DENGUE fever, still on the rise throughout the country, may have claimed its first victim in the country since 1999, and Costa Ricans are increasingly voicing complaints about what they say is the inefficiency of health authorities in handling the situation.Christian Rodríguez, 24, died Saturday at Monseñor Sanabria Hospital, in the Pacific port city of Puntarenas, dengue unit nurse Adrián López told The Tico Times.While initial press reports indicated that hemorrhagic dengue – a more severe form of the viral disease transmitted by infected female aedes aegypti mosquitoes (TT, Aug. 19) – was the apparent cause of death, health authorities say they are waiting for the results of an autopsy to confirm whether he died of hemorrhagic dengue or of leptospirosis, a rat-borne disease that causes similar symptoms to dengue and is transmitted by spirochaete bacteria.Rodríguez, a Puntarenas waiter who left behind a pregnant wife and eight-year old daughter, fell ill with a fever and diarrhea Aug. 15. At first, he thought it was a common cold, López said.RODRÍGUEZ’S death on Saturday appears to have induced his grandmother’s death as well: Juanita Véliz, 73, suffered a heart attack after hearing the news of her grandson’s death, according to the daily Al Día.The victims’ family members, who buried their loved ones on Monday, are considering filing a complaint against the Social Security System (Caja) for allegedly neglecting Rodríguez while he was hospitalized, according to the daily Al Día.“We are very hurt and do not have the spirit to think of fighting right now, but we cannot allow other families to suffer what we have lived through because of the negligence with which they treated our nephew,” Vilma Véliz, Rodríguez’s aunt, told the daily.Rodríguez’s brother, Marco, said that if anyone had been observing his brother the night before his death, they would have given him a blood transfusion in time, but his brother “was abandoned.”HOWEVER, hospital officials claim Monseñor Sanabria met its responsibility to the deceased patient, and the family’s complaints are driven by grief.“As an authority you must reject them (their comments). They were generated in the heat of the loss of their loved one,” said Dr. Rafael Gamboa, Monseñor Sanabria’s assistant director. “The hospital is responsible for each patient it takes in; we give them the best attention possible.”According to Gamboa, leptospirosis, the other possible cause of Rodríguez’s death, is transmitted through rat excrement and treated with antibiotics.Teresita Solano, chief of the epidemiological vigilance unit of the Public Health Ministry, said the cause of death will not be confirmed until the forensic lab emits its results, which are expected anytime within the next two to three weeks.THE last two reported deaths in Costa Rica from hemorrhagic dengue occurred in 1999. The disease, present in the country as an epidemic since 1993, has no known cure (TT, July 15).More than 15,533 cases of dengue fever and 23 cases of hemorrhagic dengue have been reported in Costa Rica since January, an increase of approximately 200% compared to the same period in 2004, when, by mid-August, more than 4,800 classic dengue and 8 hemorrhagic dengue cases had emerged nationwide.This week, concerned citizen Antonio Salas filed an request for an injunction against President Abel Pacheco and Public Health Minister Rocío Sáenz before the Constitutional Chamber of the Supreme Court (Sala IV), citing the government’s “inefficiency in combating dengue” as his grounds, according to the daily Al Día.Salas and his lawyer, Antonio Solano, told the daily they are worried that Costa Rica will be catalogued as an “unhealthy destination” on an international level, and that tourism might decrease as a result of the dengue cases.TOURISM authorities say the dengue outbreaks have in no way affected tourism in Costa Rica so far.While the Costa Rican Tourism Institute (ICT) has not compiled statistics linking the dengue outburst to the rate of tourist visits to the country, according to spokesman Alvaro Villalobos, representatives of regional tourism chambers throughout the country agree that the number of tourists does not appear to have declined in their respective areas.According to Marco Botti of the Cahuita Regional Chamber of Tourism, in the Caribbean province of Limón, tourism there appears unaffected by news of the disease, and continues to flow in its usual numbers.Kattia Palacios, from the Regional Chamber of Tourism in Puntarenas – one of the areas hardest hit by the disease – said she attributes any drop in tourism in the area to the fact that the May- November tourism low season is underway. When the high season begins, any decline because of the disease might become perceptible, she added.Health authorities recommend emptying standing water inside and outside homes, which can become mosquito breeding grounds, and using mosquito repellent to avoid contracting the disease (TT, Aug. 19).