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DPN Vol.61 No.18 Page 3
Laboratory testing is necessary for diag-
nostic confirmation. Viral isolation and
serologic testing are available at TDH.
For viral isolation and/or PCR, collect
serum in a red top tube within the first 5
days of illness and refrigerate for several
hours until clotted. Centrifuge the serum
and then ship it overnight on dry ice.
For serologic testing, draw serum speci-
mens in red top tubes during the acute
phase of illness and submit at ambient
temperature. Convalescent serum
specimens may be required 10 to 14
days after onset to confirm a recent
infection. Mail all specimens with the
appropriate laboratory submission forms
(G-1A or G-1B) to TDH Laboratory, 1100
West 49th Street, Austin, TX 78756. If a
form is not available, include the name
of the patient; address, age and sex;
disease suspected; date of onset; date
of specimen collection; and name and
address of physician. For further
information call 800/252-8239.
Prevention
An estimated 100 million crossings take
place each year along the Texas-Mexico
border between Brownsville and
Laredo.6 Ae. aegypti is found all along
this area. Movement of infected persons
can introduce the virus into dengue-free
areas. Travelers to regions where dengue
is endemic should avoid mosquito bites
by using repellents and protective
clothing and by staying in well-screened
or air-conditioned quarters.7 Residents
of areas where dengue is endemic and
US-Mexico border communities can
reduce the Ae. aegypti population in and
around homes by changing water in
bird baths or flower vases daily, tightly
covering stored water receptacles, and
eliminating old tires, containers, tree
holes, and other potential mosquito
breeding sites.
Following identification of 1999 dengue
cases, the Laredo Health Department
implemented mosquito reduction
activities (eg, aggressive refuse and tire
disposal campaigns and insecticide
fogging). Dengue alerts were sent to
health-care providers, and mosquito
reduction and personal protection infor-
mation was distributed through health
fairs and schools. Information exchange
increased substantially between health
officials from Laredo and Nuevo
Laredo. Although no suspected cases
were reported before the alerts were
issued, sera from 161 suspected dengue
cases were submitted from mid-August
through December 1999; 18 tested
positive for dengue. No cases were
reported from Laredo in 2000.
Several cases of febrile illness suspected
to be dengue were reported in 2000
from all along the Texas-Mexico border.
There is currently a binational study
being done of dengue along the US-
Mexico border.
Recognition of dengue can be improved
through heightened surveillance, profes-
sional and public education, and prompt
reporting of cases by the health-care
providers to local or state health
departments. When a case of dengue is
confirmed in a community, the public
health response should include education
of health-care providers and the public,
intensified surveillance, and enhanced
vector-control activities. Additional infor-
mation about dengue is available on the
World-Wide Web, http: / /www.cdc.gov /
ncidod /dvbid /dengue.htm.
Prepared by W.S. (Chip) Riggins, MD,
MPH, Director, and Army Major Eric
Ollind, Resident, PHR 8; and Tejpratap
Tiwari; MD, Kate Hendricks, MD,
MPH&TM, and Julie Rawlings, MPH,
TDH Infectious Disease Epidemiology
and Surveillance Division.
References
1. Gubler JG. Dengue and dengue hemorrhagic
fever: its history and resurgence as a global pub-
lic health problem. Ind: Gubler DJ, Kuno G, eds.
Dengue and dengue hemorrhagic fever. New
York: Cab International, 1997:1-22.
Continued
An estimated 100
million crossings take
place each year along
the Texas-Mexico
border....
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DPN
Vol. 61 No. 18