Fighting a Deadly Dengue Fever Outbreak in Honduras

Honduras 2013 © Natacha Buhler/MSF

An epidemic of hemorrhagic dengue fever is spreading through San Pedro Sula, Honduras’s second largest city, with more than three times as many cases as last year. This form of dengue can be deadly, with children most at risk.

Doctors Without Borders/Médecins Sans Frontières (MSF) teams have launched an emergency response to bring down the number of children dying from the mosquito-borne disease by providing support to health authorities in the main public hospital in northeastern Honduras.

Three out of every four patients treated at the hospital, including the most severe cases, are children.  

“The epidemic represents a great threat to the population,” said MSF Medical Coordinator Dr. Luis Neira. “Since we started to work here, we’ve seen a constant flow of patients. We are focusing on providing emergency assistance to children under 15 years of age.”

The number of suspected cases of hemorrhagic dengue fever reported in the region in August 2013 was up 235 percent over the previous year. Local health authorities were overwhelmed, prompting MSF to launch its response.

“I came from Azacualpa, four hours’ drive away, as my granddaughter was sick,” said one woman named Mariana. “She had been sick for a few days, but the local health center couldn’t treat her.” Mariana’s granddaughter, who has dengue with medical complications, was transferred to the intensive care unit set up by the MSF team in the Mario Catarino Rivas public hospital in San Pedro Sula.

Endemic in Central America, dengue is a viral disease spread by mosquitoes, with symptoms like those of flu. However, this relatively mild form of the disease can develop into hemorrhagic dengue, which can cause bleeding, irreversible shock, and sometimes death.

In Honduras, there are four different types of dengue. “The four types circulate,” said Dr. Neira, “with the risks of infection particularly high during the rainy season, from May to November, when the mosquito responsible for spreading the disease proliferates.”

There is no specific treatment for dengue fever, but early diagnosis and appropriate care can drastically decrease the death rate. However, getting diagnosed and treated in time can be a challenge, as health care in Honduras is in a state of crisis, with medical supplies and qualified staff in short supply. ”The problem is that many people face multiple barriers in accessing timely and adequate treatment,” Dr. Neira said.

An MSF team has trained medical staff in health centers around the city of San Pedro Sula to detect cases of dengue early and to refer sufferers to the hospital promptly, while also ensuring that all children under 15 are able to access medication and treatment free of charge at the Mario Catarino Rivas public hospital.

The team has set up a dengue unit in three of the hospital’s children’s wards, with MSF medical staff supporting and training hospital health staff. In the two months since starting work there, the MSF team has treated more than 560 children in the hospital’s emergency unit, one quarter of them under the age of five.

“We’ve also donated drugs and medical supplies to the hospital for the treatment of adults affected by dengue,” said Dr. Neira. MSF continues to monitor the outbreak in case an increased response is required.
In addition to its emergency response to the dengue epidemic, MSF works in the Honduran capital, Tegucigalpa, addressing the medical consequences of violence in some of the city’s most violent neighborhoods. MSF has been working in Central America for more than 25 years, responding to natural disasters, emergencies and other medical and humanitarian crises.

The health centre El Carrizal is one the four health centres supported by MSF in Tegucigalpa. It is located in one of the most dangerous neighbourhood of the city and it tends to be deserted as both staff and patients fear being robbed, kidnapped or killed going there.
Honduras 2013 © Natacha Buhler/MSF