Jamaica 2023 dengue outbreak

Jamaica is vulnerable to dengue and outbreaks are unfortunately becoming more common and intense.^1-3 Climate change is believed to be one of the main reasons behind this – dengue is a climate-sensitive disease.³ The dengue outbreak in 2023 followed a record-breaking hot and dry summer and the government swiftly implemented various measures in response.^3,4

Where

• Jamaica: all parishes were affected⁵

The numbers as reported in September 2023

• 3147 infections, 9 deaths³

The contributing causes

• First, there was a drought, which led to an increase in people storing water (often in containers ideal for mosquito breeding). Then came a record-breaking hot summer; high temperatures can speed up the lifecycle of dengue-carrying mosquitoes. Finally, the rain arrived, providing stagnant pools of water ideal for mosquito breeding^3,6

The impact

• Around 72 people per week were being admitted to already burdened hospitals³

• Children aged between five and 14 were most often affected³

  • This may be due to how the dengue virus works. The dengue virus has four strains. This means if you have been infected in the past by one strain, you will be immune to that particular strain but not to the other three strains. The last dengue outbreak to occur in Jamaica (prior to this one) was in 2010 and was caused by a strain called DENV-2. In 2023, the outbreak was again caused by DENV-2, but because most children affected were born after 2010, they had not acquired immunity to this DENV-2 strain^3,7

• The public was urged to donate blood which is needed to help manage less common cases of severe dengue (supplies at the time were not enough to meet the increased demand)⁸

• Emergency departments were under pressure, especially due to the presence of COVID-19 and the flu⁹

The response

Swift action

• Around 500 temporary vector control workers were engaged and deployed across the island to high-risk communities along with 213 permanent workers. An additional 600 temporary workers were engaged to support mosquito breeding site removal and health education activities⁴

  • Government efforts to fight dengue included a fund of nearly $200 million. Part of this fund was specifically used to help rid schools of mosquitoes. Also, $2 million was allocated to each of the 63 constituencies for Members of Parliament to lead a community clean-up campaign¹⁰

  • Breeding site treatment, fumigation, removal of bulky waste and drain-cleaning exercises were conducted across the country⁴

  • Health center opening hours were extended⁴

  • The National Emergency Operations Centre monitored and reported on the outbreak⁴

  • Service fees were waived for children who used the University Hospital of the West Indies⁴

Looking ahead

• The Jamaican government responded strongly, quickly putting many measures in place.⁴ This was recognized by the President of the Nurses Association of Jamaica (NAJ) who was “satisfied” with the government’s response to the outbreak, according to local news outlets¹¹

• However, it was suggested that despite reasonably good knowledge among the public about dengue, over three-quarters of residents did not use effective dengue preventative methods.¹² The reasons for this inaction could be examined

• A comprehensive, coordinated strategy will probably be needed to tackle dengue. Communities have a role to play a role in control efforts, scientists need to develop fresh approaches, and health workers should rely on proven methods