title: Dengue among United Nations mission in Haiti personnel, 1995: implications for preventive medicine.
abstract: The incidence of dengue infections has been increasing in the Caribbean, and cases have been identified among successive deployments of multinational peacekeepers to Haiti (1994-1997). In the absence of an effective vaccine or chemoprophylaxis to prevent dengue fever, vector-control operations and use of personal protection measures to prevent arthropod bites are the most effective means of limiting disease transmission. During our 5-month deployment as part of the United Nations Mission in Haiti, 79 cases of recent dengue fever were identified among 249 patients (32%) presenting with febrile illness to the 86th Combat Support Hospital. Further investigation revealed low unit readiness to perform standard vector-control activities and poor individual adherence to measures to prevent arthropod bites. Command enforcement of existing field preventive medicine doctrine is essential to prevent casualties caused by dengue, other arthropod-borne infections, and nuisance arthropod bites during military deployments.
authors.affiliation: Division of Preventive Medicine, Walter Reed Army Institute of Research, Washington, DC 20307-5100, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Gambel
authors.forename: J J
authors.initials: JJ
authors.lastname: Drabick
authors.forename: M A
authors.initials: MA
authors.lastname: Swalko
authors.forename: E A
authors.initials: EA
authors.lastname: Henchal
authors.forename: C A
authors.initials: CA
authors.lastname: Rossi
authors.forename: L
authors.initials: L
authors.lastname: Martinez-Lopez
mesh_terms: D003715:Dengue / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D006205:Haiti; D006801:Humans; D008887:Military Medicine / Q000379:methods*; D008889:Military Personnel / Q000706:statistics & numerical data*; D020380:Needs Assessment; D011322:Primary Prevention / Q000379:methods*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States