Date Published: October 30, 2014
Publisher: Public Library of Science
Author(s): Stephanie J. Salyer, Esther M. Ellis, Corvil Salomon, Christophe Bron, Stanley Juin, Ryan R. Hemme, Elizabeth Hunsperger, Emily S. Jentes, Roc Magloire, Kay M. Tomashek, Anne Marie Desormeaux, Jorge L. Muñoz-Jordán, Lesly Etienne, Manuela Beltran, Tyler M. Sharp, Daphne Moffett, Jordan Tappero, Harold S. Margolis, Mark A. Katz, Maya Williams. http://doi.org/10.1371/journal.pntd.0003269
Abstract: In October 2012, the Haitian Ministry of Health and the US CDC were notified of 25 recent dengue cases, confirmed by rapid diagnostic tests (RDTs), among non-governmental organization (NGO) workers. We conducted a serosurvey among NGO workers in Léogane and Port-au-Prince to determine the extent of and risk factors for dengue virus infection. Of the total 776 staff from targeted NGOs in Léogane and Port-au-Prince, 173 (22%; 52 expatriates and 121 Haitians) participated. Anti-dengue virus (DENV) IgM antibody was detected in 8 (15%) expatriates and 9 (7%) Haitians, and DENV non-structural protein 1 in one expatriate. Anti-DENV IgG antibody was detected in 162 (94%) participants (79% of expatriates; 100% of Haitians), and confirmed by microneutralization testing as DENV-specific in 17/34 (50%) expatriates and 42/42 (100%) Haitians. Of 254 pupae collected from 68 containers, 65% were Aedes aegypti; 27% were Ae. albopictus. Few NGO workers reported undertaking mosquito-avoidance action. Our findings underscore the risk of dengue in expatriate workers in Haiti and Haitians themselves.
Partial Text: Dengue is the most common mosquito-borne viral disease in the world, and resulted in an estimated 390 million infections and 96 million symptomatic cases throughout the tropics and subtropics in 2010 , . Over the last decade, the incidence and the severity of dengue have increased in the Americas, including the Caribbean , , where the four dengue virus-types (DENV-1–4) that cause dengue and the mosquitoes (i.e., Aedes aegypti and Ae. albopictus) that transmit DENV are endemic , –. The risk of acquiring dengue can be greatly reduced by following key mosquito avoidance activities, such as applying mosquito repellent multiple times a day and wearing long sleeves, pants or permethrin-treated clothing , .
In our investigation of NGO workers in Léogane and Port-au-Prince, Haiti, we found that a substantial proportion (15% of expatriates and 7% of Haitians) had recently been infected with a DENV. Six of the infected workers reported being ill, and three required evacuation from Haiti for medical care. This rate of recent DENV infection is similar to findings from two previous studies in Haiti that reported rates of infection as high as 25% in expatriates and 29% in military personnel (12,15). These findings demonstrate the risk of dengue for visitors to and residents of Haiti, and also illustrate the potential economic consequences of dengue through missed work days, hospitalization, and medical evacuation , .