Freitag, 15. Mai 2009

dengue_finaltime


P
an
American Health Organization (PAHO)


Division
of Disease Prevention and Control






A
TIMELINE FOR DENGUE IN THE AMERICAS TO DECEMBER 31, 2000


AND
NOTED FIRST OCCURENCES


Prepared
by Jennifer Schneider, MPH and Deborah Droll


June,
2001





1600s


1635
suspected dengue in Martinique and Guadaloupe





1700s


1780
dengue-like disease Philadelphia, PA





1800s


1818
outbreak in Peru


*50,000
cases


*1st
reported epidemic





1824-28
PANDEMIC



1827-28
1st recorded pandemic of dengue in the
Caribbean-Gulf-Atlantic region


*began
in the Virgin Islands then moved west to Cuba, Jamaica, Venezuela,
and the U.S. port cities of Pensacola, FL; Charleston, SC; Savannah,
GA; and New Orleans, LA


*finally
moved into Mexico (Veracruz) where it disappeared in 1828


*other
affected countries include Curacao, the Lesser Antilles, northern
Colombia, and Bermuda


*hemorrhages
from the gums, bowel, and stomach reported





1828-1850
smaller outbreaks recorded throughout the Caribbean-Gulf-Atlantic
region





1845-51
PANDEMIC


1845
cases reported in St. Louis, MO, USA and Rio de Janeiro, Brazil




    1. epidemic
      in Brazil




1850
epidemic in the southern U.S. cities of New Orleans, LA;
Brownsville, TX; Charleston, SC; Augusta, GA; Woodville, MS; Mobile,
AL; and Savannah, GA



*Havana, Cuba also affected


*hemorrhages
from the gums, bowel, and stomach reported


1851
dengue reported in Lima, Peru





1851-53
epidemic in Brazil





1870-73
PANDEMIC



  1. cases
    reported in Alabama, Louisiana and as far north as Vicksburg, MS



*40,000
affected in New Orleans, LA







    1. epidemic
      in the Caribbean & southern U.S.







1882
1st outbreak in Bahamas







    1. epidemic
      in Austin and Texas gulf ports




*16,000
of 22,000 sick


*hemorrhagic
symptoms reported





1897
epidemic in Texas


*almost
every city and village across state affected


*hemorrhagic
symptoms reported





1897-99
epidemic in the Caribbean & southern U.S.





1900s


1901-07
PANDEMIC


1904
cases reported in Florida, Texas, and Panama


1905-07
cases reported throughout the Caribbean from the Mississippi to
Colombia and Cuba





1912-16
PANDEMIC


1912
cases reported in Panama


1914
cases reported in Iquique, Chile


1915
epidemic in Puerto Rico


1916
cases reported in northern Argentina


1916
epidemic in Brazil





1921-22
outbreak in the Bahamas





1922
epidemic in Texas


*50,0000-600,000
persons affected (30,000 in Galveston alone)


*hemorrhagic
symptoms reported





1922-24
cases reported in Louisiana


1922
7,561 persons affected


1923
1,376 persons affected


1924
1 person affected





1923
epidemic in Rio de Janeiro, Brazil





1926
last epidemic in Argentina for 72 years





1941-46
epidemic in the Caribbean, Mexico, Panama, Venezuela, and Texas Gulf
cities


*cases
reported in Puerto Rico, Bermuda, Cuba (1944), and the Bahamas (1946)


*DEN-2
was identified in Panama in 1941-42


-1st
report of DEN-2 in Panama


-epidemiological
evidence indicated DEN-1 may have occurred in previous years


*3
epidemics before this one also occurred in the Caribbean and southern
U.S. during the 1900s





1942
Pan-American Sanitary Conference Resolution CSP11.R11


*1st
mention of prevention and control of Ae. aegypti in Brazil





1944
outbreak in Cuba



1945
last continental dengue epidemic in the USA occurred in the
Mississippi Delta region of Louisiana


*lasted
from September 1 to October 19


*143
cases at original site with 100 more in nearby area


*WWII
veteran returning from Pacific theater carried dengue back to U.S. in
August





1947
PAHO Directing Council Resolution CD1.R1



*adopted
hemisphere-wide Ae. aegypti eradication program to combat
urban yellow fever





1949
PAHO Executive Committee Resolutions CE7.R15 and CE8.R13 and
Directing Council Resolution CD3.R18


*Recommended
the elimination of Portugal's proof of vaccination against yellow
fever requirement for visitors from South American countries.





1950
PAHO Executive Committee Resolution CE10.R16


*Recommended
the elimination of Portugal's proof of vaccination against yellow
fever requirement for visitors from South American countries.





1950s
cases reported in Peru





1952
virtual eradication of Ae. aegypti from Colombia


*early
1900s to 1952 dengue endemic in some regions of the Magdalena Valley
and possibly other regions of Colombia



-based on serological evidence
of DEN-2 infections





1950s
and early 1960s dengue transmission suppressed by Ae. aegypti
Eradication Program






  1. DEN-2
    isolated for 1st time in the Caribbean



*found
in Trinidad


-1st
report of DEN-2 in Trinidad





1958
Pan-American Sanitary Conference Resolution CSP15.R35



*Certified
the eradication of Ae. aegypti from Belize, Bolivia, Brazil,
Ecuador, French Guiana, Nicaragua, Panama, Paraguay, Peru, and
Uruguay.


