A countrywide dengue surveillance and control program is essential in order to reduce response time and minimize morbidity and mortality. Except in those countries where
Aedes aegypti eradication might still be achievable, the program strategy should be changed from one of eradication to one of control that is based on the actions outlined below:
* The distribution of Aedes aegypti must be determined in all regions of a country, especially in the urban areas. The status of
Aedes albopictus, a second very efficient vector already present in the southern border regions of the state of Texas, should also be determined by intensifying surveillance programs to prevent the spread of this potential vector of dengue virus.
* Emphasizing environmental management as the main vector control tool. The prudent use of insecticides should only be undertaken when physical methods are impractical and biological control methods should only be pursued if appropriate. The prudent use of insecticide should include both space spraying for rapid/temporary reduction of infected adult mosquitoes and source reduction for permanent control, plus monitoring vector susceptibility to the insecticides to be used during these periods.
* Continuing to monitor the vector population through appropriate statistical sampling procedures, in order to target control efforts and evaluate control interventions as well as encouraging and incorporating the community's full participation in the design, execution, and evaluation of prevention and control activities.
* Developing a laboratory-based surveillance network within individual countries or among neighboring countries. Viral isolation capability also should be developed where possible.
* Promoting the public health and medical education of health care personnel in the recognition, management, and treatment of dengue and dengue hemorrhagic fever/dengue shock syndrome.