Rospotrebnadzor informs about the tense epidemiological situation regarding a number of diseases transmitted by mosquitoes.

Over the past 10-15 years, there has been a significant increase in the incidence of dengue fever in various regions. Outbreaks of this infection in 2017 were recorded in Brazil, Vietnam, Indonesia and Thailand.

There is currently an outbreak of dengue fever in Sri Lanka. A serious epidemiological situation has developed in 10 of the country’s 25 districts. The situation is particularly bad in the Western Province in the Kanutari region. In total, 48 thousand diseases with 77 deaths were registered throughout the country. Dengue fever outbreaks result from weather conditions that favor the breeding of the Aedas Aegypti mosquito. These mosquitoes are carriers of viral fevers, including Dengue fever.

In recent years, the countries of Southeast Asia have been particularly popular among Russian tourists. Imported cases of dengue fever have become increasingly registered in Russia. In 2012, 63 cases were recorded, in 2013 – 170, in 2014 – 105 cases, in 2015 – 136, in 2016 – 140, in 11 months of 2017 – 152 cases.

When planning a vacation in countries with tropical and subtropical climates during the New Year holidays, it is important to check in advance with the territorial bodies of Rospotrebnadzor and with tour operators about the epidemiological situation in the country of your planned stay.

The Federal Tourism Agency asks tour operators to inform tourists about the epidemiological situation in regions of tropical and subtropical climates.

The Federal Tourism Agency also asks tourists to take into account information about the epidemiological situation in these regions when planning their trips.

Previously: 06/29/2017

The Federal Tourism Agency warned tourists about an outbreak of dengue fever in Sri Lanka

The Federal Tourism Agency calls on Russian tourists planning trips to Sri Lanka to take precautions in connection with the outbreak of Dengue fever there - 68 thousand cases of the disease have been registered.

Sri Lanka has recorded 68 thousand cases of dengue fever. The Federal Agency for Tourism (Rosturizm) urges Russian tourists planning trips to Sri Lanka to take precautions in connection with the outbreak of dengue fever there. The press service of the department reports this.

In order to prevent Dengue fever and other hemorrhagic fevers, Russian tourists are recommended to use personal protective equipment, for example, window mosquito nets and curtains. It is necessary to give preference to clothing with long sleeves, use materials treated with insecticide, and repellents. Upon returning to Russia, if the temperature rises, “inform the doctor about the fact of being in a country with a tropical climate,” writes the press service of Rostourism, citing Rospotrebnadzor.

Currently, 68 thousand cases of dengue fever have been reported in Sri Lanka, 205 of which have resulted in death. 10 of the country's 25 districts are at risk. The situation is particularly bad in the Western Province in the Kanutari region. The increase in incidence is associated with the sanitary and epidemiological situation in the region.

Dengue fever is an acute viral disease accompanied by fever, muscle and joint pain, rash, nausea and insomnia. Inappropriate treatment or re-infection can lead to the development of a hemorrhagic, much more severe form of the disease with increased mortality, especially in children. Dengue, as well as chikungunya and Zika fevers, are transmitted by Aedes aegypti mosquitoes.

Dengue fever - Data from the World Health Organization (WHO)

Dengue Fever - Basic Facts

• Dengue is a viral infection transmitted by mosquitoes.
• The infection causes a flu-like illness and sometimes leads to a potentially fatal complication called severe dengue.
• The global incidence of dengue has increased dramatically in recent decades.
• Currently, about half the world's population is at risk of the disease.
• Dengue is common in tropical and subtropical climates throughout the world, mainly in urban and peri-urban areas.
• Severe dengue is a leading cause of severe illness and death among children and adults in some Asian and Latin American countries.
• There is no specific treatment for dengue/severe dengue, but with early detection and access to proper medical care, mortality rates can remain below 1%.
• Prevention and control of dengue depends on effective vector control measures, which include personal protection, sustainable vector control and chemical control.
• The dengue vaccine has been licensed by several national regulatory authorities for use in people aged 9–45 years living in endemic areas.

