Date: Sun, 10 Sep 95 12:07:38 EDT
From: Emergency Information Administrator
Subject: Central America: Haemorrhagic Fever DHA
APPEAL FOR INTERNATIONAL ASSISTANCE IN CONNECTION WITH
HAEMORRHAGIC DENGUE OUTBREAK IN CENTRAL AMERICA
COSTA RICA, EL SALVADOR, GUATEMALA,
HONDURAS, NICARAGUA, PANAMA
10 SEPTEMBER 1995
(DHA IS ISSUING THIS APPEAL AT THE REQUEST OF PAHO/WHO)
1. DENGUE AND ITS MORE SERIOUS FORM, DENGUE HAEMORRHAGIC FEVER
(DHF) ARE TRANSMITTED BY THE BITE OF THE AEDES AEGYPTI MOSQUITO.
DENGUE EPIDEMICS HAVE BEEN CONFIRMED IN THE AMERICAS SINCE 1963.
THERE IS NO VACCINE OR SPECIFIC TREATMENT AVAILABLE FOR DENGUE,
ALTHOUGH SIMPLE SANITATION MEASURES CAN GET RID OF MOSQUITO
BREEDING PLACES.
2. DENGUE AND DENGUE HAEMORRHAGIC FEVER (DHF) ARE CURRENTLY AN
ACUTE PROBLEM OF SERIOUS PROPORTIONS IN THE AMERICAS. THE
SITUATION HAS BECOME A HEALTH AND SOCIOPOLITICAL EMERGENCY,
LEADING NATIONAL AUTHORITIES REGIONWIDE TO TAKE EXTRAORDINARY
RESPONSE MEASURES FOR HEALTH DISASTER.
3. ACCORDING TO FIGURES COMPILED BY THE COMMUNICABLE DISEASES
PROGRAM OF PAHO, A TOTAL OF 23,603 DENGUE CASES (WITH 352 CASES
OF DHF) HAVE BEEN REPORTED FROM COSTA RICA, EL SALVADOR,
GUATEMALA, HONDURAS, NICARAGUA AND PANAMA.
4. IN BRAZIL 74,098 CASES OF DENGUE HAVE BEEN IDENTIFIED. IN
MEXICO 1,905 CASES OF DENGUE AND 34 CASES OF DHF HAVE BEEN
REPORTED AND IN VENEZUELA, 15,252 CASES OF DENGUE INCLUDING
2,934 CASES OF DHF.
5. IN ENGLISH-SPEAKING CARIBBEAN, 228 CASES OF DHF HAVE BEEN
REPORTED.
6. THE RESURGENCE OF DENGUE IN THE AMERICAS IS DUE IN PART TO
SETBACKS IN PROGRAMS TO ERADICATE THE MOSQUITO. CONTROL
MEASURES THAT MUST BE TAKEN TO CONTROL DENGUE INCLUDE CLEAN-UP
CAMPAIGNS, PUBLIC EDUCATIONS, SPRAYING, AND TREATMENT OF WATER
WITH LARVICIDES.
7. IMMEDIATE ACTION IS THEREFORE CALLED FOR TO CARRY OUT THE
EXTRAORDINARY RESPONSE MEASURES THAT THE COUNTRIES ARE NOT IN
A POSITION TO FINANCE WITH THEIR OWN RESOURCES, HENCE THE NEED
FOR INTERNATIONAL EMERGENCY ASSISTANCE.
8. EMERGENCY MEASURES ARE PROJECTED TO LAST 6 MONTHS AND ARE
GEARED TOWARDS TWO BASIC OBJECTIVES: PATIENT CARE AND VECTOR
CONTROL.
ORGANIZATION
============
9. EMERGENCY COMMITTEES FOR DENGUE ARE PREPARING OR UPDATING
AN EMERGENCY PLAN THAT INCLUDES THE ONGOING EVALUATION OF THE
IMPACT OF THE VECTOR CONTROL MEASURES AND DAILY MONITORING OF
THE INCIDENCE OF CASES AND PROPER MEDICAL CARE. THE PLAN
FURTHER INCLUDES INVENTORY OF AVAILABLE RESOURCES,
ESTABLISHMENT OF EMERGENCY SERVICES AND SENTINEL SITES,
COORDINATED PROCUREMENT OF SUPPLIES AND TRAINING OF PERSONNEL.
