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Dengue fever cases rise in Peru

27 June 2017

Background

During the early months of 2017, Peru was severely affected by heavy rain and widespread flooding caused by the El Niño weather phenomenon. The northern coastal departments of Tumbes, Piura, Lambayeque, La Libertad and Ancash and the Andean department of Cajamarca were particularly badly affected.

In May 2017, the Pan American Health Organization (PAHO) declared a dengue epidemic in the city of Piura when three hundred suspected new dengue infections were being recorded daily.

Peru

Map by kind permission of the University of Texas Map Libraries

Significant issues and data emerging from the outbreak

∙    53,017 suspected and confirmed dengue fever cases have been reported in the country since 1 January 2017.There were 26,453 suspected and confirmed cases of dengue fever, including 45 deaths, in the whole of 2016 in Peru.

∙    The department of Piura currently has around 60% of the national total of dengue fever cases.

∙    58 deaths from dengue fever have been confirmed since 1 January 2017.

∙    The Declaration of National State of Emergency in Piura department and the Emergency Declarations for the departments of Tumbes, Lambayeque, La Libertad, Ancash and Cajamarca which were brought in February 2017 were extended for a further 45 days in May 2017.

∙    A State of Emergency has also been extended in districts in the departments of Ayacucho (5 districts), Ica (12) and Junin (1).

Response to the outbreak

The General Directorate of Environmental Health and Food Safety (Digesa) and the Ministry of Health have carried out the following response activities:

∙    Vector control activities to eliminate mosquito breeding areas. Many of these have been carried out by soldiers from the Peruvian army who have been specially trained.

∙    Larval control using a larvacide (an insecticide) in water containers in almost 380,000 homes.

∙    More than 523,000 fumigations in houses to eliminate adult mosquitoes.

∙    The Peruvian Red Cross has carried out training in dengue prevention.

Dengue fever – a brief outline

Dengue exists in many parts of the world: 2.5 billion people live in areas where dengue is transmitted, mainly in South East Asia, the Pacific islands, Latin America, the Caribbean islands and now also in Africa and the Middle East. The World Health Organization (WHO) estimates that there are 50-100 million dengue infections worldwide each year.

Dengue is a viral disease and it is transmitted through the bite of an Aedes mosquito which is a day-biting mosquito. This mosquito lives very close to people in built-up areas and thrives in small amounts of stagnant water. The incubation period is usually 4-10 days.

Symptoms include sudden onset of:

∙    High fever which can last from 3-7 days

∙    Severe headache

∙    Muscle and joint pain, eye pain

Dengue fever is commonly known as "break bone fever" as those who have it often report severe bone pain. Nausea and vomiting can also occur. These symptoms mimic malaria symptoms so if you are in a malaria region, you should also get tested for malaria. Cases of dengue fever often improve within a few days. However, in 1-2% of dengue cases, the illness can progress into a more severe condition called Dengue Haemorrhagic Fever (DHF). Severe bleeding can occur and in extreme cases this can result in organ failure and death, but this can usually be prevented with adequate medical care. Vaccinations against dengue are in various stages of trials, however, their success is limited and none are currently available for travellers. Treatment is merely supportive with fluids and pain relief.

There is a general consensus that those who have had a previous attack of dengue fever may experience more severe symptoms on subsequent occasions, so you should take particular care to avoid being bitten.

Why is dengue fever on the rise throughout the world?

The disease has spread as a result of rapid urbanisation, especially where a lack of clean water and sanitation are a problem. Disease transmission rates increase when people live in close proximity to each other. Some experts think that climate change is also contributing to the rapid spread of dengue fever. Small pools of water are common, especially after it has rained, which have enabled the mosquito to reproduce quickly and in great numbers. Increased international travel also means that travellers can carry the virus to other countries. Also, one type of Aedes mosquito, Aedes albopictus, has adapted to survive in cooler climates, hence the increase in dengue cases in Europe.

Guidance for those travelling to or working in the areas affected

A very small number of people who travel to countries with a risk of dengue fever for holidays or for work become infected with dengue fever each year. They can develop symptoms of the disease either while they are away or after they return to their home countries.

To prevent the spread of cases we suggest the following:

·    Ensure you get rid of all standing water in and around your home and work location. Water can collect in all sorts of receptacles including discarded tyres, containers, tins, buckets and plant pots, especially during and after rainy seasons.

·    Follow bite prevention measures day and night. These include using effective repellents (dengue carrying mosquitoes are usually day-biting but those carrying malaria are more active at night), wearing long-sleeved tops and long trousers, screening windows, using air conditioning if available and sleeping under mosquito nets.

If you suspect you have contracted dengue fever:

·    Seek medical attention quickly. Rest and drink plenty of fluids.

·    Ensure you are also screened for malaria as this is also present in some regions of Peru.

·    A full recovery from dengue fever may take weeks during which your energy levels will be significantly reduced. Allow yourself plenty of time to recover fully.

For further advice please click on the related information topics on the right hand panel of this screen.

Sources

·    Dengue fever: Peru reports 6000 confirmed cases, northern coast most affected, Outbreak News Today, 5 May 2017

·    Peru: Temporada de lluvias, UN Office for the Coordination of Humanitarian Affairs, 10 May 2017

·    Peru: Rainy season – Situation Report No. 11 (as of 26 May 2017), UN Office for the Coordination of Humanitarian Affairs, UN Country Team in Peru, 26 May 2017

·    Muertes por brote de dengue suben a 54 en Peru en 2017, Panorama, 30 May 2017

·    Reported Cases of Dengue & Severe Dengue in the Americas, by Country: Figures for 2017 Epidemiological Week/EW 22 (updated June 9, 2017), Pan American Health Organization, 9 June 2017

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