to be infected from,” the letter reads.
“He was seen by a General Practitioner for signs and symptoms of Dengue fever and was tested on the 17th February, 2014. “On the same day he received a POSITVE Dengue IgM and NS-1 rapid test. His blood specimen is believed to have been sent overseas by the NHS Lab for re-confirmation and serotyping.”
In the letter Toleafoa emphasised the seriousness of the situation Samoa’s health services now face. “We wish to highlight here that this is an ALERT and that all health personnel must be vigilant as this can trigger an outbreak of Dengue Fever in the country,” the letter reads.
“Especially as there has been several outbreaks in Pacific Island countries to date.
“The Cook Islands is the latest country in the region who have declared a Dengue Fever Outbreak this month, and Tonga has recorded two positive cases so far.
“An update of Dengue Fever declared in the region since 2013 from PacNet is attached for your information.”
PacNet is an email (and fax) list-server for a network of health practitioners interested or working in the Pacific Islands, which allows rapid overall communication, and makes possible ‘Early Warnings’, regarding epidemic threats.
In his letter, Toleafoa writes that the Dengue Fever Case Definition and Case Management is attached for health practitioners’ information.
“Especially danger signs of Haemorrhagic Dengue Fever, plasma leakage, must be carefully identified,” his letter reads. “The Ministry of Health would like your co-operation in continued vigilance to report and notify further cases.
“The Ministry of Health is closely monitoring the situation and looking to address source reduction; prevention and other Public Health aspects of a possible outbreak event.”
PacNet is short for PPHSN, the Pacific Public Health Surveillance Network, but the latest available “outbreak” report from the site dates back ten years, to 2004.
There is no publicly available data on the network’s site, hosted by the Secretariat for the Pacific Community. Only four countries – Fiji, French Polynesia, Guam and New Caledonia – have provided updates to PacNet since routine surveillance reports were accepted from 2006. A search of the Samoa Health ministry website does not return any results for dengue at all. Toleafoa’s letter provides a snapshot of dengue outbreak around the region.
To date almost 22,000 cases have been reported since late 2012 across the Pacific. Fiji, Kiribati, Australia, New Caledonia, French Polynesia, the Solomon Islands and the Cook Islands – in addition to Samoa – have all reported confirmed cases.
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PacNet reports out of the 21,788 reported cases 17 people have died as a result of contracting dengue fever – three people in Fiji, five people in New Caledonia, one person in French Polynesia and eight people in the Solomon Islands.
According to the PacNet update, the most reported strain of dengue fever is type-3, however there have been some type-1 strains reported as well. New Caledonia and French Polynesia are also battling other diseases spread by the Aedes Aegypti mosquito (the same vector that spreads the dengue virus).
New Caledonia has reported the emergence of a Chikungunya fever outbreak, with 31 cases reported and French Polynesia has reported that several people have been hospitalised after presenting with the Zika virus. People travelling to these countries should be aware of the situation and take steps to prevent themselves being bitten by mosquitoes.
According to the attached Dengue Case Definition from the Pacific Outbreak Manual the infectious cause of dengue fever is the dengue virus.
“There are four types of dengue virus, numbered 1 through 4, which all cause dengue fever,” the attachment reads. It says that that the sources of infections are human beings.
“Dengue virus is transmitted from one human to another by mosquitoes of the Aedes genus,” it reads.
“These bite during the day, but mostly during the early morning and the evening.
“The disease is spread by the bite of mosquitoes.
“People with dengue fever should be cared for under bed nets so that a mosquito cannot bite them and then carry the infection to another person.”
According to the Manual the incubation period of dengue fever is between 3-14 days, but usually between 7-10 days and during the period of infectioness the disease is not directly transmitted personto- person.
“But a person can infect a mosquito while they have a fever, usually 3-5 days,” it reads.
“Mosquitoes remain infectious for life and are able to infect other humans.”
According to Queensland Health, dengue fever has many symptoms, and people usually experience a combination of symptoms.
“Common symptoms of dengue fever are, sudden fever and extreme tiredness, intense headache (especially behind the eyes), muscle and joint pain, loss of appetite, vomiting, diarrhoea, abdominal pain, a metallic taste in the mouth, red or macular (small, flat red spots) rash occurs in half of cases, minor bleeding from nose and gums,” the department’s website reads. Health is advising people experiencing similar symptoms to see a doctor as soon as possible.
World Health Organisation figures show outbreaks through the years, but does not have any statistics more recent than 2000.
Samoa dengue cases
1979 248
1980 112
1981 11
1982 25
1989 450
1992 3
1993 2
1995 278
1996 1,013
1997 163
1998 49
2000 200
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