{"id":10221,"date":"2025-03-01T14:03:11","date_gmt":"2025-03-01T19:03:11","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan255\/"},"modified":"2025-03-02T00:50:29","modified_gmt":"2025-03-02T05:50:29","slug":"dhan255","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan255\/","title":{"rendered":"php\/alerts\/dhan255 ~  Division of Public Health &#8212; 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\/dhan255.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\"]-->255 <!--[END]--> <\/h1>\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->August 2, 2011 9:40am <!--[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; Programs<\/a><\/li>\n        <li><a href=\"\/dph\/ofclocations.html\">Office Locations<\/a><\/li>\n        <li><a href=\"\/dph\/contact.html\">Contact Info<\/a><\/li>\n      \n        <li><a href=\"\/calendars.html\" target=\"_blank\">Calendar<\/a><\/li>\n      <\/ul>\n    <\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#ServicesMenu\"><h2>Services <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"ServicesMenu\">\n        <li><a href=\"\/dph\/servicesaz.html\">A-Z Services<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/environmental.html\">Air &#038; Water Quality<\/a><\/li>\n        <li><a href=\"\/dph\/ss\/vitalstats.html\">Birth, Death, &#038; Marriage Records<\/a><\/li>\n        <li><a href=\"\/dph\/clinics.html\">Clinics<\/a><\/li>\n        <li><a href=\"\/dph\/healthdatastats.html\">Health Data &#038; Statistics<\/a><\/li>\n        <li><a href=\"\/dph\/php\/emsps.html\">Emergency Preparedness<\/a><\/li>\n        <li><a href=\"\/dph\/healthandwellness.html\">Health &#038; Wellness<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthyhomes.html\">Healthy Homes<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthywp.html\">Healthy Workplaces<\/a><\/li>\n        <li><a href=\"\/dph\/lab\/labs.html\">Laboratory<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/feir.html\">Restaurant Inspections<\/a><\/li>\n        <li><a href=\"\/dph\/screen.html\">Screening and Testing<\/a><\/li>\n        <li><a href=\"\/dph\/chca\/dphwichominf01.html\">WIC<\/a><\/li>\n        <li><a href=\"\/dph\/servicesadd.html\">Additional Services<\/a><\/li><li>\n      <\/li><\/ul>\n    <\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#InformationMenu\"><h2>Information <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n        <ul class=\"panel-collapse collapse\" id=\"InformationMenu\">\n        <li><a href=\"\/dph\/factsheetsaz.html\">A-Z Fact Sheets<\/a><\/li>\n        <li><a href=\"\/dph\/pubreportsaz.html\">A-Z Publications &#038; Reports<\/a><\/li>\n        <li><a href=\"\/dph\/diseasesandconditions.html\">Diseases &#038; Conditions<\/a><\/li>\n        <li><a href=\"\/dph\/faq.html\">FAQ&#8217;s<\/a><\/li>\n        <li><a href=\"\/dph\/php\/alerts.html\">Health Alerts<\/a><\/li>\n        <li><a href=\"\/dph\/healthylifestyles.html\">Healthy Lifestyles<\/a><\/li>\n        <li><a href=\"\/dph\/hipaa.html\">HIPAA<\/a><\/li>\n        <li><a href=\"\/dph\/regs.html\">Regulations<\/a><\/li>\n        <li><a href=\"\/dph\/forms.html\">Request Forms<\/a><\/li>\n        <li><a href=\"\/dph\/links.html\">Links &#038; Resources<\/a><\/li>\n        <li><a href=\"http:\/\/delaware.gov\/help\/foia_request.shtml\">FOIA Request Form<\/a><\/li>\n      <\/ul>\n    <\/li>\n    <li><a id=\"SocialMenuHeader\"><h2>Connect <i class=\"fa fa-thumbs-o-up fa-fw\"><\/i><\/h2><\/a>\n      <ul id=\"SocialMenu\">\n        <li class=\"facebook\"><a href=\"https:\/\/www.facebook.com\/DEPublicHealth\" target=\"_blank\" title=\"Division of Public Health Facebook Page\"><i class=\"fa fa-facebook-square fa-lg\"><\/i> Facebook<\/a><\/li>\n        <li class=\"twitter\"><a href=\"https:\/\/twitter.com\/Delaware_DHSS\" target=\"_blank\" title=\"Delaware Health and Social Services Twitter Account\"><i class=\"fa fa-twitter-square fa-lg\"><\/i> Twitter<\/a><\/li>\n        <!