The dengue fever in El Salvador continues to spread. The death toll so far has reached 30 people (28 children and two adults), indicating a high fatality rate of greater than seven per cent. Campaigns to increase awareness of the disease and its means of spreading have started, but have not been put into place in some of the areas that are most affected.

The high death rate is thought due to the late arrival of many cases to receive care. In addition, effective diagnosis is limited. Dengue fever is characterised by a high fever and a rash. In emergency settings, where diagnostic possibilities are limited, such cases will easily be taken for and treated as malaria.

Convalescence might be prolonged but mortality is rare. Three general hospitals in the capital San Salvador have set up special wards, and are receiving around 60 to 100 suspected cases of dengue fever daily. Most of the registered cases come from San Salvador. However, more and more cases are arriving from the countryside. El Salvador declared an nationwide epidemic on September 14 and epidemiological data indicates the epidemic is far from being under control.

Since January 1, 2,367 cases of dengue have been registered, of which 250 are haemorrhagic fever. MSF is present in the areas most affected by the epidemic and are monitoring the developments there. According to the World Health Organisation (WHO), the mosquito population is five times bigger than usual, which is being aggravated by the rainy season. An intensive campaign against mosquitoes and larvae has been developed recently , mainly in San Salvador.

Unfortunately this programme has not been implemented in the districts of the capital that are most threatened. For years, sanitary issues have been neglected in El Salvador, particularly in the slums. Mosquito nets are rarely used. These areas are often breeding grounds for the carriers. The health authorities, together with WHO, are trying to install an effective epidemiological surveillance system.

An intensive mass media information and education campaign has been developed to promote awareness of the manifestations of the disease and of preventive measures. In addition, a group of health care workers is being trained on diagnosis and treatment. A project proposal is being prepared and will focus on prevention and education at a community level. The project activities will be developed in the Sonsonate, San Vicente and La Paz regions.