Despite increased fogging activities, the number of dengue cases remains high.
The Ebola outbreak in West Africa has caused much concern among the World Health Organisation (WHO) officials and elicited panicked reaction from governments around the world.
Temperature screening has been enacted in most airports for travellers arriving from countries such as Mali, Liberia and Sierra Leone, among others. Some countries have even gone so far as quarantining those who exhibit symptoms, such as fever, for up to 21 days.
Even here in Malaysia, the Health Ministry has stepped up monitoring at the borders and airports to ensure that Ebola does not get a foothold in the country.
Yet, while we are busy looking for the fly that may possibly get past our nets, the elephant in the room – in this case, dengue – is allowed to run amok.
While Ebola has killed – in gruesome fashion – about 5,000 people so far this year, dengue kills over 20,000 annually.
And in Malaysia, dengue cases have gone up an astounding 200% in a 10-month period from Jan 1 to Oct 25 this year, compared to the corresponding period last year.
The Health Ministry, in a statement, said it had so far recorded 84,682 reported dengue cases this year, up from 28,207 recorded last year.
The dengue death toll now stands at 160, an increase of 167% from the 60 cases recorded in the same period last year.
According to Health Minister Datuk Dr S. Subramaniam, there’s an average of 500 cases of infection reported weekly, though this is a drop from the 3,000 cases a month recorded by hospitals a few months ago.
Global health threat
The virus is transmitted by several species of mosquito within the genus Aedes, principally A. aegypti.
The WHO has warned that dengue has become one of the fastest-growing global health threats, contracted by 50-100 million people each year.
AFP reports Ahmed Jamsheed Mohamed, a doctor in the WHO’s Southeast Asia office as stating: “The increase in dengue incidence and severity of the outbreaks is a global phenomenon, with a 30-fold increase over the past five decades. Eradication is not seen as feasible in the near future.”
Dengue fever is a mosquito-borne tropical disease caused by the dengue virus. The virus is transmitted by several species of mosquito within the genus Aedes, principally A. aegypti.
Symptoms include fever, headache, muscle and joint pains, and a characteristic skin rash that is similar to measles. In a small proportion of cases the disease develops into the life-threatening dengue hemorrhagic fever, resulting in bleeding, low levels of blood platelets and blood plasma leakage, or into dengue shock syndrome, where dangerously low blood pressure occurs.
The rising number of cases this year led the Health Ministry to declare it an epidemic in July, with the authorities fast-tracking campaigns to raise awareness of this scourge while increasing fogging activities.
However, plans to release genetically modified mosquitoes to counter the Aedes threat have been shelved. Deputy Health Minister Datuk Seri Dr Hilmi Yahaya said the project had been put on hold due to the high cost and doubts over its efficacy.
The new breed of male Aedes aegypti was developed by the British company Oxitec, which has also proposed releasing the GM mosquito in four states in Malaysia at a cost of RM100 million. The mutant male mosquitoes are expected to breed with females, and the offspring have a much shorter life. Only female Aedes mosquitoes spread the virus.
New strain of virus
According to reports, the current outbreak is attributed in part to a more virulent strain called DEN-2. It is one of four virus variations and is said to be especially dangerous compared to the other three. Needless to say, the new strain is putting a real strain on our healthcare system, with many hospital reporting near full occupancy rates.
When asked why the dengue outbreak this year is so severe, health officials gave several possible reasons.
“When a new strain enters an area, we unfortunately will see a spike in dengue cases and dengue deaths because of people not having immunity to that particular type of serotype (virus),” said Dr Donald Shepard of Brandeis University, who has done extensive research on dengue, according to report in the Singapore Straits Times.
Authorities also site the prolonged dry spell earlier this year as having an effect. Low water levels at catchment areas led to water rationing in Klang Valley, which resulted in millions of households having to store water in containers for weeks on end. The Aedes mosquito breeds in clean, stagnant water.
Despite various campaigns to increase public awareness, there still seems to be a general sense of apathy when it comes to ensuring breeding grounds are destroyed.
Most people who come down with dengue recover, and as such, few take the disease seriously. Secondly, Malaysians have battled dengue since the turn of 20th century, and many just accept it as a part of life. Thirdly, Ebola’s high fatality rate and exotic history make it a “sexier” disease for the media to write about.
Meanwhile, all eyes are on drug maker Sanofi which is working on a vaccine it hopes to make commercially available late next year. But with Malaysian health officials warning that the current rainy season could see another spike in the number of cases, preventive measures are our only recourse for the moment.