Dengue is a mosquito-borne viral disease that has been spreading rapidly across all WHO regions in recent years. The dengue virus is transmitted by female mosquitoes, mainly Aedes aegypti and, to a lesser extent, Ae. albopictus. This mosquito also transmits chikungunya, yellow fever and Zika infection. Dengue is widespread in the tropics, with local differences in risk depending largely on rainfall, temperature and spontaneous, rapid urbanization.

Severe dengue (also known as dengue hemorrhagic fever) was first recognized in the 1950s. during dengue epidemics in the Philippines and Thailand. Severe dengue now affects most Asian and Latin American countries and is one of the leading causes of hospitalization and death among children in these regions.

There are 4 different but closely related serotypes of the virus that cause dengue (DEN-1, DEN-2, DEN-3 and DEN-4). After recovery from an infection caused by one of these serotypes, there is lifelong immunity to that particular serotype. However, cross-immunity to other serotypes after recovery is only partial and temporary. Subsequent infections with other serotypes increase the risk of developing severe dengue.

Global Dengue Burden

The true number of dengue cases is not fully reported and many cases are misclassified. One recent estimate is that 390 million people (95% confidence interval 284–528 million) are infected with dengue each year, of whom 96 million (67–136 million) are symptomatic (of all disease severity) 1 . Another study on dengue prevalence estimates that 3.9 billion people in 128 countries are at risk of contracting dengue viruses. 2

Member states of the three WHO regions regularly report the annual number of cases. The number of reported cases increased from 2.2 million in 2010 to 3.5 million in 2015. Although the global burden of the disease is not fully known, the rollout of efforts to report all cases of dengue partly explains a sharp increase in the number of cases of the disease recorded in recent years.

Other characteristic features of the disease include its epidemiological patterns, including the hyperendemicity of multiple dengue virus serotypes in many countries and the alarming implications for both public health and global and national economies.

Before 1970, severe dengue epidemics occurred in only 9 countries. The disease is currently endemic in more than 100 countries in the WHO regions of Africa, the Americas, the Eastern Mediterranean and the Western Pacific. The highest incidence rates are reported in the Region of the Americas, South-East Asia and the Western Pacific.

More than 1.2 million cases were reported in the Americas, Southeast Asia and the Western Pacific in 2008, and more than 3.2 million in 2015 (according to official data reported to WHO by member states). Recently, the number of reported cases has continued to rise. In 2015, there were 2.35 million dengue cases in America alone, 10,200 of which were severe dengue cases, resulting in 1,181 deaths.

As the disease spreads to new areas, not only do the number of cases increase, but explosive outbreaks occur. There is currently a threat of a possible dengue outbreak in Europe. In 2010, local transmission of dengue was first reported in France and Croatia, and imported cases were identified in three other European countries. In 2012, a dengue outbreak in the Madeira Islands, Portugal, resulted in more than 2,000 cases, and imported cases have been identified in 10 other European countries in addition to mainland Portugal. Among people returning from travel to low- and middle-income countries, dengue is the second most diagnosed cause of fever after malaria.

In 2013, cases occurred in Florida (United States of America) and Yunnan Province in China. Dengue also continues to affect several countries in South America, particularly Honduras, Costa Rica and Mexico. In Asia, Singapore reported an increase in cases after a gap of several years, and outbreaks have also been reported in Laos. 2014 saw an upward trend in the number of cases in the Cook Islands, Malaysia, Fiji and Vanuatu, with dengue type 3 (DEN 3) affecting the Pacific island countries after a 10-year hiatus. After a hiatus of more than 70 years, dengue has also been reported in Japan.

2015 was marked by major dengue outbreaks worldwide, with more than 169,000 cases reported in the Philippines and more than 111,000 suspected dengue cases in Malaysia, an increase of 59.5% over the previous year. 16% respectively.

In Brazil alone, more than 1.5 million cases of the disease were reported in 2015, about 3 times more than in 2014. Additionally, in 2015, Delhi, India, experienced its largest outbreak since 2006, with more than 15,000 cases.

