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Cluster of cases in the city with no ties to international travel indicates a migration of the mosquito that carries the parasite
Dengue cases have been identified in Los Angeles in the sprawling city’s first outbreak of the disease with no ties to international travel.
Local health officials have described the outbreak as “unprecedented” in the area, where dengue has not been transmitted by mosquitoes before.
The Los Angeles County Department of Public Health reported three cases to date in Baldwin Park, just a 30 minute drive from Hollywood.
Experts told the Telegraph that there are “certainly” more cases than reported so far given that Los Angeles has no history of surveillance.
“If you aren’t in a country where you’re used to looking out for it, the symptom set of rash, fever, and malaise could easily get missed or just thought non-specific,” said Dr Danny Altmann, a Professor of Immunology at Imperial College London, adding that some cases are asymptomatic.
The most common symptoms of dengue, which is spread by Aedes mosquitoes, are high fever, headache, body aches, nausea and rash.
Severe forms of dengue, also called dengue haemorrhagic fever, are fatal in more than 50 per cent of cases, according to the WHO.
There is no specific treatment for dengue and the focus is on treating symptoms.
Cases are common in tropical and subtropical climates and outbreaks, meaning locally acquired cases are rare in the United States.
Usually dengue is recorded in those who have recently travelled to areas where the disease is endemic.
“This is an unprecedented cluster of locally acquired dengue for a region where dengue has not previously been transmitted by mosquitoes,” said Barbara Ferrer, director of the Los Angeles County Department of Public Health.
Los Angeles County Supervisor Hilda Solis added: “The recent discovery of dengue cases in Baldwin Park underscores the need for vigilance and proactive measures.”
Professor Altmann explained that the cases back up modelling by experts that shows dengue is moving northwards.
“Local dengue cases in LA are the canary in the coalmine indicating that this has truly come,” he said. “Once Aedes have expanded their range, there’s no turning back.”
Globally, the incidence of dengue has grown dramatically in recent decades; the number of cases reported to the WHO increased from 505,430 in 2000 to 5.2 million in 2019.
Experts have linked the rising number of cases to climate change.
Rising temperatures create favourable conditions for the mosquitoes, as they thrive in warm and humid environments.
Southeast Asia, Latin America, and the Caribbean have seen sharp rises in dengue cases, and now previously unaffected areas in Europe and North America are reporting outbreaks.
Since the start of the summer, Italy has recorded 25 locally acquired dengue cases – 23 of these in the last week alone.
Most cases are linked to the Marche region in northeastern Italy, marking the first recorded local outbreak there.
The outbreak involves a more serious type of the disease – known as dengue serotype 2 – which has been associated with more serious illness.
“It has to be taken seriously. While case numbers are low, we need to take a longer term perspective; this may change,” said Professor Alain Kohl, Chair in Virology at the London School of Hygiene and Tropical medicine.
“We – decision makers as well scientific and medical communities – need to be thinking about how we can best protect ourselves, and ensure that health systems are resilient for the future.”
Professor Altmann warned that the cases recorded in LA could be a warning of things to come.
Aedes mosquitoes also carry diseases including Zika, Chikungunya and Yellow Fever – all serious and potentially fatal viruses.
He said: “If dengue is being transmitted locally, there’s no reason why the others can’t be.”
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