*Appealed
to infested countries to intensify their anti-Ae. aegypti
activities





1958-2000
Ae. aegypti eradication efforts





Belize



1958
certified eradication of Ae. aegypti



1967
re-infestation with Ae. aegypti



1974
re-eradication of Ae. aegypti


1975
re-infestation with Ae. aegypti



1978
1st report of dengue post eradication efforts


1998
1st report of DHF






Bolivia



1958
certified eradication of Ae. aegypti



1980
re-infestation with Ae. aegypti



1987
1st report of dengue post eradication efforts





Brazil



1958
certified eradication of Ae. aegypti



1967
re-infestation with Ae. aegypti



1973
re-eradication of Ae. aegypti



1976
re-infestation with Ae. aegypti


1982
1st report of dengue post eradication efforts


1986
1st report of DHF






Ecuador



1958
certified eradication of Ae. aegypti



1975
re-infestation with Ae. aegypti


1988
1st report of dengue post eradication efforts


2000
1st report of DHF





French
Guiana



1958
certified eradication of Ae. aegypti


1964
re-infestation with Ae. aegypti


1970
1st report of dengue post eradication efforts


1991
1st report of DHF





Nicaragua



1958
certified eradication of Ae. aegypti


1967
re-infestation with Ae. aegypti


1984
1st report of dengue post eradication efforts


1985
1st report of DHF





Panama



1958
certified eradication of Ae. aegypti



1969
re-infestation with Ae. aegypti



1970
re-eradication of Ae. aegypti



1972
re-infestation with Ae. aegypti



1973
re-eradication of Ae. aegypti



1975
re-infestation with Ae. aegypti



1976
re-eradication of Ae. aegypti



1981
re-infestation with Ae. aegypti



1982
re-eradication of Ae. aegypti



1985
re-infestation with Ae. aegypti


1993
1st report of dengue post eradication efforts


1995
1st report of DHF





Paraguay



1958
certified eradication of Ae. aegypti


1981
re-infestation with Ae. aegypti


1988
1st report of dengue post eradication efforts





Peru



1958
certified eradication of Ae. aegypti



1984
re-infestation with Ae. aegypti


1990
1st report of dengue post eradication efforts


2001
1st report of DHF





Uruguay



1958
certified eradication of Ae. aegypti



1997
re-infestation with Ae. aegypti





Guatemala



1959
certified eradication of Ae. aegypti



1967
re-infestation with Ae. aegypti


1978
1st report of dengue post eradication efforts


1995
1st report of DHF



Honduras



1959
certified eradication of Ae. aegypti


1967
re-infestation with Ae. aegypti


1978
1st report of dengue post eradication efforts


1978
1st report of DHF






Guyana



1960
certified eradication of Ae. aegypti



1963
reported eradication of Ae. aegypti



1968
re-infestation with Ae. aegypti


1977
1st report of dengue post eradication efforts





El
Salvador



1960
certified eradication of Ae. aegypti



1966
reported eradication of Ae. aegypti


1978
1st report of dengue post eradication efforts


1987
1st report of DHF





Costa
Rica



1961
certified eradication of Ae. aegypti



1988
re-infestation with Ae. aegypti


1993
1st report of dengue post eradication efforts


1995
1st report of DHF





Chile



1961
certified eradication of Ae. aegypti





Mexico



1963
certified eradication of Ae. aegypti


1967
re-infestation with Ae. aegypti


1971
1st report of dengue post eradication efforts


1984
1st report of DHF





Argentina



1965
certified eradication of Ae. aegypti



1986
re-infestation with Ae. aegypti


1998
1st report of dengue post eradication efforts





1959
PAHO Directing Council Resolution CD11.R13



*Certified
eradication of Ae. aegypti from Guatemala and Honduras.



*Appealed
to infested countries to intensify their anti-Ae. aegypti
activities and encouraged vector-eradicated countries to maintain
strict vigilance to prevent re-infestation.





1960
PAHO Directing Council Resolution CD12.R4


*Certified
eradication of Ae. aegypti from El Salvador.



*Appealed
to infested countries to intensify their anti-Ae. aegypti
activities and encouraged vector-eradicated countries to maintain
strict vigilance to prevent re-infestation.





1960s
Puerto Rico established a dengue surveillance system





1961
PAHO Directing Council Resolution CD13.R35


*Certified
eradication of Ae. aegypti from Chile and Costa Rica.



*Appealed
to infested countries to intensify their anti-Ae. aegypti
activities and encouraged vector-eradicated countries to maintain
strict vigilance to prevent re-infestation.


*Requested
the Director obtain the information needed to determine the
feasibility of attaining hemisphere-wide eradication by 1966.





1962
Pan American Sanitary Conference Resolution CSP16.R31



*Appealed
to infested countries to intensify their anti-Ae. aegypti
activities and encouraged vector-eradicated countries to maintain
strict vigilance to prevent re-infestation.


*Expressed
satisfaction with the eradication campaigns underway in some
countries.



*Requested
the Director strongly encourage campaigns to eradicate Ae. aegypti
as soon as possible.





1963
PAHO Directing Council Resolution CD14.R13 and CD14.R14


*CD14.R13
certified eradication of Ae. aegypti from Mexico.


*CD14.R14
appealed to infested countries to intensify their anti-Ae. aegypti
activities and


encouraged
vector-eradicated countries to maintain strict vigilance to prevent
re-infestation.