The outbreak occurred on Hawaii Island in the State of Hawaii, United States of America, where 181 cases were reported in 2015 and transmission continues into 2016. Cases continue to be reported in the Pacific island nations of Fiji, Tonga and French Polynesia.

An estimated 500,000 people with severe dengue require hospitalization each year, the vast majority of whom are children. About 2.5% of them die.

Transmission of infection

Mosquitoes are the main vectors of dengue Aedes aegypti. The virus is transmitted to humans through the bites of infected female mosquitoes. After an incubation period of 4-10 days, an infected mosquito is able to transmit the virus for the rest of its life.

Infected people are the main carriers of viruses and facilitate their reproduction, serving as a source of viruses for uninfected mosquitoes. Patients already infected with dengue virus can transmit the infection (for 4-5 days; maximum 12 days) through Aedes mosquitoes after they first show symptoms of the disease.

Mosquitoes Aedes aegypti They live in urban environments and breed mainly in artificial containers. Unlike other mosquitoes Ae. Aegypti feed during the day; Their peak biting times are in the early morning and evening before sunset. For each feeding period, the female Ae. Aegypti bites a large number of people.

Aedes albopictus, the second most important vector of dengue in Asia, has spread to North America and more than 25 countries in the European region, largely as a result of the international trade in waste tires (which provide breeding habitat) and the movement of goods (eg decorative bamboo). Ae. Albopictus easily adapt to new environments and can therefore survive in colder areas of Europe. The reasons for their spread are tolerance to temperatures below zero, hibernation and the ability to take refuge in microenvironments.

Characteristics

Dengue is a severe flu-like illness that affects infants, young children and adults, but rarely causes death.

Dengue should be suspected when a high fever (40°C/104°F) is accompanied by two of the following symptoms: severe headache, pain behind the eyes, muscle and joint pain, nausea, vomiting, swollen lymph nodes or rash. Symptoms usually last 2-7 days after an incubation period of 4-10 days after the bite of an infected mosquito.

Severe dengue is a potentially fatal complication associated with plasma leakage, fluid accumulation, respiratory failure, severe bleeding or organ damage. Warning signs appear 3-7 days after the first symptoms along with a decrease in temperature (below 38°C/100°F) and include severe abdominal pain, uncontrollable vomiting, rapid breathing, bleeding gums, fatigue, agitation and blood in the vomit. masses. The subsequent 24-48 hours of this critical stage can be fatal; Proper medical care is necessary to prevent complications and death.

Treatment

There is no specific treatment for dengue fever.

In cases of severe dengue, care from doctors and nurses trained in the presentation and progression of the disease can save lives and reduce mortality rates from more than 20% to less than 1%. When treating severe dengue, maintaining the patient's body fluids at appropriate levels is critical.

Immunization

In late 2015 and early 2016, the first dengue vaccine, Dengvaxia (CYD-TDV) from Sanofi Pasteur, was registered in a number of countries for use in people aged 9–45 years living in endemic areas.

WHO recommends that countries consider the use of CYD-TDV dengue vaccine only in geographical areas (national or subnational) where epidemiological data indicate high incidence. The full text of the recommendations is presented in the WHO position paper on dengue:

Other tetravalent live attenuated vaccines are in development, in Phase III clinical trials, and several other vaccine candidates (based on subunit, DNA, and purified inactivated viral platforms) are in earlier stages of clinical development. WHO provides technical advice and guidance to countries and private partners to support research to develop vaccines and evaluate their effectiveness. The Strategic Advisory Group of Experts (SAGE) is expected to review dengue vaccine recommendations in April 2016.

Prevention and control

Currently, the only way to control or prevent the transmission of dengue virus is to control the mosquito vector through the following measures:

• preventing mosquitoes from accessing oviposition sites through environmental management and modifications;
• proper disposal of solid waste and destruction of man-made habitats;
• storing household water supplies in closed containers and emptying and washing them weekly;
• applying appropriate insecticides to water containers stored outdoors;
• use of personal protective equipment such as window mosquito nets, long sleeves, insecticide-treated materials, coils and vaporizers;
• improving the participation and mobilization of individual communities for sustainable vector control;
• During disease outbreaks, emergency vector control measures may also include the use of insecticide sprays;
• Active monitoring and surveillance of vectors is necessary to determine the effectiveness of vector control activities.

