Dengue outbreak could presumably occur – Well being and Way of life

By Henrylito D. Tacio

While the country is struggling to contain Coronavirus Disease 2019 (COVID-19), Filipinos shouldn’t forget that there are other major diseases that should not be ignored.

It is the rainy season in the Philippines and water-borne diseases like dengue fever are most likely to recur. Last year the government declared a national dengue epidemic as dengue cases rose to more than 420,000 and 1,500 deaths nationwide.

“We don’t want to wait for it,” Davao councilor Mary Joselle Villafuerte told Edge Davao. She reported that the city had 2,500 cases and nine deaths in October last year. “We want this program to run up to the barangay level.”

Villafuerte, chairman of the 19th city council’s health committee, referred to the mosquito-borne disease prevention and control program in Davao. She proposed a resolution to adopt a regulation strengthening and institutionalizing the program.

“With the rainy season in the country again, we have to step up the four-way campaign against dengue fever,” said a health official.

The campaign relates to: “Finding and destroying” mosquito breeding grounds, “Safe self-protection measures” such as wearing long sleeves and mosquito repellants, “Early advice” for fever or flu-like symptoms and “Saying no” “to prevent indiscriminate fogging, unless it is necessary.

Dengue fever warning sign

Dengue fever mainly affects children, although adults are not spared. When six-year-old Cassie was taken to a municipal hospital in Bansalan, Davao del Sur, she was very weak. She complained of headache and an occasional high-grade fever that lasted for three consecutive days. The attending doctor believed the girl had some kind of flu.

On the third day of her detention, Cassie complained of stomach ache. She vomited every now and then. She developed measles-like rashes on his hands. The doctor became suspicious. On the fourth day of admission to the hospital, the doctor counted the patient’s blood. It was up at 8:30 a.m. and went down at 5 p.m.

The doctor became more alarmed when Cassie became restless and complained of chest pain and difficulty breathing. Even more so, when blood oozed from her nose and streaks of blood were found in her saliva.

It was ten at night when the doctor referred the patient to Digos City, where there are hospitals that are better equipped for such cases. The trip took about 30 minutes. After blood transfusions and intravenous fluids, Cassie began to feel better. Nine days later the little girl was back at her house. Her siblings greeted her with big hugs.

Cassie was lucky. Not too many children survived such an ordeal.

“The incidence of dengue fever has risen dramatically worldwide in the last few decades,” reports the Geneva-based World Health Organization (WHO). “The actual number of dengue cases is not adequately reported and many cases are misclassified.”

Facts about dengue fever

Before 1970, only nine countries had experienced severe dengue epidemics. The disease is now endemic in more than 100 countries, with Southeast Asia and the western Pacific being among the hardest hit. According to the WHO, 50 to 100 million dengue infections can occur worldwide each year.

Dengue fever occurs worldwide in tropical and subtropical climates, mainly in urban and semi-urban areas. “Dengue fever is the most important mosquito-borne viral disease in the world,” explains Dr. Duane Gubler, health administrator for the US Centers for Disease Control and Prevention. “The mosquitoes get infected when they feed on someone who has the virus.”

There are actually two types of dengue fever: dengue fever and severe dengue fever. The latter, also known as dengue hemorrhagic fever (DHF), was first recognized in the Philippines during the dengue epidemics in the 1950s. “Today, severe dengue fever affects most of Asian and Latin American countries and has become a leading cause of hospitalizations and child deaths in these regions,” reports the WHO.

Dengue fever is characterized by a high fever, severe headache, pain behind the eyes, and muscle and joint pain. Many people, including doctors, confuse dengue fever with influenza and flu-like illnesses. As a result, it is often left untreated until symptoms become severe and the patient goes into shock.

It happens when DHF occurs. “There is often a rash in dengue fever while there is none in the flu,” said Dr. Allan Schapira, an epidemiologist who was with the WHO regional office when he was interviewed by this author. “Fever from dengue usually lasts nearly a week, while that of the flu goes away in three to five days.”

Dengue patient (photo courtesy Dr. Richard Mata)

After a dengue patient is in shock, it is usually a matter of time before multiple organ failure occurs and death becomes inevitable. This terrible scenario is characterized by a high persistent fever (40-41 degrees) lasting up to seven days, which can be accompanied by loss of appetite, nausea, vomiting, abdominal pain and bleeding from the skin, nose or gums.

In the worst case, after a few days with a fever, patients may suddenly worsen and die within 24 hours. “Death often results from bleeding in the brain, intestines or other organs,” said Dr. Lulu Bravo, Professor at the University of the Philippines College of Medicine.

An ounce of prevention is better than a pound of cure, as a popular saying goes. “Prevention is critical,” said Dr. Bravo. “If we don’t take concerted action now to educate our people, dengue will continue to take its toll in the country.” – ###

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