{"id":10188,"date":"2025-03-01T14:03:03","date_gmt":"2025-03-01T19:03:03","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan225\/"},"modified":"2025-03-02T00:49:22","modified_gmt":"2025-03-02T05:49:22","slug":"dhan225","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan225\/","title":{"rendered":"php\/alerts\/dhan225 ~  Division of Public Health &#8211; &#8211; Health Alert  &#8211; Delaware Health and Social Services &#8211; State of Delaware"},"content":{"rendered":"<div data-swiftype-index=\"true\">\n\n\n\n  <br>\n\n\n\n  <div class=\"container\" id=\"main_header\"> \n\n    <!-- BEGIN readspeaker div -->\n\n    <div class=\"rs_skip rsbtn rs_preserve\" id=\"readspeaker_button1\">\n\n      <a accesskey=\"L\" class=\"rsbtn_play\" href=\"https:\/\/app-na.readspeaker.com\/cgi-bin\/rsent?customerid=7262&#038;lang=en_us&#038;readid=main_content&#038;url=https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan225.html\" title=\"Listen to this page using ReadSpeaker\">\n\n        <span class=\"rsbtn_left rsimg rspart\"><span class=\"rsbtn_text\"><span>Listen<\/span><\/span><\/span>\n\n        <span class=\"rsbtn_right rsimg rsplay rspart\"><\/span>\n\n      <\/a>\n\n    <\/div>\n\n    <!-- END readspeaker div -->\n\n\n\n    \n\n    <header class=\"pull-left\">\n\n      <h1>Delaware Health Alert Network #<!--[type=EDIT name=\"DHAN Number\"]-->225 <!--[END]--> <\/h1>\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->April 29, 2010 8:28 am <!--[END]--> <\/h2>\n\n    <\/header>\n\n  <\/div><br>\n\n \n\n  <div class=\"container\">\n\n    <div class=\"row\">\n\n      <div class=\"col-md-3\" id=\"leftCol\">\n\n        <div class=\"panel-group\" id=\"accordion\">\n\n          <div class=\"panel sectionmenu_panel\">\n\n            <div class=\"panel-heading\">\n\n              <p class=\"panel-title\"><a class=\"agency_nav\" data-parent=\"#accordion\" data-toggle=\"collapse\" href=\"#collapseOne\"><strong><i class=\"fa fa-align-justify fa-fw\"><\/i> Public Health Menu<\/strong><\/a><\/p>\n\n            <\/div>\n\n\n\n            <div class=\"panel-collapse collapse in\" id=\"collapseOne\">\n\n              <div class=\"panel-body\" id=\"clf_nav\">\n\n                  <ul class=\"nav nav-stacked nav-pills-clf\" id=\"agency_sidebar\">\n    <li><a href=\"\/dph\/\"><h2>Home <i class=\"fa fa-home fa-fw\"><\/i><\/h2><\/a><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#agency_sidebar\" data-toggle=\"collapse\" href=\"#HomeMenu\"><h2>About <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"HomeMenu\">\n        <li><a href=\"\/dph\/about.html\">About DPH<\/a><\/li>\n        <li><a href=\"\/dph\/sections.html\">Sections &#038; 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For\n\n\n  information from the Division of Public Health, contact the Bureau of Epidemiology at 1-888-295-5156.\n\n\n<\/p>\n\n\n<p>\n\n\n  <strong><em>Summary:<\/em><\/strong> \u00a0The Centers for Disease Control and Prevention (CDC) has received reports of dengue fever among\n\n\n  relief workers returning from Haiti, where the disease is endemic. Health-care providers in the United States should consider dengue in\n\n\n  the differential diagnosis of febrile illness in any person who has recently been in Haiti or other countries where dengue is being\n\n\n  transmitted, and are encouraged to submit samples to state health departments (available from AZ, CA, CT, FL, NY, PR, and TX) or the CDC\n\n\n  for proper laboratory testing. In US areas with Aedes mosquitoes present, infected travelers may also present a risk for local spread of\n\n\n  dengue virus(es).\n\n\n<\/p>\n\n\n<h3>\n\n\n  Background\n\n\n<\/h3>\n\n\n<p>\n\n\n  The 7.0 magnitude earthquake that struck just outside Port-au-Prince, Haiti on January 12, 2010, caused extensive damage to homes and\n\n\n  utilities and left many residents without proper shelter or access to important services such as electricity and water. Exposure to the\n\n\n  elements and increased opportunities for mosquito breeding site proliferation have likely increased the risk of contact with vectors that\n\n\n  may spread diseases such as dengue. Since dengue is endemic in Haiti and relief workers responding to previous disasters in Haiti\n\n\n  reported high rates of dengue infection, the CDC Dengue Branch advises that physicians evaluate travelers returning with a febrile\n\n\n  illness (or a recent history of febrile illness) from Haiti and report cases of suspected dengue to either their local health department\n\n\n  or CDC.