1963-64
1st laboratory confirmed epidemic in the Americas


*affected
Jamaica, Puerto Rico, islands of the Lesser Antilles, and Venezuela


*associated
with DEN-3



-1st
documentation of DEN-3 in the Americas



*1st
report of DEN-3 in Antigua & Barbuda, Cuba, the Dominican
Republic, Dominica, Jamaica, Puerto Rico, St. Kitts and Nevus,
Anguilla, and Venezuela


-1,500
cases in Jamaica; 27,000 in Puerto Rico; and at least 10,000 in
Venezuela; sporadic cases in Cuba





1964
PAHO Directing Council Resolution CD15.R28



*Appealed
to infested countries to intensify their anti-Ae. aegypti
activities and encouraged vector-eradicated countries to maintain
strict vigilance to prevent re-infestation.


*Instructed
the Director to intensify studies to solve the resistance problem and
to take appropriate measures to complete the eradication project as
soon as possible.





1964
outbreak in Curacao


*based
only on clinical evidence





1965
PAHO Directing Council Resolution CD16.R28


*Certified
eradication of Ae. aegypti from Argentina.



*Appealed
to infested countries to intensify their anti-Ae. aegypti
activities and encouraged vector-eradicated countries to maintain
strict vigilance to prevent re-infestation.


*Instructed
the Director to intensify studies to solve the resistance problem and
to take appropriate measures to complete the eradication project as
soon as possible.





1966
Pan American Sanitary Conference Resolution CSP17.R19



*Appealed
to infested countries to intensify their anti-Ae. aegypti
activities and encouraged vector-eradicated countries to maintain
strict vigilance to prevent re-infestation.



*Requested
the Director strongly encourage campaigns to eradicate Ae. aegypti
as soon as possible, coordinate a regional eradication efforts,
and obtain funds to finance the campaign.





1966
Pan American Sanitary Conference Resolution CSP17.R20


*Adopted
the requirements for eradication established by the PASB.


*Confirmed
these requirements must be met before a country can be certified as
eradicated.


*Established
countries must meet the PASB standards and



-Eliminate
all Ae. aegypti colonies from ecologically favorable
conditions for vector


-Eliminate
all colonies in ecologically favorable conditions except those in
scientific centers, and


-Ensure
that colonies in unfavorable conditions are maintained so as to
prevent re-infestation of other areas.


*Recommended
the Director organize a group of experts to determine standards for
existing colonies so countries can still be certified as eradicated.


*Requested
the Director submit the standards at the next meeting of the
Directing Council.





1967
PAHO Executive Committee Resolution CE56.R14


*Reaffirmed
that governments of infested countries should overcome any
administrative barriers and give the highest priority to achieving
eradication.



*Recommended
governments provide financial and material help to each other in
their eradication campaigns and/or obtain loans for Ae. aegypti
eradication.


*Recommended
the Director provide assistance to the countries in obtaining funds
and providing support to each other, strengthen the financial
contribution going towards Ae. aegypti eradication, and look into
establishing a special Ae. aegypti eradication campaign account.





1967
PAHO Directing Council Resolution CD17.R18



*Appealed
to infested countries to intensify their anti-Ae. aegypti
activities and encouraged vector-eradicated countries to maintain
strict vigilance to prevent re-infestation.


*Recommended
governments provide financial and material help to each other in
their eradication campaigns.



*Recommended
international lending agencies provide funds to governments for Ae.
aegypti
eradication and instructed the Director to help
governments use this aid.


*Authorized
the Director to seek more funds for eradication.


*Determined
the PASB may directly participate in eradication programs in special
circumstances and at the request of the country.


*Requested
the PASB establish, maintain, and periodically evaluate these
services.


*Authorized
the Director to limit certification of eradication to 3 years then
request re-certification thereafter.





1967
Brazil and Guatemala re-infested with Ae. aegypti





1968
Guyana re-infested with Ae. aegypti





1968
1st report of DHF-like disease in Curacao and Venezuela





10/1968-1/69
DEN-2 outbreak in Curacao


*confirmed
by serological studies


*reached
peak at end of November 1968



*1st
report of DEN-2 in Curacao





1968-69
dengue epidemic in the Caribbean and Venezuela


*in
Jamaica DEN-3 responsible for 1968 outbreak but DEN-2 was primary
serotype in 1969


*in
Haiti both DEN-2 and DEN-3 recovered


-1st
report of DEN-2 and DEN-3 in Haiti


*in
Puerto Rico and the Lesser Antilles only DEN-2 was noted


-1st
report of DEN-2 in Puerto Rico





1968-80
sporadic cases of DHF reported throughout the Region


*only
60 cases reported in 5 countriesCuracao,
Honduras, Jamaica, Puerto Rico, Venezuela






  1. PAHO
    Executive Committee Resolution CE61.R9



*Requested
the Director alert the governments that suspended their eradication
programs of the seriousness of the situation.


*Recommended
countries eradicate Ae. aegypti as soon as possible.


*Emphasized
the need for Ae. aegypti free countries to maintain
surveillance.



1969
PAHO Directing Council Resolution CD19.R12


*Re-iterated
that countries must meet the PASB standards and



-Eliminate
all Ae. aegypti colonies except those in scientific centers
from conditions ecologically favorable for the vector; and


-Ensure
that colonies in unfavorable conditions are maintained so as to
prevent re-infestation of other areas.


*Adopted
the standards scientific colonies in ecologically unfavorable areas
must meet if those colonies are not to prevent a country from being
declared eradicated.


*Recommended
countries distribute the regulations as soon as possible.





