Dengue outbreak may possibly happen

By Henrylito D. Tacio

Even if the country is struggling to contain the coronavirus disease 2019 (COVID-19), Filipinos should not forget that there are still other significant diseases that should not be disregarded.

The rainy season is upon the Philippines and water-borne diseases like dengue are most likely to strike again.  Last year, the government declared a National Dengue Epidemic as dengue cases surged to more than 420,000 and 1,500 deaths nationwide.

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

Villafuerte, the chairperson of the Committee on Health of the 19th City Council, was referring to the Davao City Mosquito-Borne Diseases Prevention and Control Program.  She proposed a resolution to enact an ordinance strengthening and institutionalizing the program.

“Since it’s rainy season again in the country, we need to heighten the ‘4’s’ campaign against dengue,” urged a health official.

The campaign refers to: “search and destroy” the breeding places of mosquitoes, “secure self-protection” measures like wearing of long sleeves and mosquito repellents, “seek early consultation” when having fever or flu-like symptoms, and “saying no” to indiscriminate fogging unless when necessary.

Warning signs of dengue fever

Dengue strikes mostly children although adults are not spared.  When six-year-old Cassie was brought to a town hospital in Bansalan, Davao del Sur, she was very weak.  She complained of headache and an off-and-on high-grade fever, which continued for three consecutive days.  The attending doctor thought the girl was having sort of flu.

On the third day of her confinement, Cassie complained of abdominal pain.  She vomited every now and then.  She developed measles-like rashes in his hands.  The doctor became suspicious.  So, on the fourth day of admission at the hospital, the doctor did platelet count of the patient’s blood.  It was up at 8:30 in the morning and went down by 5 in the afternoon.

The lady physician became more alarmed when Cassie became restless and complained of chest pains and difficulty in breathing. More so when blood started oozing from her nose and blood streaks were found in her saliva.

It was 10 at night when the doctor referred the patient to Digos City, which has hospitals that are more equipped to handle such cases.  The trip took about 30 minutes.  After transfusions of blood and intravenous fluids, Cassie began to feel better.  Nine days after, the little girl was back in her home.  Her siblings welcomed her with big hugs.

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

“The incidence of dengue has grown dramatically around the world in recent decades,” reports the Geneva-based World Health Organization (WHO).  “The actual numbers of dengue cases are underreported and many cases are misclassified.”

Facts about dengue

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 regions as among the most seriously affected.  According to WHO, there may be 50–100 million dengue infections worldwide every year.

Dengue is found in tropical and sub-tropical climates worldwide, mostly in urban and semi-urban areas.  “Dengue is the world’s most important viral disease transmitted by mosquitoes,” declares Dr. Duane Gubler, health administrator of the US Centers for Disease Control and Prevention. “The mosquitoes become infected when they feed on someone who has the virus.”

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

Dengue is characterized by high fever, severe headache, pain behind the eyes, and muscle and joint aches.  Many people, including doctors, mistake dengue for influenza and flu-like diseases, so it often goes untreated until symptoms become severe and the patient goes into shock.

It happens when DHF strikes in.  “There’s often a rash in dengue while there’s none in flu,” explained Dr. Allan Schapira, an epidemiologist who was then with the WHO regional office when interviewed by this author. “Fever caused by dengue tends to last almost a week, while that of flu disappears after three to five days.”

Dengue patient (Photo courtesy of Dr Richard Mata)

After a dengue patient goes into shock, it’s usually a matter of time before multi-organ failure occurs and death become inevitable.  This terrifying scenario is characterized by high continuous fever (40-41 degrees) lasting up to seven days that may be accompanied by loss of appetite, nausea, vomiting, abdominal pain and bleeding from the skin, nose or gums.

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

An ounce of prevention is better than a pound of cure, so goes a popular saying.  “Prevention is crucial,” Dr. Bravo said.  “Unless we take concerted action to educate our people now, dengue will continue to take its toll in the country.” – ###

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