Dengue among United Nations mission in Haiti personnel, 1995: implications for preventive medicine.
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.
Gambel
J M
JM
Division of Preventive Medicine, Walter Reed Army Institute of Research, Washington, DC 20307-5100, USA.
Drabick
J J
JJ
Swalko
M A
MA
Henchal
E A
EA
Rossi
C A
CA
Martinez-Lopez
L
L
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