1969
PAHO Directing Council Resolution CD19.R23



*Requested
the director sponsor a study of the strategy and methods of
preventing the diseases transmitted by Ae. aegypti and



-name
a multidiscipinary group to review the existing strategy for Ae.
aegypti
borne diseases and to define a study that would examine
all possible alternative systems including their public health and
economic impacts;


-engage
an independent agency to carry out the study designed by the
multidisciplinary group; and


-seek
voluntary contributions to finance the study.


*Recommended
countries continue their eradication efforts and prevent
re-infestation.





1969
Panama temporarily re-infested with Ae. aegypti





1970
PAHO Pan American Sanitary Conference Resolution CSP18.R43


*Recommended
countries free of Ae. aegypti strengthen their surveillance
measures.


*Requested
re-infested countries adopt measures to re-eradicate Ae. aegypti.



*Urged
infested countries to achieve eradication as soon as possible and to
take action to prevent the spread of the vector into Ae. aegypti
free countries.


*Authorized
the Director to carry out the study recommended by the PAHO Study
Group on the Prevention of Aedes aegypti-borne Diseases.


*Requested
the Director submit a report on the cost-benefit study.





1970
1st report of DEN-2 in French Guiana





1970
Panama re-eradicated Ae. aegypti





1970-72
sporadic DEN-2 activity in Puerto Rico





1971
PAHO Executive Committee Resolution CE66.R5 and Directing Council
Resolution CD20.R13


*Reaffirmed
that any studies or investigations will not entail any reduction in
existing eradication efforts or re-infestation prevention measures.


*Authorized
the Director to contract the necessary services for carrying out
cost-benefit studies.


*Requested
infested countries attempt to eradicate Ae. aegypti as soon as
possible and vector-free countries maintain surveillance to prevent
re-infestation.





1971-72
DEN-2 epidemic in Colombia


*1st
cases of dengue since 1952


*1st
report of DEN-2 in Colombia


*estimates
of >500,000 cases





1972
PAHO Directing Council CD21.R25


*Requested
re-infested countries adopt measures to re-eradicate Ae. aegypti.



*Requested
the Director convene a multidisciplinary group of experts with
knowledge about Ae. aegypti and the diseases it transmits to
make recommendations based on new knowledge and experience.





1972
Panama temporarily re-infested with Ae. aegypti





1972-73
DEN-2 epidemic in southern part of Puerto Rico


*>
7,000 cases


*DEN-2
cases continued to appear until 1975





1973
PAHO Executive Committee Resolution CE70.R17 and Directing Council
Resolution CD22.R26



*Urged
the governments to organize or intensify surveillance activities of
diseases transmitted by Ae. aegypti without sacrificing vector
eradication efforts.



*Encouraged
the governments to continue research on other control mechanisms for
diseases transmitted by Ae. aegypti.





1973
dengue prevention became driving force behind Ae. Aegypti
eradication program





1973
serological survey done in Curacao


*no
indication any serotype other than DEN-2 was circulating in Curacao
at the time





1973
Brazil and Panama re-eradicated Ae. aegypti





1974
Belize re-eradicated Ae. aegypti





1975
PAHO Directing Council Resolution CD23.R23



*Requested
the Director ask the Scientific Advisory Committee to study the
existing Ae. aegypti situation and review existing PAHO policy
in light of recent developments and scientific advancements.



*Asked
the Director to prepare an updated policy statement on Ae.
aegypti
, yellow fever, and dengue based on the report.





1975
epidemic in Puerto Rico


*3
patients with serologically confirmed dengue present hemorrhagic
manifestations


-only
1 presentation typical of DHF



-1st
report of DHF-like disease in Puerto Rico



-1st
time DSS described in Western Hemisphere





1975
Ecuador and Panama re-infested with Ae. aegypti







    1. DEN-3
      epidemic in upper Magdalena Valley of Colombia




*reported
from at least 50 towns



*1st
report of DEN-3 in Colombia





1976
PAHO adopts a more flexible policy urging vector control and
vaccination instead of hemisphere-wide eradication





1976
Brazil re-infested with Ae. aegypti





1976
Panama re-eradicated Ae. aegypti





1977
PAHO Executive Committee Resolution CE78.R18 and Directing Council
Resolution CD25.R16


*Maintained
existing policy of eradication and encouraged countries to overcome
any obstacles preventing eradication or re-eradication.


*Recommended
vector-free countries strengthen surveillance to prevent
re-infestation.


*Requested
countries support epidemiological surveillance and yellow fever
vaccination.



*Requested
the Director ensure the availability of vaccine in the event of an
emergency, ensure the availability of insecticides and equipment,
help countries train personnel for epidemiological surveillance and
eradication campaigns, and promote and support research on the
biology and control of Ae. aegypti and yellow fever.





