An epidemic of haemorrhagic dengue fever is spreading through San Pedro Sula, Honduras’ second city, with more than three times as many cases as last year. This form of dengue can be deadly, with children most at risk. Teams from the international medical organisation Médecins Sans Frontières (MSF) have launched an emergency response to bring down the number of children dying from the mosquito-borne disease. They are providing support to health authorities in the main public hospital in the northeast of Honduras.

“The epidemic represents a great threat to the population,” says MSF medical coordinator Dr Luis Neira. “Since we started to work here, we’ve seen a constant flow of patients. We are focusing on providing emergency assistance to children under 15 years of age.” Three out of every four patients treated at the hospital, including the most severe cases, are children.

In August 2013, the number of suspected cases of haemorrhagic dengue fever reported in the region was up 235 per cent compared to the previous year. Local health authorities were overwhelmed, prompting MSF to launch its response.

“I came from Azacualpa, four hours’ drive away, as my granddaughter was sick,” says Mariana. “She had been sick for a few days, but the local health centre couldn’t treat her.” Mariana’s granddaughter, who has dengue with medical complications, was transferred to the intensive care unit set up by the MSF team in the Mario Catarino Rivas public hospital in San Pedro Sula.

Endemic in Central America, dengue is a viral disease spread by mosquitoes, with flu-like symptoms. However, this relatively mild form of the disease can develop into haemorrhagic dengue, which can cause bleeding, irreversible shock and sometimes death.

In Honduras, there are four different types of dengue. “The four types circulate,” says Dr Neira, “with the risks of infection particularly high during the rainy season, from May to November, when the mosquito responsible for spreading the disease proliferates.”

There is no specific treatment for dengue fever, but early diagnosis and appropriate care can drastically decrease the death rate. However, getting diagnosed and treated in time can be a challenge, as healthcare in Honduras is in a state of crisis, with medical supplies and qualified staff in short supply. ”The problem is that many people face multiple barriers in accessing timely and adequate treatment,” says Dr Neira.

An MSF team has trained medical staff in health centres around the city of San Pedro Sula to detect cases of dengue early and to refer sufferers to hospital promptly, while also ensuring that all children under 15 are able to access medication and treatment, free of charge, at the Mario Catarino Rivas public hospital. The team has set up a dengue unit in three of the hospital’s children’s wards, with MSF medical staff supporting and training hospital health staff. In the two months since starting work there, the MSF team has treated more than 560 children in the hospital’s emergency unit, one-quarter of them under the age of five.

“We’ve also donated drugs and medical supplies to the hospital for the treatment of adults affected by dengue,” says Dr Neira. MSF continues to monitor the outbreak in case an increased response is required.

As well as its emergency response to the dengue epidemic, MSF works in the Honduran capital, Tegucigalpa, addressing the medical consequences of violence in some of the city’s most violent neighbourhoods. MSF has been working in Central America for more than 25 years, responding to natural disasters, emergencies and other medical and humanitarian crises.