Dr. Largaespada Beers of the MOH declared on the occasion of two regrettable cases of maternal deaths with signs and symptoms compatible with Dengue that “we have so many types of dengue circulating which makes it a bit more difficult to manage”.
This is certainly so. A percentage of persons who have been infected by one serotype of dengue gets infected with another dengue serotype develop bleeding and endothelial leak. This is termed severe Dengue (also known as hemorrhagic dengue and dengue shock syndrome).
There is motive for alarm then. When there is a continuous circulation of multiple viral serotypes in an area where a large pool of susceptible hosts and a competent vector are constantly present, we refer to the situation as a hyperendemic transmission pattern. This appears to be a major risk for dengue hemorrhagic fever. Travelers to these areas are more likely to be infected than are travelers to areas that experience only epidemic transmission (in an area where dengue virus is introduced as an isolated event that involves a single viral strain).
The Ministry of Health is content with indicating that the public needs to do more to help control the mosquito vector. The ministry needs to do more also. Telling people that they need to clean the backyards is not enough. The ministry needs to ascertain that it is done. If necessary, legislation has to be enacted with respect of keeping or yards clean and the ministry needs to be on the ground to ascertain that it is being complied with.
A comprehensive Dengue Management Plan must be elaborated. One where the roles of all the stakeholders are defined. That of the general public, that of the local government, that of the Ministry of Health and that of the Ministry in charge of water resources, and of all concerned in the control of the vector must be defined. A plan where the obligations of everyone are clear and set by legislation.
Alas, it may be too much of a task for an electrician, but someone somewhere in government in this mess of dengue must do something.
On the contrary, more lives will be lost unnecessarily.
And there will be other losses too when tourist learn of yet another killer in Belize: hemorrhagic dengue.