Dengue fever is a mosquito-borne illness impacting millions globally, especially in tropical and subtropical regions. Transmitted by specific mosquito species, this viral infection is a significant public health concern. Understanding dengue fever, its presence in the Dominican Republic, prevention strategies, and how to recognize and respond to symptoms is beneficial for travelers and residents.
Understanding Dengue Fever
Dengue fever is caused by the dengue virus, a flavivirus with four distinct serotypes: DENV-1, DENV-2, DENV-3, and DENV-4. Infection with one serotype provides lifelong immunity to that specific serotype but only temporary protection against the others. Subsequent infections with different serotypes can lead to more severe forms of the disease.
The virus is primarily transmitted to humans through the bite of infected Aedes aegypti mosquitoes, and to a lesser extent, Aedes albopictus mosquitoes. These mosquitoes breed in peri-domestic environments, often near human dwellings. While many dengue infections are asymptomatic, those who develop symptoms experience a sudden onset of high fever, severe headache, pain behind the eyes, and muscle and joint pain, sometimes called “breakbone fever” due to the intense pain. A rash may also appear.
Dengue’s Presence in the Dominican Republic
Dengue is widespread in the Dominican Republic, with thousands of cases reported annually. In 2022, the country reported 10,784 cases and 39 deaths. The tropical climate, with warm temperatures and significant rainfall, creates favorable conditions for the Aedes aegypti mosquito to breed and thrive.
Outbreaks are common, particularly during the rainy season, which runs from May to November. High population density in urban and semi-urban areas contributes to transmission, as these environments provide ample breeding sites and opportunities for human-mosquito contact. Challenges in mosquito control, including limited infrastructure and resources, also contribute to the ongoing presence of the disease. Dengue remains endemic.
Preventing Dengue in the Dominican Republic
Preventing dengue infection in the Dominican Republic involves personal protection and environmental control measures. Wearing light-colored, loose-fitting clothing that covers arms and legs, especially during peak mosquito hours at dawn and dusk, can reduce bite exposure. Treating clothing with permethrin, an insect-repellent fabric treatment, adds an additional layer of protection.
Applying EPA-registered insect repellents containing active ingredients such as DEET, picaridin, or oil of lemon eucalyptus to exposed skin is also important. Repellents with concentrations of more than 20% DEET or picaridin can provide protection for over four hours. Eliminating mosquito breeding sites around homes and accommodations is important. This involves regularly emptying and cleaning containers that can hold standing water, such as buckets, flowerpots, and discarded tires. Ensuring that window and door screens are intact and free of holes, and using mosquito nets over beds, can help prevent mosquitoes from entering living spaces.
Recognizing and Responding to Dengue Symptoms
Dengue fever presents with a sudden high fever, around 104°F (40°C), lasting for two to seven days. Other common symptoms include severe headache, pain behind the eyes, muscle and joint pain, nausea, vomiting, and a skin rash. Many individuals infected with dengue may not experience any symptoms, or their symptoms might be mild and easily mistaken for other common illnesses.
If dengue is suspected, seek medical attention, especially if there has been recent travel to an area with dengue transmission. While there is no specific antiviral treatment for dengue, managing symptoms involves rest and staying well-hydrated by drinking plenty of fluids. Acetaminophen (paracetamol) can be used to control fever and relieve pain; however, aspirin, ibuprofen, or naproxen sodium should be avoided as they can increase the risk of bleeding complications.
Watch for warning signs of severe dengue, which appear 24 to 48 hours after the fever subsides. These signs include severe abdominal pain or tenderness, frequent vomiting (at least three times in 24 hours), bleeding from the nose or gums, blood in vomit or stool, and feeling extremely tired or restless. The presence of any of these warning signs indicates a medical emergency requiring immediate attention at a local clinic or emergency room.