Marwaan Macan-Markar

BANGKOK, Jul 12 2007 (IPS) – End June saw health officials in Singapore confronted with a worrying trend in the affluent, squeaky-clean city-state. During two separate weeks that month, dengue fever cases had reached epidemic levels.

Aedes aegypti mosquito. Credit: USDA

The second week had seen 401 cases reported, while the last week saw 381 cases of the deadly virus, spread by the Aedes aegypti mosquito. Singaporean authorities consider any number above 378 infections a week as an epidemic.

But the rest of South-east Asia is far from immune. Health officials from across the region have been raising an alarm about the trail this mosquito is leaving in many urban areas. The surge in the number of dengue cases has already prompted health officials to say that 2007 may rank as one of the worst years recorded for a disease that is endemic from Burma to Brunei.

There is a risk we are heading towards an epidemic situation in the region, says Dr. John Ehrenberg, advisor for malaria and other vector-borne diseases at the World Health Organisation s (WHO) Western Pacific regional office. We are seeing a serious increase in the number of cases relative to previous years in Singapore, Cambodia, Vietnam and Malaysia.

Countries have to be prepared for this and ensure that patients are guaranteed proper care, he explained during a telephone interview from the WHO s regional headquarters in Manila. In some least developed countries patients are dying because it is difficult to guarantee patients health care.

Also relevant, he added, was the surveillance system to be improved, since accurate information is pivotal to gauge how far dengue fever is spreading. Countries have to get their surveillance systems in place for the official numbers to reflect the reality, because there are lot of rumours.
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Health officials in Vietnam conveyed similar concerns as they urged citizens in the central and southern provinces to search and destroy the spots where mosquitoes breed. The risk of dengue epidemic outbreak in southern and central provinces is very high in the coming time, health minister Tran Thi Chien was quoted as having told the Thanh Nien (Young People) newspaper over the weekend.

The assistance Thailand is offering neighbouring Cambodia to contain dengue fever speaks of the impact the virus is making in the region this year. Bangkok has sent medical teams and equipment to treat Cambodian patients and update Cambodian medical staff on new procedures on preventing and containing dengue fever outbreaks, according to the state-owned Thai News Agency (TNA).

Cambodia, one of South-east Asia s poorest countries, has seen 132 deaths from the dengue virus in June, a five-fold increase over the previous month, adds the TNA. In addition, there were close to 10,000 dengue cases reported that month.

Vietnam, meanwhile, has recorded 24,255 cases of this tropical fever during the first half of the year, which is over a 20 percent increase from last year. To date, 27 people have died from dengue, as against 17 deaths in the first half of 2006.

Thailand has recorded 17 deaths from dengue and over 20,000 infections, which is a 35 percent increase from last year. Burma has recorded 30 dengue-related deaths during the first six months of the year and has seen nearly 3,000 people fall ill from the virus.

Malaysia, on the other hand, has recorded 25,858 dengue cases from January to June this year, a sharp increase from the 16,808 cases during the same period the year before. According to Malaysia s New Straits Times newspaper, there have been 56 dengue-related deaths since the year began, which is also higher than the 46 deaths recorded during the previous year.

The region s largest country, Indonesia, marked the end of June with disturbing numbers, too, since there have been over 68,000 reported cases and 748 deaths during 2007.

Singapore, the region s smallest country, has also reported two dengue-related deaths.

This virus, which causes pain in the joints, high fever, rash and nausea, requires hospital care, including regular testing of the patient s blood. In severe cases, the patient suffers from internal bleeding, called dengue haemorrhagic fever (DHF) which could lead to death.

South-east Asia is home to all four strains of the dengue virus that is transmitted by the bite of the carrier mosquito. Research to produce a vaccine has proved daunting since being inoculated from one strain will not protect a patient from falling ill if bitten by a mosquito carrying another strain.

The WHO attributes the current increase in the number of dengue cases to climate change. The deaths due to dengue fever are among the 77,000 deaths recorded annually in the Asia-Pacific region linked to global warning, the Geneva-based health agency said at a recent conference in Malaysia.

We have now reached a critical stage in which global warming has already seriously impacted lives and health, and this problem will pose an even greater threat to mankind in the coming decades if we fail to act now, said Shigeru Omi, WHO regional director for Western Pacific.

This region was hit by its worst dengue epidemic in 1998 when 328,000 people fell ill due to the virus and 1,484 people died, according to the WHO. In 1991, there were 118,000 dengue cases and 1999 saw 46,000 cases.

But till the recent spate of newspaper reports about this deadly virus in the region, dengue has been overshadowed by global concerns over another deadly virus, bird flu, which has killed 187 people worldwide since its outbreak in South-east Asia in the winter of 2003.