Except in those regions 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, especially in the urban areas;
- The status of Aedes albopictus, a second very efficient vector 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;
- 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;
- Determining the important geographical epidemiologic, and socio-demographic risk factors for dengue, and stratifying the infested areas by level of risk, in order to efficiently utilize available resources;
- Utilizing information systems that integrate all pertinent data on the vector, disease, and risk factors: to aid in decision-making, improve the program, and provide future direction for the program; and
- Periodically evaluating the cost-efficiency and effectiveness of prevention and control programs as a basis for adjusting program strategies.