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Dengue fever gains beachhead in US

Several news articles are circulating today regarding the apparent re-establishment of a permanent dengue fever colony in the United States.  This should not come as a surprise; I and others have been warning of the eventual and guaranteed establishment of dengue in the US for years.  Nor should the location come as a surprise.  Key West is a mere 90 miles from the northern coast of Cuba, and Key West (as everyone knows) sticks out into that intersection of the Gulf of Mexico and the western Caribbean Sea, via the Straits of Florida. 

Two articles illustrate the re-established dengue colony in Key West. 

More than 1,000 exposed to dengue in Florida: CDC

Tue, Jul 13 2010

WASHINGTON (Reuters) - Five percent of the population of Key West, Florida -- more than 1,000 people -- have been infected at some point with the dengue virus, government researchers reported on Tuesday.

Most probably did not even know it, but the findings show the sometimes deadly infection is making its way north into the United States, the researchers said.

"We're concerned that if dengue gains a foothold in Key West, it will travel to other southern cities where the mosquito that transmits dengue is present, like Miami," said Harold Margolis, chief of the dengue branch at the U.S. Centers for Disease Control and Prevention.

"These cases represent the reemergence of dengue fever in Florida and elsewhere in the United States after 75 years," Margolis said in a statement.

"These people had not traveled outside of Florida, so we need to determine if these cases are an isolated occurrence or if dengue has once again become endemic in the continental United States."

Dengue is the most common virus transmitted by mosquitoes, infecting 50 million to 100 million people every year and killing 25,000 of them.

It can cause classic flu-like symptoms but can also take on a hemorrhagic form that causes internal and external bleeding and sudden death. Companies are working on a vaccine but there is not any effective drug to treat it.

Dengue was eradicated in the United States in the 1940s but a few locally acquired U.S. cases have been confirmed along the Texas-Mexico border since the 1980s. More cases have been reported recently in Mexico and the Caribbean.

After 27 cases of dengue were reported in Florida in 2009, scientists from the CDC and the Florida Department of Health took blood samples from 240 randomly chosen Key West residents.

Of these, 5 percent had active dengue infections or antibodies to the virus, showing they had been infected, the researchers told the International Conference on Emerging Infectious Diseases being held in Atlanta.

The second article is from the Sun-Sentinel, one of Florida's largest daily newspapers, headquartered on Ft. Lauderdale:

Officials warn again about dengue fever in Key West

 

11:02 p.m. EDT, July 13, 2010

As South Floridians motor to the Keys for summer vacation, health officials on Tuesday urged caution about the persistent presence of mosquito-borne dengue fever in Key West.

Doctors have logged 14 cases in the old town since April — two last week — after an outbreak of 27 cases last fall marked the first time since 1945 that someone got the
virus in the continental United States.

No one has died, and most people don't even get sick when infected with dengue, officials said in Tuesday's report from the federal
Centers for Disease Control and Prevention. But it's the first time the virus has returned for a second U.S. outbreak in the same place.

"Most experts thought it would not be back, but here it is. It has come back," said Carina Blackmore, a Florida Department of Health expert on mosquito diseases who helped write the CDC report. "We all need to be careful."

That includes the 3.3 million tourists who visit the Keys each year, 35 percent of whom are from
Florida and a large share of whom come from South Florida.

Officials said tourists have little to worry about as long as they take basic precautions against bug bites: Stay indoors from dusk to dawn, wear long sleeves and pants if outside at those times, use repellent with the chemical DEET and eliminate even small pools of standing water where the bugs breed.

"I don't think people have to worry about coming to Key West. They should be aware of the outbreak, but if they stay in a hotel with air conditioning and take simple steps, their risk should be absolutely minimal," said Dr. Mark Whiteside, medical director at the
Monroe County Health Department.

Aside from dengue, three horses in South Florida have died from mosquito-borne encephalitis, and a few chickens have tested positive for
West Nile virus. All three diseases are carried by different mosquitoes, but officials said the need for caution is clear.

