title: Clinician Survey to Determine Knowledge of Dengue and Clinical Management Practices, Texas, 2014.
abstract: Dengue, a mosquito-borne viral disease, is increasingly being identified as a cause of outbreaks in the United States. During July-December 2013, a total of three south Texas counties reported 53 laboratory-confirmed dengue cases; 26 were locally acquired, constituting the largest outbreak in Texas since 2005. Because dengue outbreaks are expected to continue in south Texas and early case identification and timely treatment can reduce mortality, we sought to determine clinicians' knowledge of dengue and its clinical management. A survey was sent to 2,375 south Texas clinicians; 217 (9%) completed the survey. Approximately half of participants demonstrated knowledge needed to identify dengue cases, including symptoms (56%), early indicators of shock (54%), or timing of thrombocytopenia (48%). Fewer than 20% correctly identified all prevention messages, severe dengue warning signs, or circumstances in which a dengue patient should return for care. Knowledge of clinical management was limited; few participants correctly identified scenarios when plasma leakage occurred (10%) or a crystalloid solution was indicated (7%); however, 45% correctly identified when a blood transfusion was indicated. Because of the ongoing threat of dengue, we recommend clinicians in south Texas receive dengue clinical management training.
authors.affiliation: Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
authors.forename: Jessica K
authors.initials: JK
authors.lastname: Adam
authors.affiliation: Texas Department of State Health Services, Harlingen, Texas.
authors.forename: Roman
authors.initials: R
authors.lastname: Abeyta
authors.affiliation: Texas Department of State Health Services, Harlingen, Texas.
authors.forename: Brian
authors.initials: B
authors.lastname: Smith
authors.affiliation: Texas Department of State Health Services, Austin, Texas.
authors.forename: Linda
authors.initials: L
authors.lastname: Gaul
authors.affiliation: Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.|Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
authors.forename: Dana L
authors.initials: DL
authors.lastname: Thomas
authors.affiliation: Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
authors.forename: George
authors.initials: G
authors.lastname: Han
authors.affiliation: Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
authors.forename: Tyler M
authors.initials: TM
authors.lastname: Sharp
authors.affiliation: Division of Global Migration and Quarantine, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Waterman
authors.affiliation: Division of Vector-Borne Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
authors.forename: Kay M
authors.initials: KM
authors.lastname: Tomashek
mesh_terms: D003715:Dengue / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D003716:Dengue Virus / Q000302:isolation & purification; D004196:Disease Outbreaks; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010820:Physicians; D011361:Professional Competence / Q000706:statistics & numerical data*; D019595:Severe Dengue / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D011795:Surveys and Questionnaires; D013781:Texas / Q000453:epidemiology