Remarks PAHO Director Dr. Jarbas Barbosa - Press Briefing, 28 March 2024

Washington, DC

Good morning and thank you for joining today's press briefing. I would like to give you an update on the current dengue situation in the Americas.

As of March 26, 2024, the Americas registered over 3.5 million dengue cases, including more than 1,000 deaths. This is a cause for concern, as this is three-times the number of cases reported this time in 2023 – a record year with over 4.5 million cases reported in the region.

The increase in dengue cases is seen in all countries of Latin America and the Caribbean, however three countries in the Southern Cone subregion – Brazil in particular, followed by Paraguay and Argentina – bear the brunt of the current epidemic, accounting for 92% of all cases and 87% of dengue-related deaths.

Dengue generally follows a seasonal pattern, and most transmission in the southern hemisphere occurs in the first half of the year, explaining why the subregion sees an increase in cases at the moment. In the South, the early months of the year correspond to the warmer, rainy season, when we see greater circulation of the main vector of dengue, the Aedes aegypti mosquito.

However, in other countries of the Region, where we only expect high transmission in the second half of the year, such as in Barbados, Costa Rica, Guadeloupe, Guatemala, Martinique, and Mexico, we are also currently seeing an increase in cases.

There are four serotypes of dengue, and the simultaneous circulation of two or more serotypes can increase the risk of epidemics and severe forms of dengue. Twenty-one countries and territories in the Americas have reported the circulation of more than one serotype.

We are also seeing the presence of the mosquito vector and cases in geographical areas where no endemic transmission was previously observed, which means that countries could be ill-prepared to deal with an uptick in transmission.

The Pan American Health Organization maintains a rigorous monitoring of the dengue situation in the Region. In the past 12 months, 9 alerts and epidemiological updates have been issued. These documents have highlighted the increase in dengue cases in the Americas and provided essential guidelines to our Member States for the prevention and control of the disease.

There are several factors that favor the spread of the mosquito and high dengue transmission.

Environmental causes play a key role. Increased temperatures and more frequent extreme weather events, such as heatwaves, intense droughts – which lead people to improperly store water – and storms or floods can increase the circulation of the mosquito vector. The El Nino phenomenon we are currently experiencing may also contribute, as we frequently see peaks of dengue transmission during such years due to weather variations.

But social determinants, such as rapid population growth and unplanned urbanization, can also drive the spread of dengue. Poor housing conditions, insufficient water and sanitary services, and inadequate waste disposal contribute to the spread of Aedes aegypti. In the right temperature and humidity conditions, discarded objects that can store water serve as breeding grounds for mosquitoes.

There are actions we can take to prevent and control dengue transmission and avoid deaths.

Since 2010, PAHO has been supporting countries in the implementation of a comprehensive strategy to control arboviruses, such as dengue, which has helped save thousands of lives.

Our approach includes:

• Strengthened integrated surveillance for all arboviral diseases, including dengue, chikungunya, and Zika.
• Improvement in diagnosis and treatment, with an emphasis on the early detection of warning signs and timely care of patients to avoid serious and fatal complications. Since 2020 alone, PAHO has trained over 360,000 healthcare workers on dengue management through in-person and virtual sessions.
• Implementation of efficient and effective strategies for Aedes aegypti control that prioritize high transmission areas and incorporate new technologies, such as Wolbachia.

In 2023, despite a record increase in cases, the case fatality rate for dengue in the region remained below 0.05%. This is very encouraging, given the spikes in cases we have seen since then.

Nevertheless, PAHO calls on everyone to support efforts to prevent dengue, in particular through these actions:

• Intensify efforts to eliminate Aedes aegypti breeding sites and protect people from their bite, as these are the main measures to prevent the spread of dengue.
• Ministries of Health should prepare health services and healthcare workers for the early diagnosis and timely clinical management of patients with suspected dengue.
• Continue efforts to inform and educate the population so that, upon first symptoms – including abdominal pain, persistent vomiting, drowsiness, restlessness, or bleeding – they seek prompt medical assistance.

Finally: facing the dengue problem is a task for all sectors of society. We must engage communities to succeed in our efforts to control mosquito populations and prevent severe disease and death. Mass media has a key role to play in this endeavor by disseminating disease-prevention messages and recommendations to the population, along with fighting misinformation.

I count on your support and thank you for your attention.