1977-80
DEN-1 epidemic in the Caribbean


*began
in Jamaica


-1st
report of DEN-1 in Jamaica



-400,000 members of work force
affected



-1st
report of DHF-like disease in Jamaica


*spread
to Cuba


-1st
report of DEN-1 in Cuba



-epidemic peaked here in
Sept/Oct 1977



-477,440 cases reported in 1977
and 75,692 in 1979



-estimates exceed five million
cases



-was
1st dengue epidemic since 1945


*moved
to the Bahamas in late Oct 1977 then into Antigua & Barbuda,
Aruba, Barbados, Curacao, Dominica, Grenada, Guadaloupe, Guyana,
Haiti, Martinique, Montserrat, Puerto Rico, St. Kitts, St. Martin,
St. Vincent and the Grenadines, Trinidad, Turks and Caicos, and the
Virgin Islands (UK and US)



-1st
report of DEN-1 in the Antigua & Barbuda, Aruba, Bahamas,
Barbados, Curacao, Dominica, Grenada, Guadaloupe, Guyana, Haiti,
Martinique, Montserrat, Puerto Rico, St. Kitts, St. Martin, St.
Vincent and the Grenadines, Trinidad, Turks and Caicos, and the
Virgin Islands (UK and US)


-in
Puerto Rico epidemic lasted from July to December 1977; approximately
355,000 cases; DEN-1 detected after end of DEN-2/ DEN-3 epidemic


-in
Martinique 47,000 cases reported between October 1977 and June 1978



-DEN-3 isolated from a case in
the Dominican Republic and one from Haiti


*spread
to South America in 1978



-Colombia, Surinam, French
Guiana and Venezuela affected



~in Venezuela over 100,000 cases
reported



~1st
report of DEN-1 in Colombia, Surinam, French Guiana, and Venezuela


*spread
to Central America in 1978


-began
in Honduras then spread to El Salvador, Guatemala, and Belize


~in
Honduras an estimated 134,000 cases occurred


~1st
report of DEN-1 in Honduras, El Salvador, Guatemala, and Belize


~1st
report of DHF-like disease in Honduras


*reached
southeastern Mexico in late 1978



-by July 1979 reached Chiapas,
Quintana Roo, and Oaxaca


-in
October and November 1979 outbreaks occurred near Tampico on the
coast of the Gulf of Mexico and in Merida


-by
June 1980 six border towns had reported cases



-1st
report of DEN-1 in Mexico


*spread
to Brownsville, TX in September 1980


-1st
indigenous case in US since 1945


-1st
report of DEN-1 in US


*none
of the cases in any of the outbreaks met WHO criteria for DHF or DSS





1978
Pan American Sanitary Conference Resolution CSP20.R22


*Maintained
the present policy of eradication and encourage countries to overcome
any obstacles preventing eradication or re-eradication.



*Requested
the Director convene a Working Group to prepare a regional plan for
the phased eradication of Ae. aegypti, develop a basic manual
providing step-by-step guidelines for dealing with vector control
emergencies, give all assistance necessary to national eradication
programs, and ensure the availability of yellow fever vaccine in the
event of an emergency


*Recommended
the strengthening of clinical, epidemiological, and laboratory
surveillance of dengue and yellow fever and the designation of
national collaborating centers for such surveillance.



*Recommended
PAHO specifically allocate funds for Ae. aegypti eradication
programs and for the prevention and control of diseases transmitted
by this vector.





1978
DEN-3 isolated in Puerto Rico


*not
seen again in the Americas for 16 years





1980
surveillance system established in south Texas





1980
1st report of DEN-4 in Mexico





1981
PAHO Directing Council Resolution CD28.R21



*Requested
the Director organize a technical group to study the problem and
propose possible alternative courses of action for the eradication of
Ae. aegypti and the control of dengue and yellow fever.





1981
1st major epidemic of dengue hemorrhagic fever (DHF) in
the Americas


*caused
by DEN-2 in Cuba


-1st
report of DEN-2 in Cuba



-344,203 cases of dengue, 10,312
cases of DHF and 158 deaths reported



-1st
reported cases of DHF in Cuba


*over
77,000 DHF cases reported from 28 countries between 1981 and the end
of 2000





1981
1st report of DEN-2 in Mexico


*DEN-1
outbreaks also occurred





1981
Surinam intensified its surveillance program because of reports of
DEN-2 and DEN-4 in the Caribbean





1981
Panama temporarily re-infested with Ae. aegypti





1981-83
DEN-4 emerged in the Americas


*identified
in Puerto Rico in September 1981


-1st
report of DEN-4 in Puerto Rico


-DEN-1
also caused outbreaks in Puerto Rico in 1981


*caused
outbreaks in the Caribbean, northern South America, Central America,
and Mexico



-1st
report of DEN-4 in Anguilla, Curacao, Dominica, Grenada, Jamaica,
Puerto Rico, St. Kitts, St. Nevis, , St. Lucia, and the Virgin
Islands (UK)


*in
1981 cases reported in the U.S.


*Jan
82 cases reported in Surinam


-1st
report of DEN-4 in Surinam


-1st
report of DHF-like disease in Surinam


-1st
report of DEN-2 in Surinam


*early
1982 cases reported in Barbados, Belize, Dominican Republic, El
Salvador, French Guiana, Guadeloupe, Haiti, Martinique Puerto Rico,
St, St. Vincent and the Grenadines, Trinidad and Tobago



-1st
report of DEN-4 in Barbados, Belize, Dominican Republic, El Salvador,
French Guiana, Guadaloupe, Haiti, Martinique St. Martin, and St.
Vincent and the Grenadines


*March-May
1982 in Boa Vista, Brazil



-1st
report of DEN-4 in Brazil



-DEN-1 also caused epidemics



~1st
report of DEN-1 in Brazil


-an
estimated 7,000 cases occurred





1981
DEN-1, DEN-2, and DEN-4 outbreaks in Trinidad and Tobago


*1st
report of DEN-4 in Trinidad and Tobago





1981
DEN-2 and DEN-4 outbreaks in Jamaica


*1st
report of DEN-2 in Jamaica


*1st
report of DEN-4 in Jamaica





1982
Pan American Sanitary Conference Resolution CSP21.R28


*Maintained
the present policy of eradication and encourage countries to overcome
any obstacles preventing eradication or re-eradication.


