Gambel, Drabick, and Martinez-Lopez published the findings of a formal medical surveillance capability stood up during the United Nations Mission in Haiti from June to October 1995 (see attached):
"Febrile illness" included dengue infection; 79 patients were found to be acutely infected. It was later discovered the majority of these patients did not take appropriate anti-mosquito precautions such as use of netting and repellents. Rossi et al (see attached) discovered acute infection with dengue was associated with three serotypes of the virus: DEN-1, -2, and -4. DEN-3 was not believed to be endemic to Haiti at the time. No dengue hemorrhagic fever was identified among personnel.
Four patients were infected with chloroquine-sensitive malaria. Another four patients were found to be acutely infected with hepatitis E. The laboratory had identified several drug-resistant diarrheal pathogens. Sporadic outbreaks of diarrhea were documented among personnel, usually due to inappropriate treatment and maintenance of water supplies.
These findings mirror much of what we have observed in Haiti to-date in responders, where a high percentage of febrile illness in responders has been due to dengue. We have also seen outbreaks of Shigella, Salmonella, and non-specified diarrheal illness among responders. Occasional malaria has been reported. Hepatitis E has not been reported yet, however eventual laboratory-based surveillance may well uncover this.
Download Lab Dx of Dengue Infection in Haiti Among UN Personnel
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