Experts from the UN Pan American Health Organization (PAHO) are working with Paraguayan authorities to help control the outbreak that has affected a number of communities throughout the country and raised concerns among its neighbours. There is currently no vaccine or cure for dengue, which causes high fever, muscular pain, headaches, vomiting and, in some cases, skin rash. In mid-January, Paraguay declared an epidemiological alert as new cases of dengue began to emerge and on 20 January the first two deaths of the year from dengue hemorrhagic fever were reported. By 5 February, 2,967 cases had been reported as well as 18 cases of dengue haemorrhagic fever, including three deaths. Health officials noted that in several of the affected areas, the number of cases so far this year already exceeds the total for 2006. “Our top priority is treating the people who are affected to prevent more deaths,” PAHO regional advisor on dengue José Luis San Martín said. PAHO has sent a team of experts to Paraguay to provide technical assistance in areas including medical treatment, social communication and health services organization. Health authorities in Paraguay, Argentina, Brazil and Bolivia have all stepped up prevention in border area, including intensified surveillance and control measures. “Paraguay has a comprehensive strategy for preventing and controlling dengue and has the ability to respond in an integrated way to this increase in cases,” Dr. San Martín said, noting that the country had responded effectively to outbreaks in 2006. Data from 2006 combined with current reports and the presence of the weather phenomenon El Niño, which can increase mosquito infestations, suggest that “2007 will be a difficult and complex year for responding to dengue,” he added. “The situation in the region really goes beyond the health sector and requires the active participation of other sectors and actors as well.” Ongoing cooperation between Paraguay and its neighbours includes the establishment of border commissions and the dissemination of outbreak information through established regional and sub-regional networks. Dengue is carried by the Aedes Aegypti mosquito, which flourishes in areas with poor sanitation and under conditions of high rainfall. “Citizens can play a fundamental role by keeping their homes free of breeding places for the Aedes Aegypti mosquito,” Dr. San Martín said. The UN World Health Organization (WHO) estimates that more than 2.5 billion people worldwide are at risk of dengue. Although the disease is a greater threat in Asia and some countries of the Pacific region, it is becoming a growing priority in the Americas. Prevention focuses on raising public awareness of how the disease is transmitted and getting people to use of mosquito repellent and to eliminate breeding sites such as water storage barrels, potted plants, pet bowls or any uncovered water container. PAHO, established in 1902, is the world’s oldest public health organization and serves as WHO’s regional office. 13 February 2007The entire Latin America region needs to take preventive measures to prepare for what promises to be a “difficult year” for dengue fever following an outbreak of the mosquito-borne infection in Paraguay, United Nations health officials have warned.