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Symptoms of Dengue Fever\n\n\n<\/h3>\n\n\n<p>\n\n\n  Dengue fever (DF) is characterized by high fever plus two or more of the following: headache, retro-orbital pain, joint pain, muscle or\n\n\n  bone pain, rash, mild hemorrhagic manifestations (e.g., nose or gum bleed, petechiae, or easy bruising), and leukopenia. The incubation\n\n\n  period for DF ranges from 3 to 14 days but is typically about one week; therefore, illness may occur while the workers are stationed in\n\n\n  Haiti or after they return to the US. Most dengue fever cases are self-limited and can be treated with bed rest, acetaminophen, and oral\n\n\n  fluids.\n\n\n<\/p>\n\n\n<p>\n\n\n  A small proportion of patients develop dengue hemorrhagic fever (DHF), which is characterized by presence of resolving fever or a recent\n\n\n  history of fever lasting 2\u20137 days, any hemorrhagic manifestation, thrombocytopenia (platelet count <100,000\/mm<sup>3<\/sup>), and\n\n\n  abnormal vascular permeability evidenced by hemoconcentration, hypoalbuminemia, or abdominal or pleural effusions. DHF can result in\n\n\n  circulatory instability or shock, and the risk for these complications may be increased among persons with prior dengue\n\n\n  infection.Adequate management of DHF patients generally requires timely hospitalization and judicious administration of intravascular\n\n\n  fluids and close monitoring of vital signs and hemodynamic status.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Recommendations\n\n\n<\/h3>\n\n\n<p>\n\n\n  Physicians seeing a patient who has illness consistent with dengue, as described above, and who has recently traveled to Haiti should\n\n\n  seriously consider laboratory testing. Initiation of supportive care should not be delayed pending results of laboratory testing.\n\n\n  Instead, laboratory results should be used to inform primary prevention efforts within the patient\u2019s household and community. The\n\n\n  CDC Dengue Branch provides free diagnostic testing for physicians and confirmatory dengue testing for health department and private\n\n\n  laboratories. While some commercial laboratories in the US offer diagnostic services for dengue, these commercial labs are not always\n\n\n  able to provide results that can distinguish recent from past dengue infection.\n\n\n<\/p>\n\n\n<p>\n\n\n  Physicians should collect specimens from patients who have symptoms consistent with dengue infection and who have traveled to Haiti\n\n\n  within the past 30 days and submit these specimens to their local health department or directly to the CDC Dengue Branch for dengue\n\n\n  testing. A completed <a href=\"\/wp-content\/uploads\/sites\/10\/dph\/pdf\/caseformhaiti.pdf\">CDC Dengue Case Investigation Form with \u201cHaiti\n\n\n  Travel\u201d printed on the heading of the form<\/a>\u00a0must accompany the specimens for each patient to be tested in the Dengue\n\n\n  Branch.\n\n\n<\/p>\n\n\n<ul>\n\n\n  <li>Public health departments that have the capacity to test for dengue are the following: AZ, CA, CT, FL, NY, PR, and TX.\n\n\n  <\/li>\n\n\n  <li>Physicians who practice in states not listed above should send the specimens directly to the CDC Dengue Branch (rather than to a\n\n\n  private lab) and then notify the state health department of the case.\n\n\n  <\/li>\n\n\n<\/ul>\n\n\n<p>\n\n\n  Whenever possible, physicians should submit paired acute and convalescent samples to facilitate optimal diagnostic testing.\n\n\n<\/p><br>\n\n\n<table class=\"table table-condensed table-hover\">\n\n\n  <tbody>\n\n\n    <tr>\n\n\n      <th scope=\"col\">\n\n\n        Type of sample\n\n\n      <\/th>\n\n\n      <th scope=\"col\">\n\n\n        Interval since onset of symptoms\n\n\n      <\/th>\n\n\n      <th scope=\"col\">\n\n\n        Type of Analysis\n\n\n      <\/th>\n\n\n    <\/tr>\n\n\n    <tr class=\"center\">\n\n\n      <td>\n\n\n        Acute\n\n\n      <\/td>\n\n\n      <td>\n\n\n        Until day 5\n\n\n      <\/td>\n\n\n      <td>\n\n\n        RT-PCR for dengue virus\n\n\n      <\/td>\n\n\n    <\/tr>\n\n\n    <tr class=\"center\">\n\n\n      <td>\n\n\n        Convalescent\n\n\n      <\/td>\n\n\n      <td>\n\n\n        6 to 30 days\n\n\n      <\/td>\n\n\n      <td>\n\n\n        ELISA for dengue IgM\n\n\n      <\/td>\n\n\n    <\/tr>\n\n\n  <\/tbody>\n\n\n<\/table><br>\n\n\n<br>\n\n\n<p>\n\n\n  2 cc. (ml) of centrifuged serum accompanied by a Dengue Case Investigation Form (<a href=\"\/wp-content\/uploads\/sites\/10\/dph\/pdf\/caseformhaiti.pdf\" title=\"http:\/\/www.cdc.gov\/Dengue\/resources\/caseformhaiti.pdf\">http:\/\/www.cdc.gov\/Dengue\/resources\/caseformhaiti.pdf<\/a>) should be sent to:\n\n\n<\/p>\n\n\n<p>\n\n\n  \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Centers for Disease Control and Prevention<br>\n\n\n  \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Dengue Branch<br>\n\n\n  \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a01324 Ca\u00f1ada Street<br>\n\n\n  \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0San Juan, Puerto Rico 00920<br>\n\n\n  \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Tel: (787) 706-2399; fax (787) 706-2496\n\n\n<\/p>\n\n\n<p>\n\n\n  As of 2010, dengue virus infections, including dengue fever (DF) and dengue hemorrhagic fever (DHF), were added to the list of nationally\n\n\n  notifiable conditions. Improved dengue surveillance, consistent with international public health reporting obligations under the revised\n\n\n  International Health Regulations (IHR, 2005), will help detect and report dengue cases when they occur.