Dengue among United Nations Mission in Haiti Personnel, 1995: Implications for Preventive Medicine
Jeffrey M. Gambela, Joseph J. Drabickb, Michael A. Swalkoc, Erik A. Henchald, Cynthia A. Rossid, Lester E. Martinez-Lopeze
- aDivision of Preventive Medicine, Walter Reed Army Institute of Research, Washington, DC 20307-5100
- bDivision of Communicable Diseases and Immunology, Walter Reed Army Institute of Research, Washington, DC 20307-5100
- c61st Preventive Medicine Detachment, U.S. Army Medical Research Institute for Infectious Diseases, Fort Detrick, Frederick, MD 21702
- dDiagnostic Systems Division, U.S. Army Medical Research Institute for Infectious Diseases, Fort Detrick, Frederick, MD 21702
- e86th Combat Support Hospital, Fort Campbell, KY 42223
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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.