Monday 7th May 2012
A ProMED-mail post
<http://www.promedmail.org>

- Cook Islands. 4 May 2012. 3 cases of dengue fever have been confirmed on Rarotonga in the Cook Islands and while public health officials expect more victims, they are asking people to be alert but not alarmed. All the confirmed cases emanate from Rarotonga so far, but because the 3 infected individuals come from different parts of the island officials expect more cases will surface. The Cook Islands News reports the latest cases of the mosquito-borne [virus] disease are the 1st to be recorded in the Cook Islands since 2009.
<http://www.rnzi.com/pages/news.php?op=read&id=67953>
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[A HealthMap/ProMED-mail interactive map showing the location of the Cook Islands can be accessed at <http://healthmap.org/r/2jQL>. - ProMed Mod.TY]
Date: Thu 16 Apr 2009
Source: China View [edited]
<http://news.xinhuanet.com/english/2009-04/16/content_11192941.htm>

Cook Islands has recorded 170 cases of suspected dengue fever over the last 3 weeks, the Cook Islands News reported on Thursday [16 Apr 2009]. Cook Islands Ministry of Health this week said 13 people have been admitted to hospital showing symptoms of the mosquito-borne disease [virus] with results expected to be received from Australia this week confirming the presence of a new outbreak in Rarotonga. The ministry said that no evidence has suggested the infection has reached the outer islands.

A national clean up campaign was undertaken last week with environmental risk assessments and actions completed for all probable cases. Many empty cans, bottles and plastic bags were disposed of immediately, the daily said. Residences of the 170 probable dengue cases were identified. This week, the public health team has assessed known natural and man-made habitats which include the Rarotonga Airport, seaport and other high risk areas with appropriate action completed.

The public is urged to take preventative measures and to control the spread of infection to keep the community safe. This is through the clearing of mosquito breading areas and removing containers and other water filled objects on their properties as well as using personal protection measures like insect repellents. The public health team will continue to do surveillance and to monitor the situation and raise awareness.
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[A map showing the Cook Islands and their location in the south Pacific can be accessed at <http://www.worldatlas.com/webimage/countrys/oceania/ck.htm>. - ProMed Mod.TY]
Date: Wed 8 Apr 2009
Source: Radio New Zealand [edited]
<http://www.rnzi.com/pages/news.php?op=read&amp;amp;id=45825>