*Recommended
vector-free countries increase surveillance efforts to prevent
re-infestation while countries still infested prevent the export of
the vector to other countries.


*Recommended
countries create emergency plans to inventory resources available in
other countries and a plan for implementation in the event of an
epidemic.


*Recommended
countries assist each other in eradication of the vector.



*Requested
the Director coordinate and promote all activities needed to
eradicate Ae. aegypti.


*Requested
the Director coordinate and promote all activities needed to respond
in the event of an epidemic of dengue hemorrhagic fever.





1982
DEN-2 and DEN-4 transmission detected in Tamaulipas and Oaxaca,
Mexico





1982
1st report of DEN-2 in U.S.





1982
1st report of DHF in Surinam





1982
Panama re-eradicated Ae. aegypti





1983
DEN-1 outbreaks throughout Mexico


*began
in Puebla


*later
ranged from Chiapas (south) to Jalisco (north)


*cases
also seen in Veracruz and Yucatan on the east coast





1983
1st report of DEN-3 in U.S.





1983
1st report of DEN-4 in Colombia





1983
No reported cases of DHF in the Region


*only
year from 1981 to 2000





1984
DEN-4 associated DHF epidemic in Mexico


*occurred
in Merida and the rural areas of Yucatan



*1st
report of DHF-like disease in Mexico





1984
DEN-1 outbreak in Belize





1984
1st report of DEN-1 in the Dominican Republic and
Nicaragua





1984
DEN-1 and DEN-2 isolated in Venezuela


*1st
report of DEN-2 in Venezuela





1984
1st report of DEN-2 in Honduras





1984
Peru re-infested with Ae. aegypti (detected in Iquitos)





11/84-3/85
DEN-1 outbreak in Aruba


*24,000
cases reported





1985
PAHO Directing Council Resolution CD31.R26



*Urged
the countries to overcome any barriers to the eradication of Ae.
aegypti
and to prevent the exportation of the vector to other
countries.


*Recommended
countries maintain their surveillance efforts to prevent
re-infestation.


*Requested
the Director support the mobilization of resources; promote
intersectoral mechanisms which may facilitate eradication and
control; and to stimulate new prevention, surveillance, and control
approaches.



1985
DEN-1, DEN-2 and DEN-4 isolated in Maracaibo and Caracas, Venezuela


*1st
report of DEN-4 in Venezuela





1985
dengue epidemic in Nicaragua


*2
outbreaks occurred


*17,482
total cases reported


*both
DEN-1 and DEN-2 were isolated



-1st
report of DEN-2 in Nicaragua





1985
1st report of DHF-like disease in Aruba, Colombia, and
Nicaragua





1985
1st report of DEN-2 in the Dominican Republic and St.
Martin





1985
1st report of DEN-4 in Honduras





1985
Panama re-infested with Ae. aegypti





1986
Pan American Sanitary Conference Resolution CSP22.R25



*Requested
member countries recognize the seriousness of the Ae. aegypti
and Ae. albopictus problem and support PAHO activities towards
its solution.



*Recommended
countries begin or continue effective surveillance of Ae.
albopictus
and measures to control it or eradicate it if
possible.



*Urged
the Director of the PASB to prepare a plan to combat Ae.
albopictus
, to support country surveillance and control measures
of Ae. albopictus, and to promote research to improve control.





1986
Argentina re-infested with Ae. aegypti






  1. (March)
    DEN-1 outbreaks in Rio de Janeiro, Brazil




*1st
isolation of DEN-1 in Rio de Janeiro



*1st
confirmed cases of dengue in Rio de Janeiro since 1923


*estimated
to have caused over 2,000,000 clinical cases



*1st
report of DHF-like disease in Brazil





1986
autochthonous transmission of DEN-1 in Texas


*Laredo,
Corpus Christi, and Brownsville affected






  1. DEN-4
    associated DHF epidemic in Puerto Rico






1986
(October) 1st documented case of DHF in St. Lucia of the
Lesser Antilles





1986
Ae. albopictus found in seventeen continental U.S. states and
three Brazilian states







    1. DEN-1
      associated DHF deaths in Brazil





*1st
report of DHF in Brazil





1987
PAHO Executive Committee Resolution CE99.R6



*Urged
countries to prepare and integrate an Ae. albopictus control
activities into existing Ae. aegypti control strategies.


*Asked
the Director to support these national plans with all existing
resources.





1987
DEN-1 epidemic in Bolivia



*1st
appearance of dengue in Bolivia



*1st
report of DEN-1 in Bolivia





1987
DEN-1 outbreak in Guatemala



*2,318 cases
reported





1987
autochthonous transmission of DEN-1 in Texas





1987
1st report of DEN-2 in Barbados and El Salvador





1987
outbreak in Caracas, Venezuela


*primarily
DEN-2 isolated but some DEN-4 present





1987
DEN-4 associated DHF epidemic in El Salvador



*1st
report of DHF in El Salvador


*1987-88
suspected DHF epidemic


*few
cases laboratory confirmed





1987
DEN-4 outbreak in Choluteca in southern Honduras


*8,300
estimated cases





1988
PAHO Executive Committee Resolution CE101.R19 and Directing Council
Resolution CD33.R19



*Urged
Ae. aegypti and Ae. albopictus infested countries to
implement surveillance and control measures.


