New guidelines can help health officials better predict and control dengue epidemics

mericana de Salud Pblica/Pan American Journal of Public Health," a scientific and technical periodical published by the Pan American Health Organization (PAHO). The research was conducted by K. John McConnell of the Oregon Health & Science University's Department of Emergency Medicine and Duane J. Gubler of the Division of Vector-Borne Infectious Diseases, National Center for Infectious Diseases, of the Centers for Disease Control and Prevention (CDC).

In developing the guidelines, the researchers chose Puerto Rico as the case study site and, using data on dengue transmission and its likely impacts there, were able to simulate a distribution of economic impacts based on disease rates and economic variables, including the costs of treating patients and the opportunity costs represented by lost wages. "The advantage of using such a mathematical model in this analysis," note the authors, "is that it allows us to ask a number of 'what if' questions without observing their actual implementation in a real-world setting." Drs. McConnell and Gubler used their model to examine a number of different larval-source-reduction scenarios and their associated cost-effectiveness, thereby capturing the range of costs associated with dengue and with larval control programs.

The study also examined how the existence of an early warning system can extend the range of interventions that are cost-effective and are thereby more acceptable to public officials. The authors note: "When no early-warning information is available, a larval control program that costs more than US$ 6.00 per person is not recommended [in the case study in Puerto Rico]. However, with a predicted outbreak, the same campaign is advisable, as long as the intervention can reduce disease rates by 70% or more. More costly programs may be justifiable if they have higher rates of disease reduction."

The researchers caution that "this study does not advocate for emergency vector control in preferenc

Contact: Mara Luisa Clark
Pan American Health Organization

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