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Dengue Fever and Travel in Panama



It is very unlikely that a traveler visiting Panama, especially Panama City, will catch any tropical diseases. Panama’s last case of yellow fever was thirty years ago. Diseases such as dengue fever, leishmaniasis, and Chagas' disease are primarily seen in poor and/or rural areas of Panama. Howwever,for those wishing to be safe while seeing some of Panama’s natural wonders outside of Panama City a little knowledge and a lot of bug spray would be good things. This article deals with Dengue Fever (Break Bone Fever to GI’s in the South Pacific in WWII.)

Panama

If you didn’t know already, Panama is the land bridge that connects North and South America. It is the site of the Panama Canal connecting Atlantic and Pacific. Panama has much unspoiled natural beauty including tropical rain forests and white sandy beaches on both its Pacific and Caribbean coasts. Panama has a first world infrastructure and is in the midst of an economic boom. Tropical diseases are primarily a problem for those who travel to poor urban areas or the interior of Panama.

Dengue Fever in Panama

A February 2, 2008 issue of La Prensa, Panama reports that two possibly fatal diseases, rickettsia ricketssii and dengue fever are making a comeback in Panama.

La Prensa quotes the chief of the Panama Ministry of Health, Gladys Guerrero, as saying that, “there were no diagnosed cases of dengue in Panama between 1942 and 1993, but that the disease has once again been claiming victims since then. Dengue fever is spread by a mosquito.”

Dr. Guerrero of the Panama Ministry of Health goes on to state that, “Mild dengue fever causes high fever, rash, and muscle and joint pain. More severe forms of the disease, such as dengue hemorrhagic fever and dengue shock syndrome, can additionally cause severe bleeding, a sudden drop in blood pressure (shock) and death.

“No specific treatment for dengue fever exists, and most people recover. Fifty million to 100 million cases of dengue infection occur worldwide each year, most of them in urban areas of tropical and subtropical regions.”

The July 3, 2008 La Prensa reports six new cases of dengue fever in Colon province but no cases of the severe hemorrhagic form of the disease. Health offices were stepping up efforts at fumigation, eliminating piles of trash and standing water sources which are breeding grounds for the Aedes aegypti mosquito which spreads the disease.”

Information for Panama Travelers Regarding Dengue Fever

According to the CDC Yellow Book, “The principal mosquito vector, Ae. aegypti, is most frequently found in or near human habitations and prefers to feed on humans during the daytime. It has two peak periods of biting activity: in the morning for several hours after daybreak and in the late afternoon for several hours before dark. Nevertheless, the mosquito may feed at any time during the day, especially indoors, in shady areas, or when it is overcast. Mosquito breeding sites include artificial water containers such as discarded tires, uncovered water storage barrels, buckets, flower vases or pots, cans, and cisterns.

“Dengue fever is characterized by sudden onset after an incubation period of 3-14 days (most commonly 4-7 days) of high fevers, severe frontal headache, and joint and muscle pain. Many patients have nausea, vomiting, and a maculopapular (red and raised) rash, which appears 3-5 days after onset of fever and can spread from the torso to the arms, legs, and face. The disease is usually self-limited, although convalescence can be prolonged. Most patients report a nonspecific viral syndrome or a flu-like illness.

“No vaccine is available. Travelers [to Panama] should be advised that they can reduce their risk of acquiring dengue by remaining in well-screened or air-conditioned areas when possible, wearing clothing that adequately covers the arms and legs, and applying insect repellent to both skin and clothing. The most effective repellents are those containing N,N-diethylmetatoluamide (DEET).”

Summary

There has been a recurrence Dengue Fever in Panama in recent years. Dengue is passed to humans by the bite of a mosquito. There is no vaccine and treatment of mild cases is symptomatic (Tylenol). Travelers to Panama should purchase and use insect repellent when in areas where there are mosquitoes.

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