*Requested
countries report periodically to the Director on Ae. albopictus
infestations.



*Urged
countries to implement regulations regarding importation and
exportation of used tire casings and to prepare national plans of
action for Ae. albopictus similar to those for Ae. aegypti.


*Requested
the Director support countries in Ae. albopictus surveillance
and control measures.





1988
Panama established dengue active surveillance program





1988
DEN-1 epidemics in Ecuador and Paraguay



*1st
appearance of dengue in Paraguay in 50 years and in Ecuador in at
least 32 years



*1st
report of DEN-1 in Ecuador



*1st
report of DEN-1 in Paraguay





1988
(summer) DEN-1 outbreak in Taxco, Guerrero State, Mexico


*highest
altitude at which dengue transmission has been documented (1700
meters)





1988
1st report of DEN-2 in Guatemala





1988
1st report of DEN-4 in Aruba and Guatemala





1988
1st report of DHF-like disease in the Dominican Republic





1988
Costa Rica re-infested with Ae. aegypti





1989
1st report of DEN-2 in Dominica, Guadaloupe, Guyana,
Martinique, and the Virgin Islands (U.S.)





1989
small outbreak in the Bahamas from September 19 to October 15


*laboratory
confirmed


*probably
DEN-2



-1st
report of DEN-2 in the Bahamas





1989
DEN-2 outbreak in Grenada


*1st
report of DEN-2 in Grenada





1989-90
2nd major outbreak of DHF in the Americas


*occurred
in Venezuela


*DEN-2
was predominant serotype but DEN-1 and DEN-4 also present





1990
DEN-1 epidemic in Iquitos in the Department of Loreto in the Amazon
Region and in Tarapoto in the Department of San Martin, Peru


*1st
report of DEN-1 in Peru


*DEN-4
also isolated



-1st
report of DEN-4 in Peru





1990
DEN-1 outbreak in Ecuador





1990
DEN-1 reported in Trinidad for the 1st time since 1985





1990
DEN-2 outbreak in Nicaragua


*DEN-1
and DEN-3 also isolated






  1. 1st
    report of DEN-2 in Brazil



*isolated
in Rio de Janiero





1990
1st report of DEN-2 in Bolivia, Ecuador and Martinique





1990
DEN-3 reported in the U.S.





1990
1st report of DEN-4 in Virgin Islands (U.S.)







    1. DHF
      outbreak in Rio de Janeiro, Brazil







1990-91
1st dengue outbreak in the state of Sao Paulo, Brazil


*DEN-1
isolated





1991
1st report of DEN-3 in El Salvador





1991
DEN-3 reported in the U.S.





1991-92
DEN-1 and DEN-2 outbreaks in Venezuela


*>12,000
cases





1991-92
1st dengue/DHF epidemic in French Guiana


*associated
with DEN-2





1992
1st report of DHF in Grenada and Trinidad & Tobago





1992
1st report of DEN-4 in Nicaragua





1992-95
DEN-1, DEN-2 and DEN-4 outbreaks in Colombia


*over
100,000 cases reported





1993
DHF outbreak in state of Ceara, Brazil





1993
(October) autochthonous transmission of dengue fever in Costa Rica



*1st
appearance of dengue in 40 years



*1st
report of DEN-1 in Costa Rica





1993
(November) autochthonous transmission of dengue fever in Panama



*1st
appearance in 50 years


*associated
with DEN-2





1993
1st report of DEN-2 in St. Vincent and Grenadines





1993
1st report of DEN-4 in Ecuador





1994
DEN-1 epidemic in Nicaragua


*20,469
cases reported


*cases
also reported in Panama



-1st
report of DEN-1 in Panama





1994
DEN-3 detected in Nicaragua and Panama


*1st
report of DEN-3 in Nicaragua and Panama


-belonged
to Sri Lanka/India genotype that caused major epidemics in those
countries in 1989-92





1994
1st report of DEN-2, DEN-3, and DEN-4 in Costa Rica





1994
DEN-3 reported in U.S.





1994
1st report of DEN-4 in Montserrat and Panama





1994
1st report of DHF in St. Kitts and Nevis and Anguilla





1994
PAHO published Dengue and Dengue Hemorrhagic Fever in the
Americas: Guidelines for Prevention and Control
(Scientific
Publication Number 548)





1995
1st report of DEN-2 in Peru





1995
DEN-3 outbreaks throughout Central America and Mexico


*1st
report of DEN-3 in Guatemala, Honduras, and Mexico


*also
reported in Costa Rica, El Salvador, Nicaragua, and Panama





1995
1st report of DHF in Barbados, Costa Rica, Dominica,
Guadaloupe, Guatemala, Martinique, and Panama





1995
dengue/DHF epidemic in Mexico


*DEN-2
(predominantly) and DEN-1 associated with DHF







    1. DHF
      epidemic in Colombia







1996
PAHO Executive Committee Resolution CE118.R13 and Directing Council
Resolution CD39.R11


*Urged
governments:



-To
collaborate in developing a hemisphere plan that supports from a
public health and an environmental perspective the combating of Ae.
aegypti
as a public health problem.


-To
use mass communication to inform the population and strengthen
community participation.


-To
promote epidemiological, entomological, and environmental
surveillance and strengthen national laboratories.


*Requested
the Director:


-Review
current national programs to determine effectiveness.


-Support
the improvement of surveillance and to facilitate the implementation
of integrated combat measures.