TRAINING OF HEALTH PERSONNEL
============================
10. SEMINARS FOR ALL HEALTH PERSONNEL (SIX SEMINARS PER COUNTRY),
TRAINING AT HOSPITAL LEVEL FOR PAEDIATRICIANS AND INTERNISTS,
INFORMATION DISSEMINATION WORKSHOPS FOR COMMUNITIES AND
JOURNALISTS, COUNTRY WORKSHOPS TO TRAIN PERSONS IN CHARGE OF
SPRAYING.
DRUGS AND SUPPLIES
===================
11. MEDICAL SUPPLIES REQUIRED ARE AVAILABLE IN MOST NATIONAL
HOSPITALS. INTERNATIONAL ASSISTANCE WILL BE NECESSARY TO ENSURE
THEIR UNINTERRUPTED AVAILABILITY. THEY ARE AVAILABLE IN THE LOCAL
MARKETS IN CENTRAL AMERICA AND WILL BE PURCHASED BY THE
PAHO/WHO REPRESENTATIVE OFFICES AT THE MOST FAVOURABLE PRICES
AT THE NATIONAL LEVEL.
EPIDEMIOLOGICAL SURVEILLANCE
===========================
12. THE SYSTEM FOR ACTIVE EPIDEMIOLOGICAL SURVEILLANCE WILL BE
STRENGTHENED, WITH LABORATORY SUPPORT FOR MONITORING THE
EPIDEMIC AND ORIENTING VECTOR CONTROL MEASURES. FOR THIS
PURPOSE, THE NETWORK OF SENTINEL CENTERS LOCATED IN HOSPITALS
AND HEALTH CENTERS WILL BE UPGRADED.
LABORATORY
==========
13. THE LABORATORY NETWORK WILL BE STRENGTHENED, WITH PRIORITY
GIVEN TO DIAGNOSING CASES OF DENGUE HAEMORRHAGIC FEVER AND
AREAS WHERE DENGUE IS DETECTED FOR THE FIRST TIME. MOST OF THE
EQUIPMENT MATERIAL REQUIRED MUST BE PURCHASED OUTSIDE LATIN
AMERICA.
VECTOR CONTROL
==============
14. THIS IS DONE THROUGH THE CONTROL OF ADULT MOSQUITOES AND
LARVAL FORMS. EVEN THOUGH IT IS IMPORTANT TO ELIMINATE THE ADULT
MOSQUITOES INFECTED WITH THE DENGUE VIRUSES IN ORDER TO
INTERRUPT THE CHAIN OF TRANSMISSION, THE HIGHER PRIORITY IS TO
ELIMINATE OR REDUCE BREEDING SITES. PURCHASE OF HEAVY-DUTY
FOGGERS WILL BE DONE IN MARKETS OUTSIDE CENTRAL AMERICA.
INSECTICIDES WILL BE PURCHASED, SUBJECT TO AVAILABILITY, FOLLOWING
LOCAL EMERGENCY PROCEDURES.
COMMUNICATIONS AND COMMUNITY EDUCATION
======================================
15. SIMULTANEOUSLY OR PRIOR TO THE ACTIONS DESCRIBED ABOVE, THE
EMERGENCY COMMITTEES WILL ORGANIZE AND IMPLEMENT A BROAD
PUBLICITY CAMPAIGN USING RADIO, TELEVISION, POSTERS, AND ALL OTHER
AVAILABLE MEDIA.
BUDGET FOR 6/COUNTRY PROJECT USDOLLARS
============================ =========
VECTOR CONTROL 1,368,000
MEDICAL CARE 150,000
(EQUIPMENT, DRUGS)
EPIDEMIOLOGY AND LABORATORY 162,800
TRAINING 174,000
CONSULTANTS 25,200
----------
TOTAL AMOUNT REQUESTED 1,880,000
======================
PAHO CONTRIBUTION 250,000
COUNTRY CONTRIBUTIONS 2,500,000
----------
TOTAL PROJECT COST 4,630,000
==================
(MORE DETAILED BUDGET BREAKDOWN AVAILABLE UPON REQUEST)
16. DONORS SHOULD ADDRESS THEIR CONTRIBUTIONS AND ENQUIRIES TO:
PAHO, WASHINGTON,D.C.
=====================
CHIEF, EMERGENCY PREPAREDNESS AND DISASTER RELIEF
COORDINATION PROGRAM (PED)
ATT: DR. CLAUDE DE VILLE DE GOYET, CHIEF, PED
===
TELEPHONE NO. +202-861-4325
FAX NO. +202-775-4578
-------------------------------------------------
+ DEPARTMENT OF HUMANITARIAN AFFAIRS - GENEVA +
TELEX: 414242 DHA CH
FAX: +41-22-917.00.23
EMAIL: DHAGVA AT UN.ORG
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