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Clinician Survey to Determine Knowledge of Dengue and Clinical Management Practices, Texas, 2014
Dengue, a mosquito-borne viral disease, is increasingly being identified as a cause of outbreaks in the United States. During July–December 2013, a total of three south Texas counties reported 53 laboratory-confirmed dengue cases; 26 were locally acquired, constituting the largest outbreak in Texas since 2005. Because dengue outbreaks are expected to continue in south Texas and early case identification and timely treatment can reduce mortality, we sought to determine clinicians' knowledge of dengue and its clinical management. A survey was sent to 2,375 south Texas clinicians; 217 (9%) completed the survey. Approximately half of participants demonstrated knowledge needed to identify dengue cases, including symptoms (56%), early indicators of shock (54%), or timing of thrombocytopenia (48%). Fewer than 20% correctly identified all prevention messages, severe dengue warning signs, or circumstances in which a dengue patient should return for care. Knowledge of clinical management was limited; few participants correctly identified scenarios when plasma leakage occurred (10%) or a crystalloid solution was indicated (7%); however, 45% correctly identified when a blood transfusion was indicated. Because of the ongoing threat of dengue, we recommend clinicians in south Texas receive dengue clinical management training.
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Author Notes
Authors' addresses: Jessica K. Adam and Dana L. Thomas, Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: xdc5@cdc.gov and wii6@cdc.gov. Roman Abeyta and Brian Smith, Texas Department of State Health Services, Harlingen, TX, E-mails: abeyta30@gmail.com and bajatxdoc@att.net. Linda Gaul Texas Department of State Health Services, Austin, TX, E-mail: linda.gaul@dshs.state.tx.us. George Han, Tyler M. Sharp, and Kay M. Tomashek, Dengue Branch, Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico, E-mails: gmh5@cdc.gov, iyp4@cdc.gov, and kay.tomashek@nih.gov. Stephen H. Waterman, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, San Diego, CA, E-mail: shw2@cdc.gov.