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Volume 18, Number 4—April 2012

Policy Review

Lessons Learned during Dengue Outbreaks in the United States, 2001–2011

Amesh A. AdaljaComments to Author , Tara Kirk Sell, Nidhi Bouri, and Crystal Franco
Author affiliations: University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

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Lessons learned during US dengue outbreaks, 2001–2011*

Location, year Lessons learned
Hawaii, 2001 Populations are not completely homogeneous, and messages should be tailored to specific locales.
Tourism concerns must be balanced with public health response.
Community engagement activities are palatable to the public when nonpunitive, actionable initiatives are undertaken by public health agencies.
A communication study validates the community engagement approach, with substantial numbers of residents aware of the outbreak and those taking actions performing the correct action.
A lack of in-state testing capacity delays confirmation of the outbreak.
Although the Aedes albopictus mosquito is a competent vector, its involvement may limit this outbreak in a rural Hawaii setting, especially with prompt outbreak control efforts.
Brownsville, Texas, 2005 Nearby foci of endemicity make dengue a continual threat, including the possibility of dengue hemorrhagic fever.
Involving CDC/BIDS facilitates fast identification of the index case.
Pre-outbreak awareness of and preparation for the potential threat of dengue enhances the ability to respond to an actual outbreak.
Florida, 2009–2011 An aggressive multimodal campaign engages the public.
Door-to-door vector control activities are essential; the ability to inspect property without homeowner permission improves coverage.
Clear communication with tourism officials diminishes the possibility of opposing viewpoints.

*CDC, Centers for Disease Control and Prevention; BIDS, Border Infectious Disease Surveillance.

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