Between 1 January and 7 July 2017, the Epidemiology Unit of the Ministry of Health (MOH) of Sri Lanka reported 80,732 cases of dengue fever, of which 215 were fatal. This is 4.3 times the average number of cases for the same time period in 2010-2016, and the monthly number of cases exceeds the average plus three standard deviations for each of the past six months. Based on sentinel surveillance data for the past seven years, the expected peak months of May to July coincide with the southwest monsoon, which begins in late April.

Approximately 43% of dengue cases were reported from the Western Province and the most affected district with the highest number of cases reported was Colombo district (18,186), followed by Gampaha (12,121), Kurunegala (4,889), Kalutara (4,589), Batticaloa (3946), Ratnapura (3898) and Kandy (3853). Preliminary laboratory studies have identified dengue virus serotype 2 (DENV-2) as the circulating strain in this outbreak. Although all four DENVs have been circulating in Sri Lanka for over 30 years, DENV-2 has been detected infrequently since 2009.

This dengue fever outbreak is occurring amid heavy rainfall and flooding and is currently affecting 15 of Sri Lanka's 25 districts and approximately 600,000 people. Heavy monsoons, inability of the public to dispose of wet garbage, bodies of stagnant water and other potential breeding grounds for mosquitoes are contributing to the rise in the number of cases being reported in urban and semi-urban areas.

Public health response

The World Health Organization (WHO) is supporting the MoH of Sri Lanka to provide an effective and comprehensive health response, which includes the following:

• Due to overcrowding in medical institutions, the Ministry of Health turned to military units with a request to provide additional beds. Three temporary wards have been opened at the hospital, located 38 km north of Colombo.
• The Ministry of Health has begun taking emergency measures, including to combat vectors, which are also receiving support from the military. The army, police and civil defense forces have been mobilized by health workers to ensure that all houses in high-risk areas are being visited. In addition, they mobilize communities to dispose of waste and clean up vector breeding sites and conduct health education.
• The Regional Office for South-East Asia (SEARO) established a Task Force to lead the response.
• WHO/SEARH sent an epidemiologist, an entomologist and two dengue management experts from the WHO Collaborating Center for the Management of Dengue/Dengue Hemorrhagic Fever (Queen Sirikit National Institute of Children's Health, Thailand) and the Thai Ministry of Health. In June 2017, the triage protocol was updated to improve patient management in health care settings.
• The WHO Country Office in Sri Lanka purchased 50 insecticide spraying machines to support vector control activities.
• The Ministry of Health and WHO are making efforts to develop a strategic and operational plan for intensive action to combat the dengue outbreak in the next few weeks

WHO risk assessment

Dengue fever is a mosquito-borne viral infection caused by four serotypes of the dengue virus (DENV-1, DENV-2, DENV-3 and DENV-4). Infection with any one serotype provides long-term immunity to that serotype but not to other serotypes; repeated infections put people at increased risk of developing severe dengue fever and dengue shock syndrome.

Aedes aegypti and Aedes albopictus are vectors well adapted to urban and suburban environments. Dengue fever is endemic in Sri Lanka and outbreaks occur annually, usually shortly after rains create optimal conditions for mosquitoes to breed. However, DENV-2, which has been rarely detected since 2009, was found in more than 50% of samples from this outbreak that were serotyped.

The current dengue epidemic is likely to have negative public health consequences in Sri Lanka.

To control mosquitoes, including dengue vectors, WHO recommends a strategic approach known as integrated vector management.

A significant risk factor for dengue virus infection is the proximity of mosquito breeding sites to human residences.

Prevention and control measures rely on reducing mosquito breeding sites through source-targeted measures (elimination and modification of breeding sites) and limiting human contact with mosquitoes through adult control measures. For effective control, these two types of control measures must be implemented simultaneously.

