Epidemiological Alert - Chikungunya and dengue fever in the Americas, 29 August 2014

Given the continued spread of chikungunya virus in the Americas, and the start of the period with higher dengue circulation in Central America and the Caribbean, the Pan American Health Organization / World Health Organization (PAHO / WHO) advises Member States who have the vector mosquito of both viruses (Aedes aegypti), to increase vector density reduction efforts, based on the Dengue Integrated Management Strategy (Dengue-IMS), in addition to establishing and maintaining dengue and chikungunya case management capacity, and to implement effective public communication strategies to eliminate mosquito breeding sites.

Situation summary

The first evidence of autochthonous chikungunya transmission in the Americas was recorded in December 2013, since then, autochthonous transmission has been detected in 33 countries and territories of the Americas (27 countries and territories in the Caribbean, 3 countries in Central America, 1 country and 1 territory in South America and 1 country in North America). As of epidemiological week (EW) 35 of 2014, the Pan American Health Organization / World Health Organization (PAHO/WHO) has been informed of a total of 659,367 cases, including 37 deaths, in the Americas.

Usually during the second semester of the year, Central America, Mexico and the Caribbean experience a seasonal increase in dengue fever transmission. Currently, the Dominican Republic, El Salvador, Guatemala, and Honduras, are recording increases in cases coinciding with this period of greater transmission.

The threats posed by the seasonal increase of dengue transmission and the introduction, or risks of introduction of the chikungunya virus in the Region require an integrated approach of prevention and vector control activities of both diseases. With the rapid spread of the chikungunya virus observed in some countries of the Americas, simultaneous dengue and chikungunya outbreaks may occur, which would result in increased health care demand. Accordingly, health care services must be prepared to meet expected increased demand without compromising quality of care; preparations should be guided by the PAHO/WHO recommendations for clinical management of patients with dengue or chikungunya.