Serena del Mar Hospital, committed to the fight against dengue

August 26th is commemorated as ‘International Dengue Day,’ a date that aims to raise awareness and inform the public about how to prevent the transmission of the dengue virus and thus contribute to reducing cases. Dengue is an endemic infection in the tropics, especially in the hottest and most humid regions located below 1981 meters in altitude, as these areas allow for temperatures above 30°C and a humid climate that favors the development of the life cycle of the Aedes aegypti and Aedes albopictus mosquitoes, which are the vectors that transmit the infection through their bite. In 2023 alone, in cities like Cartagena, according to the Department of Health (DADIS), cases increased by 114%, exceeding 1700 cases.

Dengue Fever

According to the World Health Organization, dengue fever is a disease that affects people of all ages, with symptoms ranging from mild to debilitating fever, accompanied by intense headache, pain behind the eyes, muscle and joint pain, and erythema. The disease can progress to severe forms, characterized primarily by shock, respiratory distress, and/or severe organ damage.

What is El Niño?

According to Dr. Emiro Buendía, an internist at Serena del Mar Hospital and a PhD in Biomedical Sciences, El Niño is a climatic pattern that repeats every two to seven years and sometimes impacts very specific regions, although at other times it can affect the planet's climate as a whole.

“In South America, the El Niño phenomenon is characterized by increased rainfall and flooding on the coasts of Peru and Ecuador, while on the other hand, there is a decrease in rainfall in parts of Brazil and the Caribbean, where Colombia is located. This is also associated with an increase in temperatures of approximately 1.5°C to 1.7°C, higher than usual,” the specialist stated.

To understand the importance of this change in the climate pattern, Buendía indicated that when these changes occur, there is an increase in the transmission of some diseases, such as dengue fever, and a decrease in the production of agricultural goods and in fishing.

Precedents of the El Niño phenomenon

The last time the El Niño phenomenon occurred was seven years ago, in 2016, impacting Colombia. However, many climate agencies, especially the U.S. Climate Change Agency, predict that this time the El Niño phenomenon will be more prolonged, given that these studies allow for predictions a year in advance.

“What is being anticipated is that in 2024, and very possibly in 2025, we will have a fairly prolonged El Niño phenomenon. This is worrying because, as we know, it favors the transmission of many diseases that have an impact on public health, such as dengue, chikungunya, and Zika,” added Dr. Buendía.

El Niño phenomenon and vector-borne diseases.

According to Dr. Emiro Buendía, the El Niño phenomenon increases temperatures and decreases rainfall in the Colombian Caribbean region, favoring the life cycle of the mosquito that transmits dengue.

“We know that the dengue vector is the Aedes aegypti mosquito, and its life cycle is favored by temperatures between 32° and 35°C. This mosquito generally takes about twelve days to complete its entire life cycle at a temperature of 30°C; however, at temperatures between 32° and 35°C, that life cycle shortens to seven days, making the mosquitoes smaller, hungrier, and more prone to biting,” explained the specialist from the Serena del Mar Hospital.

In addition, Buendía indicated that another factor impacting dengue transmission is the decrease in rainfall, which leads many people to store water in open areas, thus favoring the mosquito's life cycle.

“This mosquito prefers clear water. Since there is less rain and people don't have access to water, they store it improperly, which encourages a higher mosquito population and, consequently, increases transmission,” he added.

Relationship between El Niño and Arboviruses

Several studies suggest a relationship between El Niño periods and dengue transmissibility. An article published in 2022 by Dr. Eder Cano Pérez, from Dr. Doris Gómez Camargo's research group at the University of Cartagena, analyzed case reports from the National Epidemiological Surveillance System (SIVIGILA) along with temperature and humidity data. The study found that dengue transmission increased during the hottest and driest months of the year.

“There is an association between the occurrence of El Niño and dengue transmission. It is evident.”

It has been shown that, in cities like Cartagena, in the months when it rains less and the temperature is higher, there are many more cases of dengue. “This is important because if we know that this is going to happen, as a society and also as healthcare providers, we have to be prepared for what we know is coming,” stated Dr. Emiro Buendía.

Dengue Mitigation Strategies

According to Dr. Buendía, there are several mitigation strategies. Some are related to vector control, such as fumigation and raising community awareness about properly storing water for domestic use, using lids and preventing water from accumulating. Other vector mitigation strategies are more sophisticated, but one that is currently generating a lot of discussion. These include releasing mosquitoes infected with a special bacterium called Wolbachia into the environment so they can infect other mosquitoes, thus controlling the vector.

“There are some studies conducted, for example, in Brazil, that show that when these types of interventions are used, there is a decrease of up to 70% in dengue transmissibility.” The use of mosquitoes carrying the Wolbachia bacteria is not yet common practice in all countries, but it is one of the newest and most effective methods that will set the standard in public health in the coming years,” the specialist emphasized.

Likewise, according to Buendía, a drought with high temperatures is expected in December 2023, and January, February, and March 2024, which indicates increased dengue transmission. Therefore, healthcare providers must be prepared to identify cases and properly classify them, distinguishing between mild cases that can be sent home and more severe cases requiring hospitalization.

How is the Serena del Mar Hospital preparing?

The Serena del Mar Hospital is prepared for this public health event. It already has trained medical and paramedical personnel, as well as nursing staff, to identify suspected dengue cases at the triage stage, providing them with priority care and early classification. Patients whose clinical condition is complicated are hospitalized and receive much more specialized and targeted treatment.

“At Hospital Serena del Mar, we are constantly training our staff in the application of and adherence to management guidelines. We recently conducted a literature review and published a paper on fluid management in dengue, so in this way we are reaching out to the community to have a positive impact on what is to come,” Dr. Emiro Buendía pointed out.

Writing a new chapter in healthcare in Cartagena and Colombia, Hospital Serena del Mar offers comprehensive services to provide exceptional healthcare to residents and visitors alike.