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Dengue Virus strain returns to territory after more than 40 years

If born after that period or not in the territory since, you are susceptible to this strain

The government launched a clean up of two Eastern District villages over the weekend to try and rid the areas of breeding grounds for mosquitoes, as health officials revealed that dengue fever cases have started to go up.

And the last time the current dengue strain was seen in the territory was more than four decades ago.

The last major dengue fever outbreak in American Samoa was in 2015 with 471 suspected cases of dengue fever recorded and of that number 143 people were hospitalized for treatment. The figures didn’t include cases of people opting to stay home and self medicate.

Throughout 2016, when the Zika virus surfaced, health officials reminded local residents that dengue is still around, as both Zika and Dengue are mosquito-borne diseases. Early last week there were unconfirmed reports from some residents, who believe they have dengue.

Utilizing “rapid dengue kits” for local testing, 13 cases are positive, said Health Department epidemiologist Magele Scott Anesi.

“We are continuing to monitor and look for more suspected cases and have sent off samples [off-island] for confirmation,” Magele told Samoa News last Friday.  “We have results that have confirmed 6 cases through the Hawaii State laboratory with [more] samples pending.”

So far the majority of the cases have come from Afono and Vatia villages with one case from Nuuuli, he said, adding that the ages of victims range from 2 years old to 77.

“We still have test results pending and so do not have a total count of all positive cases at this time and will update the territory with a report as soon as the data is in,” he said, and points out that DOH’s vector control efforts began last Saturday at Afono and Vatia, spraying schools there as well as the village assessments of household for solid and metal waste removal.

Magele said identification of those that need these items removed will happen, and then be followed by removal pickups starting this week.

“We are currently working with all our partners especially with the Education Department and Samoan Affairs Office,” he said and noted that pulenu'u are on hand when “we conduct our vector control in the villages and are helping raise awareness in the community.”

He also says that DOE is in full support of focusing efforts on schools and has given DOH full access and support for vector control measures.

A local resident told Samoa News last Friday that when she went into the LBJ emergency room on Feb 8th, it was crowded and she thought it might be just the flu. However, she was told that she had dengue fever and was told by the physician to stay home, rest and take Tylenol.

Asked if the current dengue strain is a new one, Magele explained that there are 4 strains of dengue virus and the current outbreak has been identified to be Dengue Virus serotype 2, which hasn't been seen in the territory since 1972.

“So all of those that were born after that period or were not in the territory since then are susceptible to getting this strain,” he said.

Dengue has been around for sometime now; health officials cited even when the Zika virus was surfacing early last year and this at the time.

Samoa News asked: Why the 13 positive cases and six of them confirmed through laboratory testing, is alarming; and what is the average dengue fever count for a month?

“Dengue fever is a disease that is endemic, meaning that it circulates throughout the year,” he said. “There are certain spikes and outbreaks due to more people getting infected in a short amount of time.”

“For us, if we see 5 people that get infected in a 10 day period, that signifies to us that this may be the beginning of an outbreak because we usually see 3-5 cases per month on average,” Magele explained. “So this signifies a rapid increase in numbers and warrants investigations and actions.”

“Right now the increase in cases is not as much as we saw with Zika, but with up to 80% of those infected not showing symptoms, so for dengue we want to identify as many people as we can while strengthening our community response,” he points out.

With the Zika virus still present in the territory — 63 confirmed cases through laboratory testing and 29 of them pregnant women as of Feb. 6 — Samoa News asked how people would differentiate between Zika and dengue, especially when both have similar symptoms, and are both mosquito- borne diseases.

“This is the most difficult question to answer as the symptoms for both viruses are the same,” Magele noted. “For us the only way to completely differentiate is through laboratory testing. Which is why the hospital uses rapid kits testing to see if it is positive for dengue and then we send the samples to Hawai’i for official confirmation.”

He says the “rapid kits allow us to identify it locally the same day while we wait the week or two it takes to get official results from Hawai’i.”

As far as symptoms go, Magele acknowledged that both viruses would be suspected at the hospital or clinic because they present similar symptoms. “The only difference is because dengue has the potential for patients to go hemorrhagic and possibly lead to death, the healthcare providers are treating for dengue, even though they may suspect both viruses,” he explained.

Since there is no specific treatment for dengue fever, Magele suggests fluid management is the most important treatment method and “so we are encouraging that if the community does feel ill with a combination or fever, rash, muscle pain, joint pain, severe headache, pain in he eyes or any stomach problems, that they use tylenol only for pain and fever, and drink plenty of fluids.”

If they begin to have stomach problems or feel worse after 2 days of treatment or cannot hold drown and drink fluids, then they should go seek medical care at the hospital immediately, he recommends.

When the Zika virus spread fast last year, there were various clean ups — including those spearheaded by the ASG island wide clean up committee — throughout Tutuila to get rid of mosquito breeding grounds, in an effort to prevent the spread of Zika.

With all that clean up, Samoa News asked if there’s a reason why dengue fever numbers have gone up and now people are once again encouraged to clean their surroundings. “Even though we do cleanups and have been doing our campaign for Zika, there is still many areas that need more attention,” was Magele’s reply.

He explained that anything outside or inside the home that holds water is a potential breeding ground for mosquitoes “and so we have to continue to encourage our 4-D campaign: Dress appropriately when going outside with long sleeves and clothes that protect the skin area, use mosquito repellent containing Deet, Drain any water holding containers, and Discuss in their communities ways to help protect themselves and their families.”

DOH encourages the use of environmental control measures by cleaning out water collecting containers and practicing good sanitation practices.