Ongoing Dengue Epidemic — Angola, June 2013Posted: June 19, 2013
June 17, 2013 / 62(Early Release);1-4
On April 1, 2013, the Public Health Directorate of Angola announced that six cases of dengue had been reported to the Ministry of Health of Angola (MHA). As of May 31, a total of 517 suspected dengue cases had been reported and tested for dengue with a rapid diagnostic test (RDT). A total of 313 (60.5%) specimens tested positive for dengue, including one from a patient who died. All suspected cases were reported from Luanda Province, except for two from Malanje Province. Confirmatory diagnostic testing of 49 specimens (43 RDT-positive and six RDT-negative) at the CDC Dengue Branch confirmed dengue virus (DENV) infection in 100% of the RDT-positive specimens and 50% of the RDT-negative specimens. Only DENV-1 was detected by molecular diagnostic testing. Phylogenetic analysis indicated this virus has been circulating in the region since at least 1968, strongly suggesting that dengue is endemic in Angola. Health-care professionals throughout Angola should be aware of the ongoing epidemic, the recommended practices for clinical management of dengue patients, and the need to report cases to MHA. Persons in Angola should seek medical care for acute febrile illness to reduce the risk for developing complications. Laboratory-confirmed dengue also has been reported from seven countries on four continents among persons who had recently traveled to Luanda, including 79 persons from Portugal. Angola is the third of four African countries to report a dengue outbreak in 2013. Persons returning from Africa with acute febrile illness should seek medical care, including testing for DENV infection, and suspected cases should be reported to public health authorities.
Luanda, the capital city of Angola, has a population estimated at 5–20 million. No census has been conducted in Angola for several decades, primarily because of civil war during 1975–2002. A large proportion of the residents of Luanda live in densely populated urban slums and tenement housing. Access to health care is limited. Luanda is visited by many international business travelers, primarily because of commerce in oil.
Weak centralized surveillance for illnesses of public health importance has made it difficult for MHA to focus resources on populations in need. Although malaria is the greatest cause of morbidity and mortality in Angola (1), incidence is comparatively low in Luanda (2); however, an increase in malaria cases was detected in Luanda in 2012. Dengue was reported in travelers recently returned from Angola in 1986 and during 1999–2002 (3). Surveys conducted by the National Malaria Control Program during 2010–2012 showed that Aedes aegypti is the only DENV vector in Angola, and is present in all 18 provinces except Moxico.