The hurricane struck in the midst of an already raging dengue epidemic. This lead to cause for concern as stagnant water would lead to the increase in vector numbers and an increased risk of dengue transmission. Solid waste management was disrupted and debris increased the vulnerability to flooding and vector borne diseases, a realistic concern for vector related diseases such as dengue, malaria and leptospirosis.

PAHO/WHO worked very closely with the Ministry of Health and other counterparts to address the dengue outbreak. Four persons were deployed to provide technical cooperation: An epidemiologist, a dengue specialist, an entomologist technician and an environmental health specialist. The main recommendations emanated from dengue specialist were as follows:

1. Improve coordination and response;
2. Improve surveillance, data analysis and use of data to support vector control operations
3. Potential spread of Dengue to the Family Islands;
4. Assign resources to MOH for the hiring of a full time Epidemiologist;
5. Assess effectiveness of the insecticides in use;
6. Make adjustments of fogging activities;
7. Geo-referenced database;
8. Collaboration with centres of higher learning;
9. Improve water supply;
10. Review the Dengue prevention and control programme.   

The expedited response to the above recommendations by the Ministry of Health and by the Department of Environmental Health Services as well as by PAHO/WHO has resulted in the control of the Dengue Epidemic within a short period of time (See Figure). A good amount of time has been devoted to ensure recommendations were implemented.

In order to prevent any other future outbreak, PAHO/WHO has strengthened technical cooperation in several areas:

Clinical Case Dengue Aug 22 - Sep 5, 2011

1. Assess the environmental health conditions that may be contributing to the Dengue Outbreak and make recommendations to minimize public health risks;
2. Collaborate in the mapping of Dengue cases to direct vector control activities;
3. Strengthen the vector control activities of the staff at the Department of Environmental Health Services;
4. Assess effectiveness of the insecticides in use.
5. Strengthen capacity on the use of Geograhical Information Systems (GIS)

A map of the geographic distribution of Dengue Cases is presented below.