Peru Endures Historic Dengue Outbreak with Over 146K Cases

Peru is currently facing a severe outbreak of dengue, commonly referred to as “break-bone fever.” This outbreak is historically the worst the country has experienced, with over 146,000 reported cases and at least 248 fatalities. The handling of the outbreak by Rosa Gutiérrez, MD, the former Minister of Health, has raised concerns and led to her resignation. Unfortunately, Peru is likely to continue battling this outbreak for the foreseeable future.

The northern regions of Peru received heavy rainfall during April and May, thanks to El Niño and Cyclone Yaku. These weather conditions have created a favorable environment for mosquitos, particularly the Aedes aegypti species known to transmit dengue viruses. Dengue is a serious illness, and only a quarter of those infected exhibit symptoms. This makes it challenging to diagnose without a blood test. While developing immunity to one type of dengue virus can protect against future infections of the same type, it can actually increase the risk of severe dengue when infected by other types. Thus, not recognizing a previous dengue infection can leave individuals unaware of their increased vulnerability. Repeating the dengue experience can be even more debilitating.

Mild dengue typically lasts for two to seven days and includes fever, nausea, vomiting, rash, muscle and joint pain, and eye pain. However, despite its “mild” label, dengue fever can be excruciatingly painful, earning it the nickname “break-bone fever.” Resting, staying hydrated, and taking acetaminophen can provide some relief, but it is crucial to monitor symptoms closely. Mild dengue can rapidly progress to severe dengue, which requires immediate medical attention.

Be vigilant for warning signs indicating the development of severe dengue. These signs include intense abdominal pain, vomiting multiple times within 24 hours, vomiting blood, bleeding from the nose or gums, and blood in the stool. Other symptoms may include fatigue, restlessness, and irritability. Deviating from normal activities due to vomiting blood is understandable, and seeking medical assistance promptly is essential.

Severe dengue can lead to shock, internal bleeding, and potentially death, affecting approximately one in every 20 dengue patients. Those who have had dengue previously are more likely to experience severe symptoms, despite being asymptomatic during their first infection. The initial dengue episode can activate the immune system to react more aggressively during subsequent infections, resulting in “antibody-dependent enhancement” and exacerbating the disease. Infants and pregnant individuals also face a higher risk of developing severe dengue.

Globally, dengue cases have been increasing, rising from 505,430 reported cases in 2000 to 5.2 million in 2019, according to the World Health Organization (WHO). Dengue is more prevalent in hot and humid climates where Aedes mosquitoes thrive. Unfortunately, these regions have expanded due to climate change, contradicting the denial of certain politicians and personalities.

A vaccine known as Dengvaxia exists, but it is recommended to receive it only after experiencing dengue at least once. Dengvaxia is limited to children aged 9 to 16 living in dengue-endemic areas with a confirmed past infection. Vaccination without a previous dengue infection may increase the likelihood of severe dengue.

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