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No images? Click here 05 April 2023 BRIEFING NOTES Here are the briefing notes from today's press briefing on the "Rise of dengue, zika, chikungunya outbreaks and impact of climate change". The briefing was held at the UN Palais in Geneva, speakers were: Dr Raman VELAYUDHAN, Unit Head, Global Program on control of Neglected Tropical Diseases coordinating dengue and arbovirus initiativeDr Diana ROJAS ALVAREZ, Technical Lead, Zika and chikungunya and co-Lead of the Global arbovirus initiativeThe briefing can be revisited here:
Dengue updates -media brief What is dengue Dengue) is the most common viral infection that spreads from mosquitoes to people. It is more common in tropical and subtropical climates. There are four distinct serotypes of dengue. Most people who get dengue won’t have symptoms. But for those that do, the most common symptoms are high fever, headache, body aches, nausea and rash. Most will also get better in 1–2 weeks. Some people develop severe dengue and need care in a hospital. In severe cases, dengue can be fatal. You can lower your risk of dengue by avoiding mosquito bites especially during the day. Dengue is treated with pain medicine as there is no specific treatment currently. Dengue trends: The incidence of dengue has grown dramatically around the world in recent decades, with cases reported to WHO increased from 505,430 cases in 2000 to 5.2 million in 2019. The American region had reported 2.8 million cases and 1280 deaths in 2022. This increasing trend is continuing in 2023 where till the end of March 2023, 441,898 cases and 119 deaths have been reported.
The southern spread of cases is a growing concern. Bolivia, Paraguay and Peru. European region had the vector established in over 24 countries and has reported dengue and or chikungunya regularly since 2010. High number of cases have been reported from Sudan 8239 cases and 45 deaths since July 2022. It is rather early to get reports from Asia but trends are worrying. Factors: Increased movement of people and goodsUrbanization and associated problems of water and sanitationContinuing spread of the vectors to more regions and countries.Issues linked to climate High precipitation, increased temperature and even scarcity of water favors the breeding of mosquitoes.The virus and the vectors multiple faster in higher temperatureNovel tools: Several new tools are under development which provides greater hope in preventing and controlling dengue such as: Better diagnostics.Few antivirals under clinical trial;One vaccine is in the market and two are under final phase three trial and review;Several vector control tools such as: Wolbachia (population replacement and population suppression models), Sterile insect technique and spatial repellents.Response: Technical support to countries and respond to the outbreak and enhance cross border exchange of information.Community action in prevention, awareness and seeking medical careImplementation of an integrated strategy for control with guidance for clinical managementThe roll out of the Global Arbovirus Initiative in progress.
Chikungunya Chikungunya is a virus spread by Aedes mosquitoes which are found on nearly all continents and bite mostly during the day. To date 115 countries have reported CHIKV transmission.The main burden of disease is due to the chronic disabilities and severe impact in the quality of life.The clinical manifestations vary by age and the newborns and elderly are at greater risk for more severe disease. In addition to age, pre-existing conditions have also been identified as a risk factor for poor disease outcome.Current chikungunya outbreaks in Paraguay, Argentina and Bolivia and high circulation in Brazil and other countries in the region (Epidemiological Alert: Increase in cases and deaths from chikungunya in the Region of the Americas - PAHO/WHO | Pan American Health Organization).Atypical from this CHIKV outbreak are the reported cases of acute meningoencephalitis and neonatal mortality associated with the disease. Almost 70% of the deaths reported are on population more than 60 years of age mostly with pre-existing conditions such as Diabetes, hypertension, immunocompromised. 20% deaths reported are in newborns infected intrapartum.Neonatal chikungunya recorded in previous outbreaks globally: risk highest intrapartum: ~49% transmission. Most CHIKV infections that occur during pregnancy will not result in the virus being transmitted to the fetus.Main concerns: Increase on reported CHIKV cases in the Americas.Chikungunya transmission out of the usual endemic areas.Traveling has started again so the risk of introduction and further spread in areas where these viruses have not circulated before and the mosquito is present is back.Aedes aegypti - current known distribution: February 2023 (europa.eu) WHO response: PAHO/WHO has been actively working with the Member States to strengthen healthcare and surveillance capacity as part of the implementation of the Integrated Management Strategy for the Prevention and Control of Arboviral Diseases (IMS-Arbovirus)Supporting to increase the laboratory-capacity, to enable timely and accurate diagnosis and case detection throughout the region.Supporting the implementation of effective integrated vector surveillance and control by Member StatesTrainings in detection and clinical management to health care workers, through webinars and refresher sessions., and strengthening subnational networks of clinical trainers to provide clinical training at local levels.PAHO/WHO experts are regularly being deployed to countries which are experiencing high magnitude outbreaks.In 2022, WHO launched the Global Arbovirus Initiative, an integrated strategic plan to tackle emerging and re-emerging arboviruses with epidemic and pandemic potential focusing on monitoring risk and anticipation of epidemics, preparedness, early detection and response to outbreaks, developing of innovative tools (diagnosis, therapeutics, vaccines, vector control tools) and building a coalition of partners to prevent further spread and decrease the frequency and impact of arbovirus outbreaks. Call to countries, partners and the general community to be alert and prepared to detect early transmission of dengue, Zika and chikungunya to prevent complications such as severe dengue, Congenital Zika Syndrome and other complications associated with Zika infection, neonatal chikungunya.Communities to eliminate mosquito breeding sites in and around homes and personal protection of family members during the day mosquito repellent, use of clothes that cover arms and legs and people staying in bed during the day /at the hospitals the use of bed nets is strongly recommended.Zika Zika is a virus spread by Aedes mosquitoes which are found on nearly all continents and bite mostly during the day. Zika virus can also be transmitted sexually between people and from mother to child during pregnancy.Public Health Emergency of International Concern in 2016: identification of newborns with microcephaly (had babies with smaller than normal head size), preterm births and miscarriages; and other neurological complications such as Guillain Barre Syndrome in adults in the Americas.Zika virus disease have declined, globally, since 2017, they still occur at low levels in several countries in the Americas and other regions. In 2016, >600K cases were reported but millions of infections were estimated; followed by 50K in 2017, 30K 2018 which is been the average number of cases since then. So far in 2023, 3,000 have been reported in the region of the Americas, mostly from Brazil, Bolivia, Guatemala, Belize, Colombia.To date, 89 countries and territories have current or previous spread of Zika virus by Aedes mosquitoes.Zika emergence was 8 years ago which is enough time to accumulate susceptible to build a new epidemic../.
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