Five of eighteen patients recently referred to CAREC’s laboratories for diagnosis of dengue fever were confirmed as having DEN-3 virus infections by the Polymerase Chain Reaction [PCR] method. Two of these five infections were also confirmed as DEN-3 through virus isolation techniques. Additionally, another five patients were confirmed as having dengue fever on the basis of positive IgM serology.

These confirmations represent the first identification of indigenous dengue virus type 3 in Dominica. To date, this specific virus type has been identified in Belize [1997]; Puerto Rico [1998]; St. Christopher and Nevis [1998]; Jamaica [1998]; French Guyane [1999]; Martinique [1999] and Aruba [1999]. While imported infections were first notified from Barbados in 1998, local transmission of DEN-3 was, however, confirmed during 1999.

The introduction of this new virus type into countries, whose populations may have already been exposed to virus types 1, 2 and 4, increases the potential for the occurrence of dengue haemorrhagic fever [DHF] and shock syndrome [DSS].

Physicians should maintain a high index of suspicion, where suspected cases of dengue fever are concerned, in order to facilitate the early detection and timely and appropriate clinical management of cases of DHF/DSS.

Against this background, our member countries are once again being reminded of the need for the following, as they represent important facets in any dengue control strategy:

CAREC’s Epidemiology Division has just been notified by the Inter-Regional Epidemiology Cluster [CIRE] of the French National Institute for Public Health Surveillance [InVS] of the confirmation of dengue virus type 3 infection in three patients residing in the French part of Saint Martin. This also represents the first identification of this virus type on that island.

Please feel free to call us for any further information that you may require at 868-622-2152.

If there are any questions regarding specimen collection, storage and shipment, please direct these to CAREC’s Laboratories at 868-622-4262, extension 216.

Finally, you can also refer to the section on dengue fever in your Caribbean Communicable Disease Surveillance Manual for Action, for additional information.