Facing the dengue threat
Despite widespread information campaign and vigorous prevention effort by the government, dengue remains a formidable threat in many communities in the country. What was once thought to be a threat to children only has turned out to be a risk among grownu
Dengue is a mosquito-borne viral disease that has rapidly spread in different regions in recent years. The dengue virus is transmitted by female mosquitoes mainly of the species Aedes aegypti and, to a lesser extent, Ae. albopictus. This mosquito also transmits chikungunya, yellow fever and Zika infection.
Dengue is widespread in tropical countries, with local variations in risk influenced by rainfall, temperature and unplanned rapid urbanization. Before 1970, only nine countries in the world had experienced severe dengue epidemics. Today the disease is endemic in more than 100 countries.
Severe dengue (also known as dengue hemorrhagic fever) was first observed in the 1950s during dengue epidemics in the Philippines and Thailand. Today, severe dengue affects most Asian and Latin American countries and has become a leading cause of hospitalization and death among children in these areas. Not only is the number of cases increasing as the disease spreads to new areas, but explosive outbreaks are occurring.
Dengue is caused by four distinct, but closely related, serotypes of the virus. If a person recovers from infection caused by one serotype, he is immune for life against that particular serotype. However, cross-immunity to the other serotypes after recovery is only partial and temporary. Subsequent infections by other serotypes increase the risk of developing severe dengue.
The year 2015 was characterized by large dengue outbreaks worldwide, with the Philippines reporting almost 170,000 cases, more than double the figure in the previous year. A large proportion of the victims are children; about 2.5 percent of the cases results in death.
Symptoms of dengue fever, which usually begin four to six days after infection and last for up to 10 days, may include: sudden high fever, severe headaches, pain behind the eyes, severe joint and muscle pain, fatigue, nausea, vomiting, skin rash (which appears two to five days after the onset of fever), and mild bleeding (such a nose bleed, bleeding gums, or easy bruising).
Sometimes, symptoms can be mistaken for those of the flu or another viral infection. Younger children and people who have never had the infection before tend to have milder cases than older children and adults. However, serious problems can develop, including dengue hemorrhagic fever, a rare complication characterized by high fever, damage to lymph and blood vessels, bleeding from the nose and gums, enlargement of the liver, and failure of the circulatory system. The symptoms may progress to massive bleeding, shock, and death – called dengue shock syndrome.
People with weakened immune systems as well as those with a second or subsequent dengue infection are believed to be at greater risk for developing dengue hemorrhagic fever. A blood test may be conducted to check for the presence of the virus. Those traveling to areas with a dengue outbreak must be very careful and watchful of any symptoms.
There is no specific medicine to treat dengue infection. Anyone who thinks he or she may have dengue fever should avoid medicines with aspirin and, instead, use pain relievers with acetaminophen. Aspirin could worsen bleeding. Moreover, the person should rest, drink plenty of fluids, and see the doctor. If a worsening feeling is observed in the first 24 hours after the fever has gone down, one should get to a hospital immediately to be checked for complications.
The best way to prevent the dengue disease is to prevent bites by infected mosquitoes, particularly if living in or traveling to a place known for mosquito infestation. Efforts must also be taken to keep the mosquito population down.
It’s good news that world’s first ever dengue vaccine is now available in the country, and doctors in several private hospitals are providing the vaccine. The Pediatric Infectious Disease Society of the Philippines announces that the vaccine could be given to any healthy individual aged nine to 45 “unless they are immune-compromised.” Children and adults should visit their doctors first for assessment prior to vaccination.
The Philippines is reportedly the first country in the world to have access to the dengue vaccine, although Mexico was the first to have it licensed for the market. The Food and Drug Administration has approved the distribution of the dengue vaccine in the country since last December. (References: www.who.int, www.webmd.com, www.philstar.com)