-Cooperate
in the preparation of national plans to combat Ae. aegypti.


-Build
consensus and co-operation among countries about dengue and yellow
fever.





1996
1st report of DEN-2 in Aruba





1996
DEN-3 reported in Costa Rica, Guatemala, Honduras, and Mexico





1996
1st report of DEN-4 in Antigua/Barbuda





1997
PAHO Executive Committee Resolution CE120.R19 and Directing Council
Resolution CD40.R15


*Urged
governments:



-To
adopt the hemisphere plan entitled Dengue and Dengue Hemorrhagic
Fever in the Americas: Guidelines for Prevention and Control.


-Identify
human and financial resources needed for the implementation of the
plan.


-Include
yellow fever vaccine in national immunization programs.


*Requested
the Director:


-Collaborate
with the countries in the implementation of the plan.


-Promote
communication between the countries to optimize plan implementation.


-Cooperate
with the countries in seeking external funds for implementing the
plan.





1997
Uruguay re-infested with Ae. aegypti after 30 years





1997
1st report of DEN-3 in Belize


*DEN-3
also reported in Costa Rica, Guatemala, Honduras, and Mexico





1998
PANDEMIC


*epidemics
in Colombia, the Dominican Republic, El Salvador, Honduras, Jamaica,
Nicaragua, Puerto Rico, St. Vincent and the Grenadines, and Trinidad
& Tobago


*epidemic
in Argentina



-1st
report of DEN-2 in Argentina



-1st
dengue epidemic in Argentina in over 70 years


*epidemic
in Brazil


-over
500,000 cases of dengue and DHF reported





1998
1st report of DEN-1 in St. Lucia





1998
1st report of DEN-3 in Aruba, Barbados and Guyana


*also
reported in Belize, Costa Rica, El Salvador, Honduras, Jamaica,
Mexico, Nicaragua, Puerto Rico, and St. Christopher/Nevis




1998
1st report of DEN-4 in the Bahamas





1998
1st report of DHF in Belize





1999
1st report of DEN-3 in French Guiana and Martinique


*DEN-3
also reported in Barbados, Guatemala, Honduras, Nicaragua, Panama,
Puerto Rico, and St. Christopher/Nevis





1999
DEN-3 reported in Venezuela





1999
PAHO produced A Blueprint for Action for the Next Generation:
Dengue Prevention and Control
(PAHO/HCP/HCT/136/99)


*promoted
intersectorial activities


*emphasized
the incorporation of social communication into control programs





1999
PAHO held sub-regional dengue meeting in Port of Spain, Trinidad
(PAHO/HCP/HCT/171.00)


*analyzed
the dengue situation in the sub-region


*presented
blueprint to countries





2000s


2000
DEN-1 outbreak in Paraguay





2000
1st report of DEN-3 in Ecuador and Peru



*1st
appearance of DHF in Ecuador


*all
4 serotypes now circulating in Ecuador and Peru


*DEN-3
also reported in Barbados, Brazil, Costa Rica, Cuba, Curacao,
Dominica, the Dominican Republic, Ecuador, French Guiana, Guadaloupe,
Martinique, Mexico, Panama, Puerto Rico, Venezuela, and the Virgin
Islands (UK)





2000
PAHO held sub-regional dengue meetings in Lima, Peru
(OPS/HCP/HCT/172.00); and Asuncion, Paraguay (OPS/HCP/HCT/173.00); &
Managua, Nicaragua (PAHO/HCP/HCT/174.00).


*analyzed
the dengue situation in the sub-region


*presented
blueprint to countries





2001
1st confirmed cases of DHF in Peru





2001
1st report of DEN-2 in Paraguay





2001
1st report of DEN-3 in Brazil and Surinam





2001
PAHO presented blueprint to the PAHO Governing Bodies











Literature
Cited


Gratz,
NG and Knudsen, AB. The Rise and Spread of Dengue, Dengue
Haemorrhagic Fever and Its Vectors: A Historical Review (Up to 1995).
WHO. 1996. CTD/FIL (DEN) 96.7





PAHO.
1999. Proceedings of the CAREC/PAHO Sub-Regional Dengue Meeting,
Port of Spain, Trinidad June 1-3, 1999. OPS/HCP/HCT/171.8





PAHO.
2000a. Promocion de Estrategias para el Estimulo de la
Participacion Comunitaria y la Educacion Popular en el Control del
Dengue a traves dela Comunicacion Social. Lima, Peru 25 al 27 de
Abril, 2000. OPS/HCP/HCT/172.00





PAHO.
2000b. Reunion Sub-Regional Sobre la Promocion de Estrategias para
el Estimulo de la Participacion Comunitaria y la Educacion Popular en
el Control del Dengue a traves dela Comunicacion Social, Paises del
Cono Sur, Asuncion, Paraguay 10 al 12 de Mayo, 2000.
OPS/HCP/HCT/173.00





PAHO.
2000c. Reunion Sub-Regional Sobre la Promocion de Estrategias para
el Estimulo de la Participacion Comunitaria y la Educacion Popular en
el Control del Dengue a traves dela Comunicacion Social, Paises de
Centroamerica. Managua, Nicaragua 16 al 18 Mayo, 2000.
OPS/HCP/HCT/174.00





PAHO.
2001. PAHO Home PageDiseases:
Control and PreventionDengue.
www.paho.org/Project.asp?SEL=TP&LNG=ENG&CD=DENGU





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