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Introduction
The Ghana Health Service (GHS) has issued alerts after nine people were confirmed to have contracted dengue fever in the country’s Eastern Region.
In a two-page statement issued on July 14, 2024, the Ghana Health Service’s Director-General, Dr Patrick Kuma-Aboagye, said the National Surveillance System detected “unusual cases of malaria-like illness in some districts of the Eastern Region.”
“These cases were not responding to recommended antimalarial treatment regimens and were, therefore, managed as acute febrile illness,” the Director-General said.
The news about the GHS dengue fever alert has been reported on multiple platforms, as seen here, here, here, and here.
Ghana is not the only country to have recorded an outbreak of dengue fever on the African continent.
Records available at the Africa Center for Disease Control and Prevention (CDC) show that Burkina Faso, Cote D’Ivoire, Cape Verde, Nigeria, and Egypt have reported dengue infections in the past.
However, a report by the Noguchi Memorial Institute for Medical Research has disclosed that dengue in Ghana does not “give rise to large epidemics contrary to what happens in some parts of Africa, Asia, America, or Pacific regions, which is poorly documented.”
Data provided by the Africa Centres for Disease Control and Prevention
What is dengue fever?
According to the World Health Organisation (WHO), Dengue fever, also known as Break-bone fever, is a viral infection common in tropical and subtropical climates that spreads from mosquitoes to people.
“Most people who get dengue will not have symptoms. But for those who do, the most common symptoms are high fever, headache, body aches, nausea, and rash. Most will get better in 1–2 weeks. Some people develop severe dengue and need care in a hospital,” the global health body said.
However, the Mayo Clinic has noted that the “severe form of dengue fever, also called dengue hemorrhagic fever, can cause serious bleeding, a sudden drop in blood pressure (shock) and death.”
In some cases, dengue fever can be fatal; however, the WHO has said one can lower the risk by avoiding mosquito bites during the day.
Common Symptoms of Dengue Fever:
Health experts have said that many people who contract the dengue fever experience no signs or symptoms of the infection. “Most people with dengue have mild or no symptoms and will get better in 1–2 weeks. Rarely can dengue be severe and lead to death,” the World Health Organisation has said.
Regarding the symptoms of the dengue infection, Ghana’s health authority said: “Many people who get dengue will not have symptoms.”
However, the WHO has noted that in some people, symptoms occur between “4 to 10 days after infection and last up to 2 to 7 days.” The common symptoms may include high fever(40oC/140oF), severe headache, pain behind the eyes, muscle and joint aches, nausea, vomiting, swollen glands, and rashes.
Individuals infected for the second time are at a “greater risk of severe dengue.” The symptoms of severe dengue infection are severe abdominal pain, persistent vomiting, rapid breathing, bleeding gums or nose, fatigue, restlessness, blood in vomit or stool, being very thirsty, pale and cold skin, and feeling weak.
Deaths recorded from dengue fever
According to 2020 data released by the World Health Organisation (WHO), 31 deaths caused by the dengue virus were recorded in Africa in 2019 alone. Of these, 20 occurred in Ethiopia, five in Egypt, one in Nigeria, two in Tanzania, one in Zambia, and one in Uganda.
The highest number of deaths recorded from dengue virus was in India in 2019, with 17,546 deaths, the WHO has said. This was followed by 7,938 deaths in Indonesia, 1,429 deaths in Pakistan, 1,060 deaths in the Philippines, and 12 deaths in China.
WHO data on dengue fever deaths in 2019
How does dengue infection spread
The US Centers for Disease Control and Prevention have revealed that there are generally three ways in which dengue spreads to people: through mosquito bites, from pregnant person to fetus, and through other routes.
“Dengue viruses are spread to people through the bites of infected Aedes species mosquitoes (Ae. aegypti or Ae. albopictus). These are the same types of mosquitoes that spread Zika and chikungunya viruses,” the US Center said.
It has been established that these mosquitoes, indoors and outdoors, lay eggs in containers containing water, such as bowls, animal dishes, flowerpots, buckets, and vases.
“Mosquitoes become infected with dengue virus when they bite a person infected with the virus [and] infected mosquitoes can then spread the virus to other people through bites,” the US Center explained.
Similarly, a pregnant person infected with the dengue virus can pass the virus to her fetus “during the pregnancy or around the time of birth.”
Also, the virus has been found in breast milk. However, because of the health benefits of breastfeeding, health officials have recommended that breastfeeding take place even though there is a dengue infection.
The US Centers for Disease Control and Prevention has further stated, “Rarely, dengue is spread in laboratory or healthcare setting exposures through blood transfusions, organ transplants, or needlestick injuries.”
Diagnostics and treatment
The US Centers for Disease Control and Prevention (CDC) has said that patients with suspected dengue infection should receive the appropriate management “without waiting for diagnostic test results.”
“Clinicians should monitor for shock and reduce the risk of complications resulting from increased vascular permeability, plasma leakage, and organ damage,” the US Center said.
However, there is no specific treatment for dengue. The WHO has advised that the focus should be “treating pain symptoms.”
“Most cases of dengue fever can be treated at home with pain medicine. Acetaminophen (paracetamol) is often used to control pain. Non-steroidal anti-inflammatory drugs like ibuprofen and aspirin are avoided as they can increase the risk of bleeding,” the WHO has said.
The Ghana Health Service issued a health alert regarding the outbreak of dengue infection in the Eastern Region.
Prevention of dengue infection
Health experts have noted that no vaccine is available to prevent dengue infection worldwide. However, some best practices can be adopted to protect oneself from mosquito bites.
Individuals have been advised to use insect repellent, wear loose-fitting, long-sleeved shirts and pants, control mosquitoes in and around their homes and neighbourhoods, and remove all objects that have collected water from their homes.
The Ghana Health Service has advised Ghanaians and non-Ghanaian residents to cover all drain water from coolers, drums, buckets, and tanks and ensure that all containers used to collect water should remain covered at all times.
“We urge the population to avoid self-medication and assure all that we will work with our Partners to contain the outbreak and limit the impact,” the Director-General of the Ghana Health Service, Dr Patrick Kuma-Aboagye, said.
Conclusion
Despite the low death rate recorded in Africa from dengue infection, some health authorities have warned about citizens’ total disregard for best practices and preventive measures.
