Early Evidence of Person-to-Person Dengue Transmission Identified

The Ministry of Health & Wellness and the Public Health Department would like to notify the public of early evidence of local person-to-person Dengue transmission identified in the Cayman Islands.

“While previous confirmed cases of Dengue were linked to persons with a travel history, new evidence has identified that local transmission- meaning passed from a person in the Cayman Islands to another person in the Cayman Islands with no travel history- has occurred,” explains Chief Medical Officer, Dr. Nick Gent.

Since the beginning of 2023, 28 cases of Dengue have been investigated locally, with 4 cases confirmed, three with travel history, and 1 with no travel history.

“Thus far we have had one confirmation of a person with no travel history, but I caution that this a disease where there can be a number of asymptomatic cases, so we will remain vigilant and will continue our efforts to educate the public on how to protect themselves while taking measures to control the mosquito population,” Dr Gent added.

Typically, there are between 0-8 confirmed Dengue cases annually in the Cayman Islands, with the exceptions being an outbreak in 2012 where there were 37 cases confirmed (18 imported and 19 locally transmitted), and another in 2019, 24 cases confirmed (3 imported and 21 locally transmitted). It is important to note that Cayman now has local testing capability for Dengue at the

Cayman Islands Molecular Biology Laboratory (CIMBL), putting it in a much better position than it has been in previous years by eliminating the need to send samples overseas for confirmation.

“These limited outbreaks in the last twenty years have happened after the introduction of the disease into the Cayman Islands, and aggressive mosquito control measures targeting the Aedes mosquito -which is responsible for the person-to-person transmission of the disease- were quite effective,” explains Medical Officer of Health, Dr. Samuel Williams-Rodriguez.

Active surveillance and continued liaison between the Public Health Department and Mosquito Research and Control Unit (MRCU) to take vector control measures every time a suspected case is reported is ongoing.

Dr. Williams-Rodriguez also emphasizes that in order for the Aedes mosquito to transmit Dengue, they must bite infected persons. “For Aedes mosquitoes to transmit dengue, they must bite infected persons; otherwise, they can’t become infectious and transmit the disease.  Dengue fever is caused by a virus, but a mosquito biting a person with Dengue can spread the virus to another person.” Dr. Williams-Rodriguez adds. “Hence, persons who develop Dengue symptoms within two to three weeks of returning from countries with Dengue cases are advised to consult their physician and inform them of their travel history“.

The best way to prevent the transmission of Dengue fever is by preventing mosquito bites.

“I encourage residents to familiarise themselves with the public health advice for travel and local prevention,” Dr. Gent adds. “And, as always, early diagnostic testing is paramount, so if showing symptoms please contact  your physician or the Public Health Department on 244-2648.”

Travel Advice

1-Research your destination and learn the risk for Dengue and other mosquito-borne illnesses such as chikungunya, malaria, and zika.

2-Review the country specific travel recommendations, health notices and warnings, including any identified ‘hot spots’.

3-Add mosquito repellent to your packing list.  Repellents that contain DEET are recommended.

4-Include items of clothing with long sleeves and long pants for additional protection.

5-Sleep indoors in places with air conditioning and window screens.  If this is not possible, use a bed net.

6-Seek medical attention if you develop symptoms of dengue.

Countries in the region that reported having dengue fever:

Antigua and Barbuda, Argentina, Aruba, Bahamas, Barbados, Belize, Bolivia, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, El Salvador, Grenada, Guadeloupe, Guatemala, Guyana, Honduras, Jamaica*, Martinique, Mexico, Montserrat, Nicaragua, Panama, Paraguay, Peru, Puerto Rico, Saint Barthelemy, Saint Kitts and Nevis, Saint Lucia, Saint Martin, Saint Vincent and the Grenadines, Suriname, Trinidad and Tobago, United States of America, Uruguay, Venezuela

*The Jamaican Ministry of Health & Wellness declared a Dengue outbreak on 23 September 2023. The Ministry release read: “As of Friday, September 22, 2023, the country had recorded 565 suspected, presumed and confirmed cases of Dengue. Of that number, 78 cases had been confirmed with majority of the cases seen in Kingston & St. Andrew, St. Catherine and St. Thomas. The dominant strain is Dengue Type 2, which last predominated in 2010. There are no Dengue-related deaths classified at this time, however, six deaths are being investigated.” Travellers to Jamaica should monitor the situation closely. (Full release can be found on: https://www.moh.gov.jm)

Local /Community Prevention Advice

- Use mosquito repellent, especially during peak times of mosquito traffic (dusk and dawn)

- Use light long sleeve shirts and long pants to prevent bites

- Take steps to keep mosquitoes out of your home via the use of air conditioning, window and door screens

- Once a week, empty and scrub, turn over, cover, or throw out items that hold water, such as tires, buckets, planters, toys, pools, birdbaths, flowerpots, or trash containers. Check inside and outside your home. Mosquitoes lay eggs near water.

- Contact the Mosquito Research and Control Unit on 949-2557 with a service request should you find the mosquito situation in your area warrants attention

Additional advice on mosquito control:

Mosquito Research and Control Unit (MRCU):  949-2557 in Grand Cayman or 948-2223 in Cayman Brac.

Department of Environmental Health (DEH):  949-6696 in Grand Cayman or 948-2321 in Cayman Brac.

Sidebar: More about Dengue Fever

Most people recover without any complications, using pain relievers and bed rest. Once a patient has developed a fever, the infectious period lasts for one week only.

Dengue symptoms include:

• high fever

• severe headache

• backache

• joint and eye pain

• nausea and vomiting

• Muscle and or bone pain

• A rash (sometimes) may be visible two to five days after the onset of fever

• Nausea or vomiting (sometimes)

• Signs of bleeding (such as pinpoint red or purple spots on the skin, nosebleeds,bleeding gums, blood in urine or stool, or vaginal bleeding) dengue fever is seen in a severe form known as dengue hemorrhagic fever, severe dengue, or dengue shock syndrome.

Source: Public Health Department, HSA