The good, the bad and the ugly about dengue

TAYAG photo by Charles E. Buban

First, the good news: The number of patients diagnosed with dengue since January is 33.5 percent lower compared to the same period last year. Even the number of those who died from the most common mosquito-borne viral disease in humans is also 50 percent lower.

The bad news?

“Well, 45,333 is 45,333 (as of Aug. 6 figures) infected individuals and despite the significant reduction in the number of deaths, it is still 267 individuals we could have saved,” Health Assistant Secretary Eric Tayag says during the “Pinoy Laban sa Dengue: United to Fight and Prevent” symposium.

Tayag, who is also the director of the Department of Health’s National Epidemiology Center, says what’s more depressing is that majority of these infections and deaths are happening in children 1 year to 10 years old.

“As a result, we have seen a serious problem of overcrowding in a number of hospitals in Metro Manila and in some parts of the Philippines, with emergency beds put up in the lobbies to accommodate these very young patients,” Tayag reports.

Hotspots

Aside from Metro Manila, other hotspots now being observed are in several towns in the provinces of Ilocos Sur, La Union, Pampanga, Bataan and Pangasinan (an area is considered a hotspot when there are clustering of cases with increasing number in two consecutive weeks).

“Dengue fever is spread mainly by the bite of a female Aedes aegypti mosquito. There’s no cure yet for dengue but we can prevent it by maintaining cleanliness in our surroundings, searching and destroying all possible mosquito breeding grounds,” urges Lyndon Lee Suy of the DOH Emerging and Reemerging Infectious Diseases program manager.

While Tayag and Lee Suy report that a vaccine, developed by French-based vaccines provider sanofi-pasteur to prevent dengue, is on its final stage of testing, the vaccine will not be available until 2014.

“We are looking forward to the eventual public distribution of the world’s first vaccine that could effectively fight the four strains of dengue but until then, we should continue to trust the current strategy,” Tayag advises.

4S

LEE SUY photo by Charles E. Buban

The strategy refers to the 4S, with emphasis on search and destroy of possible mosquito breeding grounds as well as to seek early consultation. We also discourage self-medication because a more severe infection, known as dengue hemorrhagic fever, which is caused by the same virus, can be fatal if not detected at an early stage,” Lee Suy reminds.

Other component of the 4S are implementing self-protective measures (like using mosquito nets) and to say no to indiscriminate fogging. Fogging is only recommended  in case of a confirmed outbreak because of the possibility of mosquitoes becoming immune to the chemicals used.

“Fogging should only be done if there is an outbreak. In areas where dengue hotspots were noted (a hotspot is just one step away from an outbreak), there should be dengue express lanes in hospitals. Similarly, if there is a clustering of dengue cases, the search and destroy strategy in mosquito breeding sites should be continued,” Tayag says.

No reactions

Dr. Maria Rosario Zeta-Capeding, head of the Dengue Study Group that supervises the dengue vaccine clinical trial being done in San Pablo, Laguna and Guadalupe, Cebu reports that so far, the close to 3,000 children 2 to 14 years old involved in the test are experiencing no vaccine-related health problems.

For the trial, each child will receive three shots, with the second injection administered six months after the first.

“We will continue to monitor the children for the next three years through regular health checkups,” informs Capeding, who is also head of the Research Institute on Tropical Medicine’s Department of Microbiology.

The RITM and its counterpart in Cebu—the CYD Dengue Vaccine Project-Cebu—handle the testing of the vaccine in the two communities.

“While we wait for the vaccine to become available, we should realize that one of the reasons the number of cases continue to rise is the fact that the 4S is not fully implemented and Filipinos still have the lack of knowledge about the symptoms of dengue fever. As a result, the people feel panicky whenever they suffer from any fever and in some cases die without proper and immediate treatment,” Tayag says.

While high fever could be a symptom of so many other ailments, parents and household members should also watch out for the development of rashes, vomiting, stomach pains, nose bleeding and difficulty in breathing. Even a low platelet count is not a reliable manifestation of dengue infection, so patients should be closely monitored by a doctor.