On a trip I took last year to Nicaragua, a problem I noticed was the widespread effect of Dengue. From the signs at the airport warning travelers about dengue to the many warnings scattered through different cities and towns in the country, dengue was clearly an issue of interest in Nicaragua. Dengue is transmitted through mosquitoes and is common in tropical regions. The disease has affected many people in the country.The disease is both a concern for Nicaraguan citizens and tourists. In 2013 the Nicaraguan disaster control agency declared a "sanitary red alert", as a result of an increased number of visitors being taken to hospitals with Dengue. The United States embassy also warns travelers to take precautions against the disease. The Nicaraguan Ministry of Health reported 4,300 cases of dengue in 2013. Dengue has become a public health concern for Nicaragua, consequently many people are creating innovative ways to solve this issue.(Below is a video explains the general outbreak of Dengue. The video also delves into a scientific and statistical method used to predict the outbreak of dengue in the city of Leon, Nicaragua.)
SIGNS , SYMPTOMS, AND DIAGNOSIS
Dengue is an incredibly dangerous disease. Recipients of the virus may not know that they are infected until several weeks later. Symptoms are usually incubated for a period of two weeks as the disease develops in your body. The symptoms of Dengue usually manifest themselves in a series of phases. A patient in the first phase or Febrile Phase will experience vomiting,
headaches, fever, joint and muscle pain, rash, and diarrhea. The second phase or Critical Phase will result in a patient experiencing gastrointestinal bleeding, hypotension, and pleural effusion ascites.The third phase or Recovery phase will result in a patient experiencing seizures, itching and a slow heart rate. One of the biggest problem with the disease in Nicaragua is early treatment. If the disease is neglected during the Febrile Phase it will continue into the dangerous Critical Phase very strongly. It is important to be vigilant of these signs in order to catch the disease at an early stage. Dengue is often diagnosed by observing patients symptoms and ordering a mono-test, which is the exam used by the ministry of health to determine dengue infections. Between 8,000-10,000 samples are sent in for testing each year. The earlier a diagnosis is made and treatment is given, the less severe the effects of dengue on the patients will be. If the disease goes untreated it could result in severe bodily reactions and possibly even death.
(Below is a video about the biology, signs, and symptoms of the Dengue Virus)
One of the most effective ways to combat Dengue is through the use of preventative techniques. It is important that these techniques are taught and talked about throughout Nicaragua in order to increase the effort of prevention. Both the citizens of Nicaragua and the Government of Nicaragua can take steps at helping to prevent this disease. There are several steps Nicaraguan citizens and outside tourists can take to prevent Dengue. These include using insect repellent, wearing protective closing, and sleeping under a mosquito net. The government has also been taking measures to decrease the amount of Dengue infections. Environmental Sanitation Campaigns are an important tool used by the government in Nicaragua to tackle this problem. The government identifies problem areas, such as homes or public places, which could serve as breeding grounds for Aedes Aegypti, the mosquito that carries dengue. These problem areas are then sanitized and any potential breeding grounds are exterminated. Larvicide Campaigns and Fumigation are another form of government intervention to prevent dengue. There are 6-8 national campaigns a year that go home to home in search of potential risk factors. The government employs up to 1,000 people each year in an effort to prevent and fight the disease. Moreover, they spend nearly 750,000 US$ on insecticides each year, and over 55% of the national ministry of health's diseases budget is devoted to dengue.
(Below is a graph detailing the dengue risk areas in Nicaragua for 2013, as well as reported cases by June of 2013)
OUTBREAK HISTORY
There have been various outbreaks of Dengue in Nicaragua spanning back to 1985. The most recent outbreaks of the disease have occurred in Managua (2002), Chontales (2003), and Carazo (2007). In 2002 Managua experienced , perhaps the most widespread and dangerous outbreak. This outbreak involved 684 cases of Dengue spread throughout households in the city. An issue that contributed to this outbreak was the reluctance of the population to use the Abate Larvicide. 17% of the identified population refused to use this larvicide, and 40% of those who accepted the larvicide threw it away. This is believed to have contributed widely to the spread of dengue in Managua. Several factors have been identified that increase the chance of a Dengue outbreak.
The overcrowding of urban areas, such as Managua, Leon or other big cities in Nicaragua.
The absence of utilities, such as electricity, sanitary sewage, and garbage collection services
A high rate of illiteracy or Poverty.
CONCLUSION
Dengue presents a serious threat for both visitors and citizens of Nicaragua. This mosquito borne disease can cause serious symptoms, potentially resulting in the death of a patient. The Ministry of Health in Nicaragua has noted the potential threat of dengue to the country. The large amount of cases in the country and occasional large outbreaks, have pushed the Ministry of Health to devote a large amount of resources and capital to combat the disease. Each year they conduct several countrywide larvicide and environmental sanitation campaigns aimed at exterminating the disease. Yet, this is not enough, tourists and citizens of Nicaragua must be cautious and take the appropriate measures to decrease their chances of contracting the disease. Unfortunately, there is currently no cure or vaccine for dengue, hopefully in the future there will be a cure for the disease and preventative measures will have eradicated it from the country.
