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Epidemiologic Notes and Reports Dengue Fever in Puerto Rico
-- 1981
An outbreak of dengue fever took place in Puerto Rico in the
late
summer and fall of 1981. In this period, almost 7,000 cases of
dengue-like illness were reported to the Puerto Rico Health
Department. Numbers of cases of dengue-like illness began
increasing
in August, reached a peak in mid-October, and declined steadily
thereafter (Figure 2). Generally, throughout this period,
50% of the
paired serum specimens tested at CDC were positive for dengue.
Cases
were reported from all parts of the island, but the areas reporting
the highest proportion of cases were districts outside the San Juan
metropolitan area. No deaths or illnesses meeting World Health
Organization criteria for dengue hemorrhagic fever were documented
during the outbreak. However, sporadic hemorrhagic manifestations
occurred among patients with confirmed dengue infection for whom
the
clinical and laboratory data were incomplete.
The Puerto Rico Health Department, in association with other
government agencies, organized an extensive island-wide
source-reduction and educational campaign in the early phases of
the
outbreak. By December 2, CDC had isolated 114 dengue type 1
viruses
and 1 dengue type 4 virus. However, by late December, dengue type
4
was the predominant virus being isolated, and by mid-January 1982,
more than 40 such isolates had been obtained.
Reported by A Hernandez-Torres, MD, Environmental Health, Puerto
Rico
Dept of Health; Dengue Br, Vector-Borne Viral Diseases Div, Center
for
Infectious Diseases, CDC. Editorial Note
Editorial Note: The last major outbreak of dengue in Puerto Rico
was
in 1978 when type 1 was the prevailing virus; apparently, a large
susceptible population remained after that outbreak. Outbreaks of
dengue occurred in Puerto Rico in 1963-1964 (type 3), 1968-1969
(type
2), 1975 (type 2), and 1977 (types 2 and 3).
Dengue type 4 was reported for the first time in the Caribbean
in
the spring of 1981 from St. Barthelemy and St. Martin (1).
Subsequently, dengue type 4 was confirmed in Dominica, Guadaloupe,
St.
Thomas, Curacao, Belize, Haiti, and Jamaica, as well as Puerto
Rico.
The possibility exists that an outbreak of dengue type 4 could
occur
in Puerto Rico in 1982.
Reference
CDC. Dengue type 4 infections in U.S. travelers to the
Caribbean. MMWR 1981;30:249-50.
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