This can be achieved by reducing the number of artificial water reservoirs (cement water tanks, barrels, used tires, empty bottles, coconut shells, etc.) in and around homes and by using barrier products such as mosquito nets , closed doors and windows, long sleeves and repellents, indoor insecticide sprays, mosquito coils and others. As an emergency measure, insecticides can be sprayed in open areas. As a measure of protection against Aedes mosquitoes (the main vector), it is recommended to sleep (especially young children, the sick and the elderly) under mosquito nets, treated or not treated with insecticide.

Based on available information about this event, WHO does not recommend the imposition of any general travel or trade restrictions on Sri Lanka.

The island of Sri Lanka is currently experiencing a serious outbreak of dengue fever. The National Dengue Control Team reports more than 107,000 dengue cases since January 1, 2017. The death toll currently stands at 269. In comparison, in 2016, only 55,150 cases of dengue fever were reported throughout the year.
Monsoon rains in May caused flooding and waterlogging that affected an estimated 600,000 people in 15 of the country's 25 districts. These were the worst monsoon rains in Sri Lanka since 2003. The presence of standing water and rain-soaked debris provided ideal breeding conditions for the Aedes mosquito, which transmits the dengue fever virus.
Now some more facts:
About 44% of the cases were reported in Western Province.
The highest number of cases were reported in the districts of Colombo (20,010 cases), Gampaha (13,401), Kurunegala (5,543), Ratnapura (5,512) and Kalathura (5,093).
The current outbreak is mainly due to dengue fever virus type 2 (DEN-2).

How Sri Lanka fights dengue fever

Dengue experts have been deployed to Sri Lanka by the World Health Organization (WHO). They visited the affected areas, analyzed the current situation and made recommendations to combat this outbreak. The Ministry of Health has launched an emergency response to the outbreak. It has increased the number of casualty beds, including temporary wards at Negombo Hospital, and created a new High Dependency Unit (HDU) for more serious dengue patients at the National Hospital.
Essential supplies and critical equipment for the treatment of dengue patients are being supplied to hospitals in Sri Lanka. The government deployed 450 military personnel to help clear breeding sites and train communities in clearing breeding sites.
Nearly 100 entomologists were mobilized from low-risk to high-risk areas to complete the entomological survey (insect survey).
WHO has provided 50 fog machines to provide more reliable vector control in areas particularly affected by the outbreak.

What you need to know about dengue fever

Dengue fever exists in many parts of the world: 2.5 billion people live in areas where dengue fever is transmitted, mainly in Southeast Asia, the Pacific Islands, Latin America, the Caribbean Islands, and now Africa and the Middle East. The World Health Organization (WHO) estimates that there are 50-100 million dengue infections worldwide each year.
Dengue is a viral disease and is transmitted through the bite of the Aedes mosquito. This mosquito lives very close to people in built-up areas and loves areas with stagnant water. The incubation period is usually 4-10 days.
Symptoms include high fever that can last 3 to 7 days, severe headache, muscle and joint pain, and eye pain.
Dengue fever is commonly known as "breaking bone fever" as those who have this fever often complain of severe bone pain. Nausea and vomiting may also occur. These symptoms are similar to those of malaria, so if you are in a malaria region, you should also get tested for malaria.
In most cases, dengue fever often improves within a few days. However, in 1-2% of cases, the disease may progress to a more severe condition called dengue hemorrhagic fever. In extreme cases, it can lead to death, but this outcome can usually be prevented with adequate medical care. A very small number of people who travel to countries with a risk of dengue fever (which includes Sri Lanka) become infected with dengue fever each year. Symptoms of the disease develop either while on holiday or after the traveler has returned to their home country.