-- <li class=\"googleplus\"><a href=\"#\"><i class=\"fa fa-google-plus-square fa-lg\"><\/i> Google +<\/a><\/li>\n        <li class=\"flickr\"><a href=\"#\"><i class=\"fa fa-flickr fa-lg\"><\/i> Flickr<\/a><\/li>\n        <li class=\"youtube\"><a href=\"#\"><i class=\"fa fa-youtube-square fa-lg\"><\/i> Youtube<\/a><\/li>\n        <li class=\"instagram\"><a href=\"#\"><i class=\"fa fa-instagram fa-lg\"><\/i> Instagram<\/a><\/li>\n        <li class=\"linkedin\"><a href=\"#\"><i class=\"fa fa-linkedin-square fa-lg\"><\/i> Linkedin<\/a><\/li>\n        <li class=\"pinterest\"><a href=\"#\"><i class=\"fa fa-pinterest-square fa-lg\"><\/i> Pinterest<\/a><\/li> -->\n      <\/ul>\n    <\/li>\n  <\/ul>\n\n              <\/div>\n\n            <\/div>\n\n          <\/div>\n\n        <\/div><br>\n\n      <\/div>\n\n\n\n      <div class=\"col-md-9\" id=\"main_content\"> \n\n  \n\n<h2 class=\"center\">Health\n\n<!--[type=EDIT name=\"DHANType\"]-->\n\n\n\n   Advisory<!--[END]-->\n\n<br>\n\n<!--[type=EDIT name=\"DHAN Heading\"]-->\n\n\n\nDENGUE-LIKE ILLNESS CLUSTER AMONG DELAWARE MISSIONARY TRAVELERS TO HAITI<!--[END]-->\n\n<\/h2>\n\n\n\n<!--[type=HTMLEDIT name=\"Content\"]-->\n\n\n\n<p>\n\n\n  The Delaware Division of Public Health (DPH) would like to alert the medical community of the increased potential for severe\n\n\n  mosquito-transmitted illnesses among travelers to endemic countries or regions. Clinicians should be vigilant for severe\n\n\n  mosquito-transmitted illnesses among local travelers returning from the tropics and subtropics.\n\n\n<\/p>\n\n\n<p>\n\n\n  Dengue is a mandatory reportable disease to Delaware\u2019s Division of Public Health. Report suspected cases to DPH Epidemiology\n\n\n  (1-888-295-5156).\n\n\n<\/p>\n\n\n<h3>\n\n\n  Summary:\n\n\n<\/h3>\n\n\n<p>\n\n\n  DPH is investigating a small cluster of Dengue-like illnesses among 4 of 12 missionary workers from Delaware who recently returned after\n\n\n  10 days in Haiti. Initial testing of these four cases is Dengue-specific for IgM and\/or IgG antibodies. Serum samples from 3 of the 4\n\n\n  cases are being sent to the Centers for Disease Control and Prevention (CDC), Dengue Branch, for confirmatory testing.\n\n\n<\/p>\n\n\n<p>\n\n\n  In this cluster, a clinician identified Dengue-like illness in a pediatric traveler returning from Haiti, submitted specimens for testing\n\n\n  to a reference laboratory, and promptly notified DPH. After this case was identified, DPH was able to investigate and identify three\n\n\n  additional individuals that sought medical care and were diagnosed as having a Dengue-like illness.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Background:\n\n\n<\/h3>\n\n\n<p>\n\n\n  Dengue transmission has been increasing to epidemic levels in many parts of the tropics and subtropics where it had previously been\n\n\n  absent or mild. Dengue-affected areas are widely distributed throughout Africa, Asia, Pacific, the Americas and the Caribbean. During\n\n\n  2010, more than 50 countries reported evidence of Dengue transmission; including 17 countries in Asia, 17 in the Americas, 10 in Africa,\n\n\n  seven in the Caribbean, and one in the Pacific. As many as 100 million people are infected in the world every year. The mosquitoes known\n\n\n  to transmit dengue virus, <em>Aedes aegypti<\/em> and <em>Aedes albopictus<\/em>, are present throughout much of the southeastern United\n\n\n  States and infected returning travelers may pose a risk for initiating local transmission.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Symptoms:\n\n\n<\/h3>\n\n\n<p>\n\n\n  The principal symptoms of Dengue fever are high fever, severe headache, severe pain behind the eyes, joint pain, muscle and bone pain,\n\n\n  rash, and mild bleeding (e.g., nose or gums bleed, easy bruising). Generally, younger children and those with their first Dengue\n\n\n  infection have a milder illness than older children and adults.