A. Situation analysis
Description of the disaster
On 5 July 2019, the Dominican Republic's Ministry of Public Health (MSP) issued an epidemiological alert due to a sustained increase in dengue cases in the country. This report indicated that between Epidemiological Weeks (EW) 1 and 23 2019, 2,921 (probable and confirmed) cases of dengue were reported in the Dominican Republic, for a cumulative incidence (CI) of 63.76 cases per 100,000 inhabitants, five times higher than reported in the same period of the previous year (CI = 11.75/100,000 inhabitants). Among the provinces with the highest CI are Barahona (337.1), Independencia (335.9), Monte Cristi (215.2), Peravia (177.4) and San José de Ocoa (164.5).
The number of dengue cases increased from 5,548 cases reported in Epidemiological Week (EW) 29 to 8,855 during EW 33 (August 11-17) 4 . This increase showed a peak of the outbreak and highlighted the need for a response. In addition, a significant increase was observed compared to 711 reported cases in EW 33 of 2018. The predominant serotypes identified during this Dengue outbreak were D1 and D3, and the presence of four serotypes in the Dominican Republic increased the risk of serious cases.
The MSP’s Epidemiological Bulletin for EW 42 (October 13 to 19) showed that between EW 1 and 42, 15,326 (probable and confirmed) cases were reported, of which 34 resulted in deaths (0.2% mortality). By that date, the greatest number of cases was registered in the provinces of National District, Gran Santo Domingo and San José de Ocoa. This data correlates with the multiple environmental, geographical and educational features that resulted in the significant reproduction of arboviruses in these areas.
By the end of this emergency operation, and despite the challenges encountered, the health situation in the provinces affected by dengue improved and the level of risk decreased substantially, favouring the communities of the three affected provinces where the Dominican Red Cross implemented measures to raise awareness, prevention and elimination of mosquito breeding sites. The number of weekly reported cases decreased starting on EW 42 (the actions of the Dominican Red Cross had already been implemented). Cases decreased from 492 during EW 42 2019 to 229 during EW 7 20205 (end of operation and response).