Aileen M. Marty, M.D.

Director, FIU Health, Travel Medicine Program

Health officials have confirmed the first locally acquired case of dengue fever in Miami-Dade County. They say the 50-year-old woman was first diagnosed based on symptoms, and subsequent laboratory tests confirmed she had dengue. The woman has since fully recovered, but dengue can be fatal, even to otherwise young healthy people.

Dengue is not spread person to person. It is transmitted by mosquito, and unfortunately for us in Florida, the type of mosquito that transmits this infection, Aedes is common to the southeastern United States and the tropics. Still, most of the dengue cases we see are imported. According to state health officials, 24 cases of dengue fever have been confirmed in Florida this year in patients who recently traveled to South America and the Caribbean. This is the state’s first case of dengue acquired locally this year. Last year, 23 cases of locally acquired dengue were confirmed in Florida.

Dengue Symptoms

Symptoms often vary from person to person, and it’s hard to predict how sick someone with dengue will become, but the most frequent symptoms of dengue fever include: fever (over 101° F), severe headache, severe pain behind the eyes, muscle, joint and bone pain, a rash, loss of appetite, nausea and vomiting.
Some patients develop a hemorrhagic fever, which can be deadly, so please see your doctor if you feel ill, particularly if the vomiting is very frequent, your nose or other tissues begin bleeding, or you develop severe abdominal pain.

Prevention
There is no specific medication or vaccine for dengue fever. To avoid getting dengue you must avoid being bitten by mosquitos. But there’s a reason they call them pests-it takes work to keep them at bay. You must protect yourself and stop mosquitos from breeding.

Top 3 Ways to Prevent Dengue

1. Cover Up- When you’re outside, wear shoes, socks, long pants and long sleeves
2. Use Repellent-Apply to bare skin and clothing. Make sure you use repellents with DEET, picaridin, oil of lemon eucalyptus, or IR3535.
3. Drain Standing Water-Mosquitos can breed in very small amounts of water; make sure you drain standing water around your house from garbage cans and buckets to flower pots and toys.

3 Things I Bet You Didn’t Know You Shouldn’t Do

1. Don’t Drink Beer (around mosquitos)-Drinking beer makes you more attractive to mosquitos. Researchers believe the pests are attracted to odor and breath changes caused by alcohol.
2. Don’t Swat Wildly-Everyone does it, but studies show this can actually double the number of mosquitos attracted to you.
3. Don’t Forget Your Deodorant-Mosquitoes are attracted to stinky bacteria on your skin.

Keep Reading for More Prevention Information

For personal protection:
COVER your skin with:

• CLOTHING - If you must be outside when mosquitoes are active, cover up. Wear shoes, socks, long pants and long sleeves.
• REPELLENT - Apply mosquito repellent to bare skin and clothing. Repellents with 10-30% DEET, picaridin, oil of lemon eucalyptus, or IR3535 are all effective and recommended by the CDC, EPA, and WHO. Look at the label when purchasing repellent to be sure the one you purchase has at least one of those four ingredients, and always use repellents according to the label.
• Use mosquito netting to protect children younger than 2 months old.
• Keep mosquitoes out of your house by repairing broken screening on windows, doors, porches, and patios.
• Turn on outdoor fans when you are outside in your yard, mosquitoes are not very strong fliers and have a hard time biting you if there is wind.
• Beer consumption increases human attractiveness to mosquitoes, so be aware of this risk
• Resist swatting wildly when insects start hovering, studies indicate this action can double the number of mosquitoes attracted to you.

To reduce mosquito breeding:
Be aware that some mosquitos can breed in very small amounts of water (the amount in the top of a soda bottle or inside a bromeliad plant) therefore: DRAIN standing water (Eliminate as many sources of standing water from areas you are responsible for as possible to decrease mosquito populations):

• Drain water from garbage cans, buckets, pool covers, coolers, toys, flowerpots or any other containers where sprinkler or rainwater has collected.
• Flip over, or cover, or store, or remove equipment such as buckets, barrels, wheelbarrows, traps, and any other containers to prevent standing water.
• Remove discarded tires or keep them dry and under cover.
• Fill in ruts and other areas that collect standing water (this includes holes in trees in your yard).
• Protect boats and vehicles from rain with tarps that don't accumulate water.
• Change the water every 4 to 5 days in animal drinking troughs, birdbaths, and other water containers or add a few drops of organic, enzymatic, bio-catalytic agents, or food-grade diatomaceous earth, or starch.
• Change water in bottom of plant containers, including hanging plants, at least once a week.
• Place drain holes in containers that collect water and cannot be discarded.
• Clean out rain gutters.
• Fix dripping outdoor faucets or pipes that create pools of water.
• Fix air conditioner drain outlets.

Scrub the sides of water containers to dislodge eggs.
Add an aerator to ponds and water gardens to keep the water circulating, or add fish e.g. fathead minnow (Pimephales promelas) that will eat mosquito larvae or adults.
Remove debris (leaves, twigs, trash) from ditches.
Maintain swimming pools in good condition and appropriately chlorinated. Empty plastic swimming pools when not in use.
Keep grass cut short and shrubbery trimmed to eliminate hiding places for adult mosquitos.
Cultivate dragonfly or damselfly populations to eat mosquitos.
Create areas in your yard with plants that repel mosquitos (citrosa plants, citronella grass, scented geraniums, lemon thyme, common marigold, tomato, eucalyptus, sweet basil, sassafras).
Consider applying the bacterium Bacillus thuringiensis israelensis; which eats mosquito larvae on your lawn.
Constantly monitor for new larval habitats.