More than 60 people have contracted dengue [virus] type 1 in Rarotonga in the Cook Islands since late February [2009].  The Cook Islands secretary for health, Dr Roro Daniel, says the 9 people that have been hospitalized are all in a stable condition. "It has been traced back to somebody who has come from outside the country. The number of cases is slow; we see around 2 cases a day; some of them are admitted, but some of them are sent home on oral treatment."  Dr Roro Daniel says health officials are running awareness campaigns and are encouraging people to destroy all mosquito breeding sites, such as water containers.
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[A map showing the Cook Islands and their location in the south Pacific can be accessed at <http://www.worldatlas.com/webimage/countrys/oceania/ck.htm>. - ProMed Mod.TY]
Date: 14 May 2007 Source: Radio New Zealand International - Wellington, New Zealand [edited] Health officials in the Cook Islands are confident that an outbreak of dengue, which has affected over 700 people, is on the decline. A medical officer, Dr. Henry Tikaka, says health officials are confident the worst is over. "For the month of April [2007], [there] has been a dramatic fall in [the] number of cases. We can see that [the] cases [at] the moment are really sporadic cases, so we really hope that the trend will go right down and then disappear completely." Heavy rain in the region since the beginning of the year [2007] has increased the number of mosquito breeding grounds and is thought to be the main reason for the increase in the infection rate. ------------------------------- [The approximately 700 dengue cases represent a relatively high proportion of the 21 388 (July 2006 estimate) population of the Cook Islands. A map of the Cook Islands can be accessed at: . The WHO (World Health Organization) describes dengue fever as a severe, flu-like illness that affects infants, young children, and adults but is seldom fatal. The clinical features of dengue fever vary according to the age of the patient. Infants and young children may have a non-specific febrile illness with rash (although some infants and very young children may develop shock syndrome, with sudden loss of circulating fluid volume, and die). Older children and adults may have either a mild febrile syndrome or the classical incapacitating disease, with abrupt onset and high fever, severe headache, pain behind the eyes, muscle and joint pains, and rash. Dengue hemorrhagic fever [DHF] is a potentially deadly complication that is characterized by high fever, hemorrhagic phenomena -- often with enlargement of the liver -- and in severe cases, circulatory failure. The illness commonly begins with a sudden rise in temperature accompanied by facial flush and other non-specific constitutional symptoms of dengue fever. The fever usually continues for 2 to 7 days and can be as high as 40-41 C (104-105.8 F), possibly with febrile convulsions and hemorrhagic phenomena. In moderate DHF cases, all signs and symptoms abate after the fever subsides. In severe cases, the patient's condition may suddenly deteriorate after a few days of fever; the temperature drops, followed by signs of circulatory failure, and the patient may rapidly go into a critical state of shock and die within 12-24 hours or quickly recover following appropriate volume replacement therapy. There is no specific treatment for dengue fever. However, careful clinical management by experienced physicians and nurses frequently saves the lives of DHF patients. With appropriate intensive supportive therapy, mortality may be reduced to less than one percent. Maintenance of the circulating fluid volume is the central feature of DHF case management. (Abstracted from the WHO website fact sheet on dengue at: ). ProMED-mail thanks the contributors to this update and encourages others to contribute reports also. - ProMed Mods.TY, JW]
Date: 14 Jan 2007 From: Brent Barrett Source: Radio New Zealand [edited] ------------------------------------------------------------ About 460 people have so far been affected by a dengue fever outbreak in the Cook Islands. Dengue fever is transferred by a mosquito, and cases have been reported in Rarotonga, Arorangi and Tupapa since October 2006. The director of clinical services, Dr Henry Tikaka, says officials have adopted a wait and see approach. "It is a cyclical thing. About every 2 years, we have an outbreak of dengue fever, and this one is not different. We are just going through the process of the outbreak. We actually peaked in October [2006]; there has been a falling in the number of cases in December [2006]. In the last couple of weeks, there [has] been an increase in the number of cases. But we will just wait and see what is in for us in January [2007]." Dr Tikaka says a dengue outbreak usually lasts up to 6 months. --------------------------- [A-Lan Banks is thanked for providing an identical report. A map of the Cook Islands can be accessed at: . WHO describes dengue fever as a severe, flu-like illness that affects infants, young children, and adults but is seldom fatal. The clinical features of dengue fever vary according to the age of the patient. Infants and young children may have a non-specific febrile illness with rash (although some infants and very young children may develop shock syndrome, with sudden loss of circulating fluid volume, and die). Older children and adults may have either a mild febrile syndrome or the classical incapacitating disease, with abrupt onset and high fever, severe headache, pain behind the eyes, muscle and joint pains, and rash. Dengue hemorrhagic fever is a potentially deadly complication that is characterized by high fever, hemorrhagic phenomena -- often with enlargement of the liver -- and in severe cases, circulatory failure. The illness commonly begins with a sudden rise in temperature accompanied by facial flush and other non-specific constitutional symptoms of dengue fever. The fever usually continues for 2 to 7 days and can be as high as 40-41 C (104-105.8 F), possibly with febrile convulsions and hemorrhagic phenomena. In moderate DHF cases, all signs and symptoms abate after the fever subsides. In severe cases, the patient's condition may suddenly deteriorate after a few days of fever; the temperature drops, followed by signs of circulatory failure, and the patient may rapidly go into a critical state of shock and die within 12-24 hours or quickly recover following appropriate volume replacement therapy. There is no specific treatment for dengue fever. However, careful clinical management by experienced physicians and nurses frequently saves the lives of DHF patients. With appropriate intensive supportive therapy, mortality may be reduced to less than one percent. Maintenance of the circulating fluid volume is the central feature of DHF case management. (Abstracted from the WHO website fact sheet on dengue: ). ProMED-mail thanks the contributors to this update. - Mod.TY]
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