June 26, 2017 Situation Update: Dengue Outbreak

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1 Republic of Palau Ministry of Health P.O. Box 6027 Koror, Republic of Palau Phone: (680) /3 Fax: (680) Website: June 26, 2017 Situation Update: Dengue Outbreak Summary A steep rise in dengue cases was recognized starting November of In Epi Week 48, the number of cases of dengue fever exceeded the threshold for an outbreak of 10 cases in a month. An outbreak of dengue fever was subsequently declared. Surveillance for Zika virus was already in place following WHO s declaration of Zika as a Public Health Threat of International Concern in February of Enhanced surveillance, public awareness campaigns, and increased scope of lab testing capability for dengue and Zika continue. This summary provides an overview of the dengue outbreak from October 2016 to June 25, Demographics Although the number of cases exceeded the threshold in November, cases identified in October were found to be linked to the outbreak. Between October 10, 2016 and June 25, 2017 there have been 329 cases of dengue fever identified primarily through lab surveillance. Nearly half of all cases were between years of age and there were more males (59%) than females (41%). Age range: 9 months 88 years; Mean age: 33 years; Median age: 27 years.

2 Symptoms/Deaths Based on available data, the most common symptoms were: Fever Loss of appetite Headache Diarrhea Chills Vomiting Body pain Arthralgia In April and May 2017, there were three (3) deaths as a result of dengue virus infection in patients with preexisting medical conditions and who sought medical attention too late. This highlights the importance of protecting the vulnerable populations those with NCDs, infants and young children, the elderly and anyone with a weakened immune system and strengthening community awareness efforts to encourage infected persons to seek medical attention as soon as possible, in order to avert future deaths.

3 As the table on the left shows, 77% of dengue cases identified reside in Koror state. All hamlets in Koror have been affected. Overall, the dengue cases identified from the Koror hamlets of Madalaii, Ngermid, Ngerbeched, Meyuns, Dngeronger, Ngerchemai account for more than half of all cases during the whole outbreak. In the last two months, 80% of cases have been from Koror. We have seen a decrease in new cases from Ngermid and Ngerchemai and an increase in Madalaii, Ngerbeched, Dngeronger and Meyuns.

4 June 25, 2017 Treatment and Prevention There are currently no licensed vaccines or anti viral drugs for prevention or treatment of dengue virus infection. Prevention is key to stopping the spread of dengue fever. Please see attached 3S flyer.

5 DENGUE FEVER The 3S of Dengue Prevention Search & Eliminate 1. Discard old tires. 2. Cut & rake yards as well as bushy areas. Fill in puddles or crab holes. 3. Pick up empty coconut shells, empty bottles, and cans. Discard the trash properly. 4. Empty canoes and boats that contain water, then turn them upside-down to avoid catching water. 5. Empty wash containers & pet dishes daily and change water in flower vases once a week. 6. Clean out & tightly cover water collection tanks. Self-Protection Measures 1. Use screens on doors and windows. 2. Use insect repellant on exposed skin in areas where mosquitoes are detected. Re-apply repellant as needed following product use instructions. 3. Wear long sleeves, pants, socks, and shoes especially in areas where mosquitoes are detected or while cleaning around the house. Seek Early Consultation 1. If you or a family member has a fever that lasts two days or longer and rashes on the skin, consult a physician/doctor or visit the nearest health center. The Belau National Hospital as well as the private clinics in Palau are able to test for Dengue Fever. 2. Severe cases of Dengue Fever can result in Dengue Hemorrhagic Fever, Dengue Shock Syndrome, and even death. Those with weakened immune systems young children, the elderly, or those who suffer from chronic diseases as well as those who have been infected with Dengue in the past, are more at risk for severe Dengue. 3. Avoid taking Aspirin, Motrin, or Ibuprofen if you think you may have Dengue Fever. If you are currently on a medication regimen that requires taking Aspirin, consult with a physician/doctor as soon as you exhibit symptoms of Dengue Fever. 4. If you are tested positive for Dengue Fever, serious complications can develop. Consulting with a physician/doctor and recognizing Dengue Fever early can save your life. COMMON SYMPTOMS Sudden High Fever Severe Headache & Backache Chills Body Ache Joint & Muscle Pain Pain When Moving Your Eyes Loss of Appetite Vomiting DAILY OPERATION HOURS OF PRIVATE CLINICS BELAU MEDICAL (YANO) CLINIC DAY is 8:00AM - 11:00AM NIGHT is 5:00PM - 8:00PM PFMS (KUARTEI) CLINIC 8:00AM - 4:00PM FAMILY SURGICAL (EMAIS) CLINIC 8:00AM - 4:00PM CAMP KATUU IN AIRAI Mondays: 10AM-12PM Tuesdays & Thursdays: 3PM-5PM Wednesdays & Fridays: 8AM-10AM For more information on mosquito-borne diseases, please contact the MOH Communicable Disease Unit at For more tips on how to stop the breeding of mosquitoes and prevent infection, please contact the MOH Division of Environmental Health, Vector Control and Prevention Program at or #fightthebite