MSF teams in El Salvador have started for a dengue control project and case management support in the three departments worst-hit by the current dengue epidemic, which has been declared a national emergency.

Although dengue is endemic in El Salvador, an unusually high fatality rate (12%), and a five-fold increase in mosquito numbers, has caused concern that the epidemic will spread. So far 2,800 people have been diagnosed with dengue fever. 280 of these people have haemorrhagic dengue fever, which has already killed 33 people. Most of the fatalities were children.

The MSF project will work alongside teams of entomologists to investigate the aedes vector; the mosquito which spreads the disease.

Meanwhile health workers are being trained to go from house to house, killing mosquitoes with fumigation, using advice from Cuban experts. Instructors will work to stimulate public support for vector control and raise awareness of the benefits of early detection, as well as referral of suspect cases to health centres. In addition, rubbish collection teams will gather old tires and tin cans, which serve as breeding grounds for the mosquitoes.

In addition, MSF expat medical personnel have started assessing case management in local health centres and hospitals.

This type of project is new for MSF but potentially important because dengue in the Americas is considered the most debilitating mosquito-born disease and a high risk factor in public health. Another concern is the potential return of yellow fever which is transmitted by the same vector.