\n\n\n<\/p>\n\n\n<p>\n\n\n  Dengue hemorrhagic fever is characterized by a fever that lasts from 2 to 7 days, with general signs and symptoms consistent with Dengue\n\n\n  fever. When fever declines, symptoms including persistent vomiting, severe abdominal pain, and difficulty breathing, may develop. This\n\n\n  marks the beginning of a 24- to 48-hour period when the smallest blood vessels (capillaries) become excessively permeable\n\n\n  (\u201cleaky\u201d), allowing the fluid component to escape from the blood vessels into the peritoneum (causing ascites) and pleural\n\n\n  cavity (leading to pleural effusions). This may lead to failure of the circulatory system and shock, followed by death, if circulatory\n\n\n  failure is not corrected. In addition, the patient with Dengue Hemorrhagic Fever (DHF) has a low platelet count and hemorrhagic\n\n\n  manifestations, tendency to bruise easily or other types of skin hemorrhages, bleeding nose or gums, and possibly internal bleeding.\n\n\n  <a href=\"http:\/\/www.cdc.gov\/dengue\/fAQFacts\/index.html\">http:\/\/www.cdc.gov\/dengue\/fAQFacts\/index.html<\/a>\n\n\n<\/p>\n\n\n<h3>\n\n\n  Laboratory Guidance and Diagnostic Testing:\n\n\n<\/h3>\n\n\n<p>\n\n\n  Health care providers seeing a patient who has an illness consistent with Dengue, as described above, and who has recently traveled to\n\n\n  Haiti or other endemic regions should seriously consider laboratory testing. Initiation of supportive care should not be delayed pending\n\n\n  results of laboratory testing.\n\n\n<\/p>\n\n\n<p>\n\n\n  Dengue can be diagnosed by isolation of the virus, by serological tests, or by molecular methods. Diagnosis of acute (on-going) or recent\n\n\n  Dengue infection can be established by testing serum samples during the first 5 days of symptoms and\/or early convalescent phase (more\n\n\n  than 5 days of symptoms). Infection with Dengue virus is confirmed when the virus is isolated from serum or autopsy tissue specimens, or\n\n\n  the specific Dengue virus genome is identified by reverse transcription-polymerase chain reaction (RT-PCR) from serum or plasma,\n\n\n  cerebrospinal fluid, or tissue specimens during an acute febrile illness.\n\n\n<\/p>\n\n\n<p>\n\n\n  The CDC Dengue Branch provides free diagnostic testing for physicians and confirmatory Dengue testing for health departments 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  Please contact DPH Epidemiology at 1-888-295-5156 to coordinate confirmatory testing at CDC.\n\n\n<\/p>\n\n\n<p>\n\n\n  Complete CDC guidance: <a href=\"http:\/\/www.cdc.gov\/dengue\/clinicalLab\/laboratory.html\">http:\/\/www.cdc.gov\/dengue\/clinicalLab\/laboratory.html<\/a>\n\n\n<\/p>\n\n\n<h3>\n\n\n  Reporting:\n\n\n<\/h3>\n\n\n<p>\n\n\n  Prompt reporting of suspected cases of dengue or other mosquito-transmitted illnesses to DPH Epidemiology (1-888-295-5156) can facilitate\n\n\n  diagnostic testing and initiate the public health investigation.\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>Dengue &#8211; Clinical Guidelines for Diagnosis, Treatment, Prevention and Control <a href=\"\/wp-content\/uploads\/sites\/10\/dph\/pdf\/9789241547871_eng.pdf\">http:\/\/whqlibdoc.who.int\/publications\/2009\/9789241547871_eng.pdf<\/a>\n\n\n  <\/li>\n\n\n  <li>DPH Bureau of Epidemiology: 1-888-295-5156\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 message because you are a registered member of the Delaware Health Alert Network. If you are not a member and\n\n\n  would 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 #255 August 2, 2011 9:40am 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 Screening [&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-10221","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10221","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=10221"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10221\/revisions"}],"predecessor-version":[{"id":11397,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10221\/revisions\/11397"}],"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=10221"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}