Dengue fever and Yemen Outbreaks September 2015


Aedes mosquito

A recent increase in dengue fever activity has become an serious outbreak concern in Yemen. A country that has been suffering from civil unrest and conflict, collapsed medical infrastructure and is now suffering from “an extreme spike” in dengue fever cases according to the World Health Organization (WHO) in August, 2015 means that the only winners in Yemen right now are the mosquitoes.

The epicenter of this Yemeni Dengue outbreak is the city of Taiz, located in central Yemen. The city of Taiz is on the civil war frontlines, in the middle of the conflict between the Houthi rebels from the north and the Saudi-backed fighters loyal to the exiled president Abbdu Mansour. The WHO reports 1,243 cases thus far in 2015 but on-ground intelligence estimates the number of actual cases to be almost 10 times higher.

Dengue Fever Basics

Dengue is a viral illness spread through the bite of infected mosquitoes (Aedes Aegypti). Typically a mild to moderate illness with flu-like symptoms of fever, malaise and myalgia (muscle aches), severe cases can have hemorrhagic manifestations and progress into Dengue Hemorrhagic Fever (DHF). Approx 75% of cases are asymptomatic.

Causative Agent: Dengue viruses are in the Flavavirus group and have four distinct sero-types numbered DENV-1, 2, 3 and 4. All types can cause DHF.

Prevention: Insect bite prevention with DEET and Permethrin treated clothing, bed nets and screens; destruction of mosquito breeding grounds (standing water) and control of insect vectors

Treatment: Supportive; fever control, rehydration, pain control and  blood/blood products as needed for severe cases


Looking at why the Dengue outbreak has become so severe will also show more about the damage that has been done to the country of Yemen with all the recent unrest. Dengue is spread through mosquitoes. Mosquitoes like to breed and incubate in standing water. Yemen is a country that has had its infrastructure destroyed and running water in homes is rare. Access to clean water is limited. Garbage collection services are non-existent. People are storing water in makeshift containers and water is collecting in tires, pots, canisters and cups left out as trash. This makes for a prime breeding ground to increase mosquito numbers.

Combining this increase in mosquito numbers with a loss of almost half of the medical services in the country means conditions are perfect for this outbreak. While death from Dengue or DHF is rare (approx 1%), good medical care is required to have these good outcomes.

For more information on Dengue:

Dengue in Yemen:

Thanks for including my posts!

I am currently in Arizona on a job hunt and have had little time between interviews and meeting for any decent new posts.  Fortunately, a few of my articles have been published on other websites!

I want to thank Matador Travel for publishing an article about travelers and bedbugs.  These nasty insects are making a comeback and really do not care how much you paid for your hotel room.  This article looks at methods to deal with them on your travels.

Friends over at WorldNomads are also publishing an article about Dengue fever.  Dengue can be a fatal disease, spread through mosquito bites, and is something every traveler to the tropics needs to know about.

Greg and the crew over at also have an article I wrote about medicine for your travel first aid kit.  Common medications, their uses and what to carry are all discussed.  Greg’s new site also looks great and has a load of information for backpacker travel!

US Army declares war on Dengue article covered by Medical News Today discusses the US Army and its attempts to control Dengue Fever, by attacking the mosquito that carries the disease.

Basics: Dengue is also known as “breakbone fever” after the muscular aches and myalgia it causes. An Arbovirus, transmitted by the bite of the Aedes mosquito, Dengue comes in 4 serotypes numbered 1-4. Found worldwide, this single stranded RNA virus is most closely associated with urban transmission. Infection may progress to Dengue Hemorrhagic Fever(DHF) and the risk of DHF increases with each subsequent infection. Typical symptoms include fever, severe muscle aches and fine petechial rash.

Location: Tropics worldwide, more common in urban settings

Transmission/ Incubation: transmitted by A. Aegypti in cities and A. Albopictus in jungles. Incubation is generally 5-10 days.

Prevention: Mosquito and vector control, topical DEET spray and permethrin treated clothing and bed nets.

Diagnosis: Serology/PCR

Treatment: Supportive Care including antipyretics, pain control and IV fluids

Dengue fever is a viral illness that is carried by Aedes mosquitoes. There is no treatment and no vaccine against this disease, nicknamed “breakbone fever” due to the body aches and pains associated with the disease. This infection is found in virtually all tropical countries, around the world and is a major source of mortality, especially in children. Complications of Dengue can include progression to “dengue hemorrhagic shock” where there is massive bleeding.

The Army’s plan is to make use of technology designed by SpringStar Inc, which is basically an innovative mosquito trap. The Aedes mosquito lays it’s eggs in standing water, such as water basins, old tires and virtually anything else that can hold water. The trap takes advantage of the fact that the mosquito likes to lay it’s eggs on the sides of the water, not in the middle. Using this information, a tiny (one millionth of a kilogram) dose of insecticide can be placed in the area where the eggs are to be laid. Thus, killing the mosquito and preventing massive local contamination of harmful “bug poison”.

Annually, Dengue infects 20-50 million people worldwide, with 15-20,000 deaths per year. One estimate also puts 2.5 billion people at risk for infection with Dengue fever. This is also considered the third most important infectious disease that effects US military troops, abroad.

Aedes Aegypti in Portugal

EuroSurveillance had a good article released about the increase in Aedes mosquitoes in Madeira, Portugal. This is of importance beacuse the species of mosquito is known for carrying Dengue Fever and Chikungunya virus. Chickungunya outbreaks were recently seen in Italy.

Portugal is now devoting some research into the effects this will have on the people and reasons for the species of mosquito to be in the area, as well as vector control.


Dengue in the Cayman Islands

There is a pretty good blog that tracks dengue activity in the carribean, over at WoodShedEnvironment. They are looking at the effects of environment and links between increased Dengue activity in the Carribean. Good Stuff!

ProMed is giving a lot of attention to Dengue and the new cases in the Carribean, lately.

However, the comments seem to indicate the cases in the Caymans are acquired in Jamaica or Nicaragua, both areas with known Dengue fever. Perhaps the virus hasn;t made it to the Caymans, yet. The Aedes mosquito is there, to carry the virus. Hopefully, the cases in the Caymans were acquired elsewhere, meaning the island is still safe. We’ll see…

Adventure Doc Dengue Fever Page

Dengue Updates

The good people at ProMed Mail has just sent out some new info on Dengue activity. For the “hard core” out there, you can get all the info form the above link. Here’s a brief summary on where they are saying the problems are:

Martinique, Carribean
Still in the apparent midst of their Dengue epidemic, the island nation of 430,000 people have a total of 6,400 suspected cases, this year. A few fatalities due to Dengue Hemorrhagic Fever (DHF) have also been reported.

A total of 80 confirmed cases here, with most of them being in Belize City or Corozal District. The government is encouraging citizens to help decrease the mosquito population by eliminating standing water and potential breeding sites.

Costa Rica
24,000 new cases, this year. Puntarenas and Limon seem to be the host spots, in the country. Also, there are 250 reported cases of DHF.

80,000 new cases this year with the provinces of Dong Thap, Tien Giang, and An Giang leading the number of reports.

Karachi, Pakistan
After being a little shy about sharing information on new cases, Karachi hospitals have started talking. 534 new cases this year and a bit of a problem with correct diagnosis, it seems. There is some speculation of under-reporting the number of new cases due to problems with their testing methods.

If all this bug and infection talk got you interested, check out more on Dengue Fever over at: Adventure Doc Dengue Page