\n\n\n<\/p>\n\n\n<p>\n\n\n  Many parts of the US have competent vectors for dengue viruses; therefore, infected travelers may also present a risk for potential local\n\n\n  spread of dengue. Three states (Florida, Texas and Hawaii) have had local outbreaks identified in the last decade.\n\n\n<\/p>\n\n\n<h3>\n\n\n  For More Information:\n\n\n<\/h3>\n\n\n<ul>\n\n\n  <li>Criteria for the processing of dengue samples at the CDC Dengue Branch is available at: <a href=\"\/wp-content\/uploads\/sites\/10\/dph\/pdf\/TestpolEng_2.pdf\" title=\"http:\/\/www.cdc.gov\/Dengue\/resources\/TestpolEng_2.pdf\">http:\/\/www.cdc.gov\/Dengue\/resources\/TestpolEng_2.pdf<\/a>.\n\n\n  <\/li>\n\n\n  <li>Additional information about dengue is available at: <a href=\"http:\/\/www.cdc.gov\/dengue\/\" title=\"http:\/\/www.cdc.gov\/dengue\/\">http:\/\/www.cdc.gov\/dengue\/<\/a>\n\n\n  <\/li>\n\n\n  <li>Call CDC\u2019s toll-free information line, 800-CDC-INFO (800-232-4636) TTY: (888) 232-6348, which is available 24 hours a day,\n\n\n  every day.\n\n\n  <\/li>\n\n\n<\/ul>\n\n\n<p>\n\n\n  ************************************\n\n\n<\/p>\n\n\n<p>\n\n\n  You are receiving this email because you are a registered member of the Delaware Health Alert Network. If you are not a member and would\n\n\n  like to subscribe, please register at <a href=\"https:\/\/healthalertde.org\">https:\/\/healthalertde.org<\/a>\n\n\n<\/p><br>\n\n\n<br>\n\n\n<p class=\"smalltext\"><a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\"><img loading=\"lazy\" decoding=\"async\" alt=\"Download Adobe Acrobat Reader\" height=\"21\" src=\"\/wp-content\/uploads\/dhss\/img\/getacro60.gif\" width=\"60\"><\/a> Please note: Some of the files available on this page are in Adobe PDF format which requires Adobe Acrobat Reader.  A free copy of Adobe Acrobat Reader can be downloaded directly from <a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\">Adobe <\/a>. If you are using an assistive technology unable to read Adobe PDF, please either view the corresponding text only version (if available) or visit Adobe&#8217;s <a href=\"http:\/\/access.adobe.com\">Accessibility Tools page<\/a>.<\/p>\n\n\n\n<!--[END]-->\n\n  \n\n        <div class=\"panel panel-danger\">\n\n          <div class=\"panel-heading\">    \n\n      <h2>Categories of Health Alert messages:<\/h2>\n\n       <\/div>\n\n       <div class=\"panel-body\">\n\n      <ul>\n\n        <li><strong>Health Alert:<\/strong> Conveys the highest level of importance; warrants immediate action or attention.<\/li>\n\n        <li><strong>Health Advisory:<\/strong> Provides important information for a specific incident or situation; may not require immediate action.<\/li>\n\n        <li><strong>Health Update:<\/strong> Provides updated information regarding an incident or situation; unlikely to require immediate action.<\/li>\n\n            <\/ul>\n\n         <div><strong>NOTE: This page is for informational purposes only and dated material (e.g. temporary websites) may not be available.<\/strong><\/div>\n\n          <\/div> \n\n        <\/div><br>  \n\n\n\n      <\/div>\n\n    <\/div>\n\n  <\/div><!-- \/container -->\n\n  <\/div>","protected":false},"excerpt":{"rendered":"<p>Listen Delaware Health Alert Network #225 April 29, 2010 8:28 am Public Health Menu Home About About DPH Sections &#038; Programs Office Locations Contact Info Calendar Services A-Z Services Air &#038; Water Quality Birth, Death, &#038; Marriage Records Clinics Health Data &#038; Statistics Emergency Preparedness Health &#038; Wellness Healthy Homes Healthy Workplaces Laboratory Restaurant Inspections [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":9294,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-10188","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10188","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/comments?post=10188"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10188\/revisions"}],"predecessor-version":[{"id":11364,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10188\/revisions\/11364"}],"up":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9294"}],"wp:attachment":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/media?parent=10188"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}