Re-emergence of Dengue in parts of South East Asia

Dr. Reepa Agrawal
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28 Aug, 2019

Dengue fever is endemic in many parts of the world including countries like Philippines and Malaysia. This year has witnessed an increased number dengue fever cases in both these countries. According to World Health Organization (WHO), 82,529 dengue cases and 120 deaths have been reported from Malaysia by the 32nd week of 2019. There is more than 40 percent jump in cases: 44,613 cases including 73 deaths as compared to same period in 2018. Philippines has now announced a national epidemic of Dengue with 167,607 cases as per WHO with 720 deaths by week 30 of 2019. The previous year by this time a total of 85,011 cases with 464 deaths were reported. Higher number of cases are also reported from Vietnam, Lao and Singapore as compared to previous year.

Dengue is a mosquito borne viral disease spread by Aedes aegypti. The symptoms are similar to flu, shock hemorrhagic complications occur in severe dengue. There is no specific treatment available. Symptomatic treatment along with taking care of fluid balance of body is of paramount importance as is being watchful about warning signs like abdominal pain, decreased urine output, petechiae etc.

Anti-dengue vaccine ‘Dengvaxia’ certificate of product registration was revoked by Philippines FDA this year (February 2019) after they found that its manufacturer Sanofi Pasteur failed to submit post approval documents. This was mainly triggered by Sanofi Pasteur's own advisory warning that this vaccine may lead to a severe dengue illness in people without prior exposure to dengue virus. There were few deaths during the mass vaccination campaign but it is not proved whether they were directly related to the vaccine. Nevertheless this vaccine scare shooed away general public from immunization centres resulting in panic and confusion, hence decreasing coverage for the measles vaccine too. At present life threatening measles cases have also risen in Philippines.

Mosquito control measures are important and also the reintroduction of vaccine is also required but it is a political decision with major health implications. Prior exposure testing of vaccine recipient is a way out as the same vaccine is WHO approved and is administered at age group between 9 to 45 years in endemic countries in individuals with proven dengue exposure.



Reference:

WHO dengue situation update number 575
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