To reduce your risk of contracting dengue fever, you should do the following:
1. Make sure there is no standing water near where you live. Water can collect in all sorts of containers, including discarded tires, jars, buckets and plant pots, especially during and after rainy seasons.
2. Follow bite prevention measures day and night. These include using effective repellents (mosquitoes that carry dengue tend to bite during the day, while mosquitoes that carry malaria are more active at night), wear long pants and long sleeves, and do not open a window for long periods of time unless it has a screen. , use air conditioning if available, and sleep under mosquito nets.

If you suspect you have been exposed to dengue fever, seek medical attention immediately. Be sure to drink plenty of fluids. In Sri Lanka you will also need to take a malaria test as the symptoms of dengue fever and malaria can be similar.
Full recovery from dengue may take weeks, during which time your energy levels will be significantly reduced. Give yourself enough time to fully recover.

December 19, 2016

An increased incidence of dengue fever has been recorded in Sri Lanka, reports Rospotrebnadzor...

The agency calls on Russians in Southeast Asian countries to observe security measures.

According to Rospotrebnadzor, an outbreak of dengue fever has been recorded in Sri Lanka. The disease was detected in 48 thousand people, 77 of them died as a result. The fever has spread to 10 of Sri Lanka's 25 districts. The most unfavorable situation has developed in the Western Province in the Kanutari region. Due to the characteristics of the fever, this outbreak is seasonal.

Rospotrebnadzor emphasized that recently the tourist flow of Russians to Southeast Asia has increased.

The agency recommends that compatriots traveling to Thailand, India, Bangladesh, Peru, Indonesia, Vietnam, Hong Kong and other countries with a tropical climate take preventive measures. This will help prevent infection with Dengue fever and other hemorrhagic fevers transmitted by vectors. It is necessary to wear long sleeves, use repellents, and install mosquito nets on windows. When returning from the country, you need to listen to your health, and if your temperature rises, tell your doctor about your trip.

The Federal Service for Surveillance on Consumer Rights Protection and Human Welfare informs that in countries with tropical and subtropical climates, epidemiological problems with Dengue fever have continued in recent years.

Dengue fever is widespread in Southeast Asia (Thailand, Indonesia, China, Malaysia, Japan, Vietnam, Myanmar, Singapore, Philippines), India, Africa (Mozambique, Sudan, Egypt), in the tropical and subtropical zones of the North, Central and South America (Mexico, Honduras, Costa Rica, Puerto Rico, Panama, Brazil, etc.)

There is currently an outbreak of dengue fever in Sri Lanka, where 48 thousand diseases with 77 deaths have been registered. 10 of the country's 25 districts are at risk. The situation is particularly bad in the Western Province in the Kanutari region. The increase in incidence is associated with the peculiarities of the epidemiological process, which are characterized by seasonality.

In recent years, the countries of Southeast Asia have been particularly popular among Russian tourists.

In recent years, imported cases of dengue fever have begun to be registered in the Russian Federation, including 63 cases in 2012, 170 in 2013, 105 cases in 2014, 136 in 2015, and 125 in 11 months of 2016. Infection occurred when visiting Thailand, Vietnam, Indonesia, India, Bangladesh, Hong Kong, and the Maldives.

The main carriers of dengue fever are the Aedes aegypti mosquito. In the absence of a carrier, a sick person does not pose an epidemiological danger.

Dengue fever is a viral infection transmitted by mosquito bites. Symptoms include high fever, nausea, rash, headaches and lumbar pain. The hemorrhagic variant of fever is accompanied by severe internal bleeding caused by the collapse of blood vessels.

In order to prevent dengue fever and other hemorrhagic fevers with vector-borne transmission among Russian tourists traveling to Peru, Thailand, Indonesia, India, Vietnam, Bangladesh, Hong Kong and other countries with tropical climates, it is necessary:

When traveling to countries with tropical climates, inquire about the possibility of contracting hemorrhagic fevers through transmissible transmission;

Use personal protective equipment, such as: window mosquito nets, curtains, long sleeves, insecticide-treated materials, repellents;

Upon return, if the temperature rises, inform the doctor about the fact of being in a country with a tropical climate.

The situation remains under the control of the Federal Service for Surveillance on Consumer Rights Protection and Human Welfare.