By Giff Johnson, Marshall Islands correspondent
Five months after a dengue fever outbreak started in Majuro, the outbreak is getting worse.
After numbers dropped to less than 10 cases per day after peaking at 30 on 20 November, the government's Cabinet ended a directive that had banned travel to remote outer islands for four months in an effort to contain the problem from spreading.
But since Christmas, the number of dengue fever cases in the capital of the Marshall Islands has been climbing again, with a record 41 cases seen at Majuro hospital on 13 January.
The hospital has been seeing an average of over 20 dengue cases daily for the past three weeks, according to data provided by the Ministry of Health and Human Services.
"People think this is over and it's worse than ever," said Health Secretary Jack Niedenthal.
A total of 162 dengue cases were reported in Majuro this past week - the highest one-week total since the outbreak in Majuro started five months ago, confirming that dengue is not only not on the wane, it is getting worse.
The mosquito-borne illness is hammering the hundreds of local residents getting sick as well as Majuro hospital, sapping resources and energy from the health system that has spent an estimated $2 million to deal with the extended outbreak, according to Mr Niedenthal.
A 2011 dengue outbreak in Majuro peaked and declined after only about three months and 1600 cases. The current outbreak originated on Ebeye Island in July 2019. Ebeye, one small island compared to Majuro Atoll, managed to get the problem under control relatively quickly and has not reported a new case for nearly two months.
Majuro has accounted for the vast majority of the 2073 confirmed and suspected dengue cases through last Wednesday, with 1762 cases identified in Majuro. The end of the travel ban to outer islands has seen three outer atolls report a handful of dengue cases over the past four weeks.
Mr Niedenthal said mosquito prevention needs to ramp up again in Majuro. In August and September, there was a big focus on cleaning and removal of trash to eliminate mosquito-breeding areas in Majuro. But these efforts slowed with the 18 November election and the holidays that followed.
The government's National Disaster Committee met at the end of last week to renew focus on the ongoing dengue outbreak.
"We are gathering all the data to have some serious meetings with a variety of organisations," said Mr Niedenthal. "We need community members, individual home and business owners to take care of their areas."