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St. Croix Schools Hit in 2012 Dengue Outbreak

Twenty percent of students and 17 percent of staff tested at seven St. Croix schools were found to have dengue during the three months that preceded a December 2012 study, the Health Department announced Thursday in a press release.

Results of the study showed that 40 of 202 students and 20 of 118 staff members were determined to have suffered from dengue, the press release indicated.

Four students tested positive for two of four dengue virus types, DENV-1 and DENV-4, indicating they were infected when they were tested, the Centers for Disease Control said in its report. The other dengue virus types are DENV-2 and DENV-3.

“This investigation suggested that schools were part of a larger islandwide dengue outbreak that might not have been identified without school reporting because only a low proportion of suspected cases were reported to the Health Department,” CDC epidemiologist Dr. George Han indicated in the report.

Han noted that while dengue is endemic to the region and that reporting of suspected cases to the Health Department had improved, reliable baseline case counts were unavailable for comparison.

Efforts to learn more about the investigation were unsuccessful. Health Department spokesman Eunice Bedminster said Health Commissioner Darice Plaskett would answer questions but three calls the phone number provided by Bedminster throughout Thursday afternoon were met with a recording that said, “mailbox not initialized: cannot accept messages.” The Health Department’s telephone operator referred calls to the same number.

The Health Department called in the CDC after a school nurse reported in November 2012 that an increased number of students and staff were suffering from dengue fever.

Plaskett said in the press release that the investigation showed that the Aedes aegypti mosquito, which transmits the dengue virus, was found in all but one of 10 schools in St. Croix that were evaluated for the presence of mosquitos.

Han, who led the team of epidemiologists during the investigation, said they also looked at data retrospectively that dealt with suspected dengue cases at St. Croix’s Juan F. Luis Hospital. He noted that 194 patients were tested for suspected dengue in 2012 and, of that total, 31 percent were confirmed as positive.

Before the CDC began the investigation, the Health Department staff conducted surveillance at public, private and parochial schools on St. Croix. In some instances, they found windows without screen protection or areas with stagnant water where mosquito eggs, larvae and pupae could grow.

“Residents should undertake practices to reduce mosquito production around dwellings and schools and visitors should take personal protective measures to avoid mosquito bites,” Han said.

Plaskett said the Health Department has taken measures to improve dengue surveillance, reporting and prevention. They include improving the physician reporting form to make it more user-friendly, using mosquito larvicides to treat containers with water that cannot be eliminated in place of fogging, routinely inspecting areas like schools that are prone to have containers that accumulate water and produce mosquitoes, and sponsoring training for healthcare providers to improve the care of patients with dengue.

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