Dengue fever outbreak in El Salvador

An outbreak of dengue fever with some instances of dengue haemorragic fever, has been affecting El Salvador since July, 2000. On September 12, the President of El Salvador declared the dengue outbreak a national emergency. Since the beginning of the year, over 2,000 cases of dengue have been registered of which 221 are haemorragical cases (10,54%). Of these, 24 patients have died. The lethal rate is 7.65%. Dengue fever is characterised by a high fever and a rash. In emergency settings, where diagnostic possibilities are limited, such cases will easily be taken for and treated as malaria. Convalescence might be prolonged but mortality is rare. Dengue hemorrhagic fever and dengue shock syndrome (DHS/DSS) are severe illnesses: after a classical dengue pattern, the patient suddenly deteriorates and develops haemorrrhages. Eventually s/he might develop shock syndrome. Case fatalities are high (10-60%). During the weekend of September 8-10, 36 children were admitted at the Public Pediatric Hospital in San Salvador, all suspected of having dengue. Of these children, 27 have symptoms of haemorragical dengue. Unfortunately, two of them have died. The Ministry of Health (MoH) is managing the situation but has recently asked for assistance from international agencies including MSF. MSF teams are monitoring the situation in areas where the organisation is active and has offered support to the MoH if necessary. Emphasis is on preventative measures to assist the general population. Military forces are spraying from house to house and even children are involved in some of the preventative work such as the removal of garbage and stagnant water.