Health@Heart
The War on Dengue
Let’s ‘bite’ back!
Dengue has been grabbing headlines in various publications in Asia, particularly in the Philippines the past few days. In Mabolo, Cebu, a 4-year-old girl was the latest fatality as of August 9, 2005, raising the toll to 19 this year. Since 2 days before this, 35 new cases of Dengue have been reported, making the total cases 704. Sixty-seven of the 80 barangays have been affected, with Guadalupe at the top, with 121 cases and one death, 65 cases occurring in Sitio Banawa. This translates to about 15 new case a day.
The Philippine National Epidemiological Center reported in the latter part of 2003 that nationwide, there were 7,541 cases of dengue fever (with 80 deaths) from January 1, 2003 to August 17, 2003, an increase of 6.6% compared to the same period in 2002. Metro Manila had the highest (1262), followed by Central Visayas (944), Southern Visayas (862) and Northern Mindanao (834).
In our CDN column September 22, 2003, entitled “Dengue Epidemic in 2004?” we echoed the statement of Dr. Socorro Enter, Region 7 coordinator of the dengue program, who made that “prediction.” A little more than a year later, as of July 26, 2005 to be exact, there were 1298 cases of Dengue with 26 fatalities. Cebu was third highest in the country, following region 10 and 6. Compared to the same period last year, there were 537 cases (59% less), with 8 (70% less) deaths.
In 1981, Cuba had a large outbreak of this disease affecting more than 100,000 children and adults (with shock syndrome), 158 of whom died. In the Philippines, the 1997 first outbreak of dengue nationwide has been reported to have reached 13,024, with 236 fatalities, as of September 14, 1998.
What is Dengue Fever?
Dengue Fever is a severe, potentially fatal, hemorrhagic febrile disease caused by dengue viruses, which are carried and transmitted by the female, day-biting, Aedes aegytpti mosquito, the same mosquito responsible for Yellow Fever. Dengue was first reported in Australia in 1897.
How does one catch this disease?
One catches Dengue through the bite of a female Aedes aegypti mosquito. It is not transmitted directly from person to person. The vector (carrier) mosquitos inhabit and rapidly breed in stagnant pools of water or in tanks of drinking or bath water in the backyard of homes, which makes the situation more dangerous. They do not thrive in dirty contaminated water as some may think. The disease is more widespread during the rainy season. Forty percent of the world population, or about 2.5 billion people, live in areas where Dengue is endemic. Each year, more than 50 million Dengue cases are reported.
What are the symptoms of Dengue Fever?
In areas where Dengue is found, any abrupt onset of fever (38-40 degrees) 2 to 7 days duration must be suspected as Dengue till proven otherwise. More specifically, there will be (but do NOT wait for these before seeing a physician) skin rash, malaise, pain behind the eyes, headache, joint and bone pains, anorexia, vomiting, nose and/or gum bleeding, easy bruising, coffee-ground loose stools, and cough. This may be followed, after 2 to 5 days, by rapid deterioration in the patient’s condition and collapse.
What can be done to prevent Dengue Fever?
Eliminate the breeding sites and the mosquitos will be gone. No mosquitoes, no virus. No virus, no Dengue. Pure and simple. So, the most prudent strategy is to eliminate all possible breeding places of mosquitos around us, like pools of stagnant water (in tanks for drinking or bathing, pools of water in the ground, in discarded auto tires, bottle, coconut husks, plastic container, etc.) Tanks of drinking or bath water must be covered, and mosquito nets used where needed. DEET (N,N-diethylmetatoluamide) mosquito repellent and/or Katol are helpful. In addition to DEET, US health authorities are recommending two more safe repellents: picaridin and oil of lemon eucalyptus. A study in Cebu showed Permethin-coated curtains are also effective in repelling mosquitos. The chemicals used for fumigation (fogging) have potential health hazards. Vaccines for the prevention of the different types of dengue fever are not available.
The elimination of Dengue is the responsibility of each and every citizen in every sitio, barangay and town in the country. The Department of Health, its regional centers and allied agencies are impotent without the people’s help. To rely on these agencies alone, without doing our share, will be a costly mistake. The only hope we have to stamp out Dengue is to eliminate the mosquitos ourselves. Each community must wage an all-out war against the harbinger of this deadly disease. This can be accomplished by an aggressive community action, led by barangay leaders and with the help of each and every member of the community, to eliminate all the breeding sites of mosquitos in their midst. This is the only effective strategy: “bite” back and wipe out this potentially fatal infection, to which no one is immune, and for which there is no cure.
Too many lives have already been lost. Let’s not wait for a fatality within our own family before we start cleaning our own backyard.
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