Abstract
In October 2012, the Haitian Ministry of Health and the US CDC were notified of 25 recent dengue cases, confirmed by rapid diagnostic tests (RDTs), among non-governmental organization (NGO) workers. We conducted a serosurvey among NGO workers in Léogane and Port-au-Prince to determine the extent of and risk factors for dengue virus infection. Of the total 776 staff from targeted NGOs in Léogane and Port-au-Prince, 173 (22%; 52 expatriates and 121 Haitians) participated. Anti-dengue virus (DENV) IgM antibody was detected in 8 (15%) expatriates and 9 (7%) Haitians, and DENV non-structural protein 1 in one expatriate. Anti-DENV IgG antibody was detected in 162 (94%) participants (79% of expatriates; 100% of Haitians), and confirmed by microneutralization testing as DENV-specific in 17/34 (50%) expatriates and 42/42 (100%) Haitians. Of 254 pupae collected from 68 containers, 65% were Aedes aegypti; 27% were Ae. albopictus. Few NGO workers reported undertaking mosquito-avoidance action. Our findings underscore the risk of dengue in expatriate workers in Haiti and Haitians themselves.
Highlights
Dengue is the most common mosquito-borne viral disease in the world, and resulted in an estimated 390 million infections and 96 million symptomatic cases throughout the tropics and subtropics in 2010 [1,2]
A 2007 study in Port-au-Prince showed that 65% of children,5 years of age had evidence of prior infection with a DENV [12], and a two-year prospective study in an outpatient clinic in Leogane found that 2% of patients presenting with undifferentiated fever tested positive for DENV infection by a rapid diagnostic test (RDT) [13]
Of 885 patients with acute febrile illness who were admitted to four hospitals in Haiti during 2012–2013, 4% tested positive for DENV infection by RDT [14]
Summary
Dengue is the most common mosquito-borne viral disease in the world, and resulted in an estimated 390 million infections and 96 million symptomatic cases throughout the tropics and subtropics in 2010 [1,2]. The incidence and the severity of dengue have increased in the Americas, including the Caribbean [3,4], where the four dengue virus-types (DENV-1–4) that cause dengue and the mosquitoes (i.e., Aedes aegypti and Ae. albopictus) that transmit DENV are endemic [1,5,6,7]. Despite an absence of routine systematic surveillance data, dengue is likely endemic in Haiti, as it is in the Dominican Republic, which shares the island of Hispaniola with Haiti. Both Ae. aegypti and Ae. albopictus have been detected in Haiti, as have all four dengue virus-types [10,11]. Of 885 patients with acute febrile illness who were admitted to four hospitals in Haiti during 2012–2013, 4% tested positive for DENV infection by RDT [14]
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