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Tahiti Prepares As WHO Declares Pacific Dengue Pandemic

Friday: September 19, 2008

(Tahitipresse)

The French Polynesia Health Ministry has issued vigilance alert to residents and visitors arriving in Tahiti from other Pacific Islands as the World Health Organization declares a dengue pandemic in the region.

Tahiti's public health officials noted that the serotype 4 dengue involved in the current outbreak in the region was last detected in French Polynesia in major epidemic numbers in 2001. More than 33,000 people were diagnosed with the mosquito-borne fever seven years ago, causing the death of eight children.

The World Health Organization (WHO) today in Fiji declared a dengue pandemic in the Pacific region, calling for a coordinated regional response to the situation as thousands of cases of the virus have been confirmed and the number continues to rise, Radio Australia reported.

"There's more than 1,600 (people), and those are the reported cases," Dr. Kevin Palmer, the WHO's Pacific representative based in Fiji, told Radio New Zealand International. "So if you multiply that number by five, you get 5- to 6,000 people. This certainly has a major impact on the work force, on the health system.

"Dengue is really the pandemic disease of the Pacific and we need to do something about it, invest the similar kind of money that was put into bird flu and put that back into dengue," Dr. Palmer said. So far, however, there have been no reports of the potential deadly bird flu virus in the South Pacific.

There is no vaccine and no cure for the dengue, which has the potential of becoming a deadly hemorrhagic virus. However, on a worldwide basis, more than 500 million people are infected yearly with malaria, compared with "just" 50 million people for dengue, according to Olivia Judson, an evolutionary biologist who is a research fellow in biology at Imperial College in London.

"As diseases go, it's (the dengue's) not terribly dangerous either: the death rate from dengue hemorrhagic fever is around 2.5 percent," she wrote on Sept. 9 in her New York Times Op-Ed blog, The Wild Side.

Describing the dengue as "on the rise . . . an up-and-coming virus,” Judson proposes using genetic engineering of mosquitoes "as a way to stop the spread of the dengue fever."

The dengue, which is not contagious, is passed from person to person through the bite of a virus-carrying Aedes aegypti mosquito, which bites only during the day. But there is no cross immunization, so someone who has had the Type 1 dengue is not immune from the Type 4 version.

The Health Ministry in Tahiti reported a continued "stable" dengue situation through the end of August in French Polynesia with only 150 confirmed cases since Jan. 1 and 12 cases during August. Only the much milder Type 1 form of the dengue has been detected in French Polynesia, requiring the hospitalization of only three people. One was a child under five years of age; the second was a child under 10 and the third was an adult over the age of 80.

What concerns public and private health officials in Tahiti is the potential threat of a Type 4 dengue epidemic for some 155,000 people in French Polynesia should the more lethal version arrive for the first time since 2001. The people threatened are those who never had the Type 4 dengue so, therefore, have not become immune.

The more lethal version could arrive in Tahiti from tourists or returning residents after visits to the current Pacific Islands with known type 4 dengue cases. Kiribati, Samoa, American Samoa and the Cook Islands have reported Type 4 dengue cases. The only one of those islands that Tahiti has a direct link with is the Cook Islands. Air Tahiti operates regular weekly flights between Rarotonga and Papeete.

The Cook Islands has reported only one Type 4 case of dengue fever that was imported by a passenger from elsewhere, according to Tahiti's health ministry.

The most recent period of a dengue epidemic in French Polynesia was in 2006/2007 when more than 2,000 confirmed cases of the Type 1 fever were detected, the health ministry said. The situation has remained "relatively calm" in French Polynesia since the end of 2007, according to the ministry.

The latest official statistics through Aug. 31 show that since Jan. 1 there were 110 Type 1 dengue cases on the island of Tahiti, or 73% of the 150 confirmed cases throughout French Polynesia. In the Leeward Islands, Raiatea had 17 cases, Bora Bora had seven cases and Taha'a had three cases. Tahiti's sister island of Moorea had one case and the Tuamotu atoll of Fakarava had one case. Five cases were considered indeterminate.

New Caledonia is reported to have had 990 Type 1 dengue cases so far this year, according to media reports from Nouméa.

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