The Rotary Club of Ft Collins has a long association with Dengue Fever prevention and control programs.  One of our former members, Dr. Duane Gubler, is a worldwide expert on Dengue Fever and was the Director of the Division of Vector-Borne Infectious Diseases of the Centers for Disease Control and Prevention until he moved to Hawaii in 2005.  While a member of our club, Dr. Gubler developed and initiated several Dengue Fever prevention and control programs and we have continued these important efforts. 

What is Dengue Fever? Dengue fever and dengue hemorrhagic fever (DHF) are viral diseases transmitted by Aedes mosquitoes, usually Aedes aegypti.  This species of mosquito is most frequently found in or near human habitations and prefers to feed on humans during the daytime.  The mosquito may feed at any time during the day, especially indoors, in shady areas, or when it is overcast.  Mosquito breeding sites include artificial water containers such as discarded tires, uncovered water storage barrels, buckets, flower vases or pots, cans, and cisterns.

Where does the disease occur?  Dengue is found in most tropical and subtropical areas of the world and has become one of the most common diseases of humans, with an estimated 100 million cases per year and more than 2.5 billion people at risk of acquiring the infection.  As of 2005, dengue fever is endemic in most tropical countries of the South Pacific, Asia, the Caribbean, the Americas, and Africa.  The incidence of the severe form of the disease, DHF, has increased dramatically in Southeast Asia, the South Pacific, and the American tropics in the past 25 years, with major epidemics occurring in many countries every 3-5 years. In addition to the millions of cases in endemic countries, cases of dengue fever and DHF are confirmed every year in travelers returning to the United States after visits to tropical and subtropical areas.

What are the symptoms of Dengue?  Infection with the Dengue virus can result in a flu-like illness that is characterized by sudden onset of high fever, severe headache, and joint and muscle pain.  Symptoms usually begin 4-7 days after infection.  Many patients have nausea, vomiting, and a rash, which appears 3-5 days after onset of fever and can spread from the torso to the arms, legs, and face. The disease is usually self-limited, although some people require weeks to recover completely.  Asymptomatic infections are also common.  Approximately 1% of patients with dengue infection progress to a much more serious form called Dengue hemorrhagic fever (DHF), which is characterized by leaky capillaries, hemorrhaging under skin, bleeding from the gums and nose and accumulation of fluid in the chest and abdominal cavities.  Left untreated, the fatality ratio for DHF can be as high as 20% although, with proper clinical management, the mortality rate can be kept below 1%.  There is no specific treatment for Dengue and no vaccine is available. 

How can we prevent epidemics of dengue hemorrhagic fever (DHF)? The emphasis for dengue prevention is on sustainable, community-based, integrated mosquito control.  Given the fact that the mosquitoes tend to reproduce in artificial water containers in and around homes, mosquito control depends a great deal on the participation of the community at large to reduce mosquito habitat.  While insecticides (chemical larvicides and adulticides) also play a role in controlling mosquito numbers, their use should be limited as these chemicals are expensive (many Dengue endemic areas are quite poor) and overuse can lead to resistance.  Preventing epidemic disease therefore requires a coordinated community effort to educate and increase awareness about dengue/DHF, how to recognize it, and how to control the mosquito that transmits it. Residents are responsible for keeping their yards and patios free of sites where mosquitoes breed.

Dengue prevention and control has become one of the key areas of international service for the Rotary Club of Ft. Collins.  We have worked with Rotary clubs in numerous countries and collaborated with the Centers for Disease Control and Prevention as well many local and national health agencies.  To date, we have collaborated on Dengue prevention and control projects in Sri Lanka, Indonesia, the Philippines, Argentina, Australia, Bali, Thailand, Columbia and Guatemala.  The projects we have supported largely focus on these key aspects:

Community participation with collaboration with municipalities and local/national ministries of health, education and other influential organizations

Training of key medical personnel including physicians and nurses

Targeted education in schools, companies and community groups

Broad-based community awareness programs through print, radio and television

Personal visits with homeowners by trained Dengue educators

Community clean-up to reduce mosquito breeding habitat

Targeted spraying with insecticide to reduce mosquito numbers

Equipping local medical facilities to better diagnose, treat and follow up infected individuals

Below are photos that highlight various aspects of these Dengue projects.  These photos were all taken in Gualan, Guatemala where we have established an excellent partnership with the Rotary Club of Gualan in introducing and implementing a broad community based Dengue prevention and control program.

Dr. Edwin Oliva, Rotarian with the Rotary Club of Gualan, addresses community leaders and medical personnel on Dengue prevention and control.


Dengue educators with schoolchildren (left picture) and participating in community awareness campaign (right picture) in Gualan, Guatemala


The left picture is a close-up of the Dengue educational cartoon. The center picture is an educational billboard in the community. In the right picture Chuck Rutenberg (left) and Claude Piché (right) with Dengue educator Ms. Amarilis Salguero in Gualan.  Amarilis is demonstrating some of the educational materials for the Dengue prevention program. 


Community-based clean-up effort to reduce mosquito breeding habitat by removing trash left) and fumigation equipment to help reduce mosquito populations (right).


Dengue educator Ms. Amarilis Salguero during a home visit near Gualan.  Amarilis is discussing Dengue prevention with the owners of the home while they make tortillas.


In the left photo, Gualan Rotarian Dr. Edwin Oliva smiles in front of some of the new equipment. In the right photo, Rotarians Susie Ewing (center) and Claude Piché (right) with Juan Mejia, the Mayor of Gualan, participating in the official opening ceremony of the newly equipped laboratory for the local medical clinic.