Dengue fever infects about 50 million people worldwide and kills 25,000. The symptoms can include fever, aches, pains, rash, upset stomach and vomiting. Two of those infected in the Keys were hospitalized.

Last fall, health officials took blood samples from 240 Key West residents and reported Tuesday that 5 percent had been exposed to dengue. Blackmore said the number probably has gone up.

There's little risk of the carrier mosquito — Aegus aegypti — venturing off the island. Blackmore said the species generally stays close to home. But a risk is that a visitor could get infected and then be bitten by mosquitoes at home, spreading dengue to a new locale.

"We're concerned that if dengue gains a foothold in Key West, it will travel to other southern cities where the mosquito that transmits dengue is present, like
Miami" and the rest of South Florida, said Harold Margolis, dengue chief at the CDC.

For more information, see
http://www.cdc.gov/dengue or call 800-232-4636. 

We once had a powerful weapon to fight mosquitoes, and it was a doozy:  DDT.  But the advent of Silent Spring, the '60s Rachel Carson book, pretty much killed DDT like Ralph Nader killed Corvairs.   Now, however, we are learning more and more about DDT.  And it appears Ms. Carson took extreme liberties when it came to the effects of DDT on the environment.  I am stopping short of saying Ms. Carson lied, but the effect on DDT was the same as if she had. 

I head a story on the radio, and I heard a similar story from another source, and the stories prompted me to remember riding my bicycle behind the ol' fogger truck as it made its way through my old Lighthouse Point, Florida neighborhood.  It was so cool to ride in the "fog" created by that machine as it lumbered through our streets!  Sometimes it would back up and hit a backyard, a vacant lot, a wooded area or a construction site with more fog, upon request.

I am certain that some readers are recoiling in abject horror at that statement!  But I am also confident that there are several of you out there who recall those days with fondness.  Despite the recoil, let me assure you that I have no visible nor invisible scars to show for those days. 

How many African children could have been saved with the re-establishment of DDT?  Perhaps the million per year that die from mosquito-borne viruses?  Sadly, our only answer to malaria, dengue and chickungunya (all mosquito-borne) is to buy a lot of DEET-enriched repellent and to ship mosquito nets to Africa. I shake my head at that.

Even the WHO has issued entreaties to restore the development and production of DDT.  It's the only thing that reliably works on mosquitoes.  And I do not believe (someone will correct me, I am sure) that mosquitoes develop a resistance to DDT.

As mosquito-borne diseases continue to grow and expand, there is a knee-jerk reaction from governments, courtesy of the Friends of the Mosquitoes, to do little to nothing to combat the winged vector of diseases.  Here in the Peoples' Republic of Tallahassee, the Leon County Commission bowed to the wild-eyed lunatic fringe, and imposed one of the most ludicrous acts in recent memory.  If one single homeowner objected to the spraying for mosquitoes, then spraying would be abandoned for every parcel within a quarter-mile -- a quarter-mile!  -- of that home.  The effect was that 100 homeowners would effectively shut down mosquito spraying for almost all Leon County, Florida residents.

Former Leon Commissioner Ed DeDuy, a very good friend of mine, once said that few things arose as much passion as messing with mosquito spraying.  And we was proven right again, as the silent majority of homeowners went apoplectic and raised such a ruckus that the commission flip-flopped and reversed the ban. 

Those who oppose spraying for mosquito control strike me as in the same league as those who oppose vaccines because they (mistakenly) think they cause autism.  Mosquito control is as much of a public health issue as vaccinating the population.

With West Nile Virus, Eastern Equine Encephalitis and Dengue fever, Florida is a contender for the Triple Crown of mosquito-borne diseases.   Throw in some other diseases that hypothetically might be controlled by such spraying -- Lyme disease, for example -- and it is an imperative that we deal with these dangerous pests quickly and decisively.  To paraphrase: Spray, baby, spray!

And bring back DDT.  Let's abandon the junk science and save some lives. 

 

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