MANILA, Philippines — Health Secretary Enrique T. Ona said Friday that they expect the number of dengue cases to go up in three months, as the rainy season approaches.

Ona called on health workers to help achieve this year’s target of less than 100,000 dengue cases for 2012. “If we do nothing, we will be again over our heads come July and August when our public hospitals are being filled to the brim with Dengue patients and Dengue outbreaks are being reported left and right. We do not want that to happen this year. More than outdoing the number of cases in 2011, our target is less than 100,000 cases for 2012. It seems a tall order for all of us but I believe that if we work together, this can be achieved.”

At the Dengue Summit in Pasay City, the Department of Health said that it has recorded 16,511 dengue cases from January 1 to March 31 so far this year. The figure is 28.96 percent lower as compared to the same period last year with 23,241 cases.

“We are probably 2 years away a from a Dengue vaccine which will drastically reduce the number of Dengue cases in the country. We know this because we are coordinating with the researchers and manufacturers in the development of these vaccines. Given this limitation, the only way we can achieve our target is if all stakeholders – Local Governments up to the Barangay level, the National Government, non-governmental organizations, most especially the private sector – should intensify their collaboration and cooperation to implement a holistic and comprehensive Dengue Control action plan,” the health chief said.

This is because if all goes well in the final test being done here in the Philippines, the world will finally have its first effectivevaccine against dengue no later than 2014.

There is currently no treatment, cure orvaccine for dengue.

The dengue fever vaccine, developed by France’s Sanofi Pasteur, is the first to undergo the advanced “Phase III” clinical trial, the final hurdle before it becomes available to the public.

The clinical trial aims to establish the efficacy of the vaccine. While the test is scheduled to last four years, the trial may be cut short especially if no dangerous side effects are detected or if the authorities and regulatory bodies including the World Health Organization and the United States Food and Drug Administration decide to fast track approval.

“Researchers worldwide have been working on a dengue vaccine for almost 60 years and for the first time, we have a potential candidate that actually shows great promise. The vaccine is important considering that while the dengue fever death toll is relatively small (of the current 27,000 hospitalized, 172 died already), most victims involve infants and young children,” says Dr. Maria Rosario Capeding, head of the Dengue Study Group that supervises the dengue vaccine clinical trial being done in San Pablo, Laguna and very soon in the province of Cebu.

Capeding explains that numerous obstacles have hindered scientists from finally coming up with an effective dengue fever vaccine. First, it could not be tested on animals—the virus only infects humans.

Second, since the dengue virus has four strains, the vaccine that must be developed should induce immune responses against all four types of dengue virus.

Proving effective

“Based on the initial results observed from the 2,000 children in Laguna (ages 2 to 14) since last month, the vaccine is proving to be effective as well as safe. The result validates the report coming from Thailand where 4,000 children are being evaluated since 2009,” Capeding reports.

San Pablo and Cebu was chosen because these two areas have an established monitoring and evaluation system that is required in the monitoring of the vaccine.

The Philippines and Thailand share a common history when it comes to dengue because it was in these two countries where the dengue hemorrhagic fever, a lethal complication of dengue fever, was first reported and identified in the 1950s.

Fifty-eight years later, dengue fever has become a major international public health concern considering that majority of those affected are children ages between one and 10 years old.

[Read the full story at Inquirer.net ]

What is Dengue Fever (DF)?

Dengue fever is an infection caused by a virus. It occurs commonly as dengue fever. Occasionally a patient suffering formdengue may develop bleeding. Common sites for bleeding are the nose, gums and skin. Sometimes, the patient may have coffee-ground vomiting or black stools. This indicates bleeding in the intestines. The patient with dengue fever who develops bleeding has dengue hemorrhagic fever (DHF).

How does dengue spread?

Dengue fever is transmitted to people by the bite of an Aedesmosquito that is infected with the dengue virus. The mosquito becomes infected with dengue when it bites a person who hasdengue fever or DHF. Dengue fever cannot be spread directly from person to person.

When should I suspect Dengue?

Dengue should be suspected when you have sudden onset of high fever, 39-40°C, accompanied with severe headache, pain behind the eyes, body aches, rashes on the skin and nausea or vomiting. The fever lasts for 5-7 days. In some patients, fever comes down on the third or fourth day but it recurs.

Can dengue fever be treated at home?

Most patients with dengue fever can be treated at home. They should take rest, drink plenty of fluids and eat nutritious food. Whenever available, Oral Rehydration Salt (commonly used in treating diarrhea) should be used. Sufficient fluid intake is very important. Generally the progression towards dengue hemorrhagic fever or dengue shock syndrome occurs after 3-5 days of fever. At this time, fever has often come down. This may mislead many of us to believe that the patient is heading towards recovery. This is the most dangerous period that requires high vigilance. It is best to consult a physician. Indications for hospitalization are persistent vomiting, inability to take oral fluids, persistent abdominal pain, restlessness, or bleeding from any site (nose, gums, passage of black stools).

What is the treatment?

Like most viral diseases there is no specific cure for dengue fever. Antibiotics do not help. Paracetamol is the drug of choice to bring down fever and joint pain. Aspirin and Ibuprofen should be avoided since they can increase the risk of bleeding.

Can people die from dengue fever?

People who suffer from dengue fever have no risk of death but some of them develop Dengue Hemorrhagic Fever or Dengue Shock Syndrome. In some of these cases death can occur. With proper treatment, the patients with these conditions can recover fully. Proper treatment provided in time can save lives.

Is there a vaccine to prevent dengue fever?

A vaccine has been developed to prevent dengue fever but it is still under trial. It is not yet available in the market.

How can the multiplication of mosquitoes be reduced?

Dengue mosquitoes breed in stored, exposed water collections. To prevent the mosquitoes from multiplying, drain out the water from tanks, barrels, drums, buckets, etc. Remove all objects containing water (e.g. plant saucers) from the house. Collect and destroy discarded containers where water can collect, e.g., bottles, plastic bags, cans, tires, etc. If storage of water can’t be helped, the container should be covered with a tight fitting lid.

How can I prevent mosquito bites?

Dengue mosquitoes bite during the day time. The highest biting intensity is about 2 hours after sunrise and before sunset. Wear full sleeves clothing and long dresses to cover as much of your body as possible. Use repellents but be careful in using them in young children and the elderly. Use mosquito coils and electric vapor mats during daytime. Use mosquito nets to protect children, old people and others who nap during the day.

What can the community do to prevent dengue?

The main strategy in the prevention and control of dengue issource reduction, or prevention of breeding places. Every household can undertake simple measures to prevent existing water collections from becoming breeding places of Aedes aegypti. House cleaning by all members of the community will ensure that no breeding places exist, preventing dengue form occurring.

Source: Health Alert, A Bulletin from the Infection Control Service, St. Luke’s Medical Center, www.healthypinoy.com

National Epidemiology director Eric Tayag said 1,753 new cases were monitored for the period.

He said the National Capital Region still has the highest incidence of dengue, with 118 new cases. Tayag also lauded the newest invention of the Department of Science and Technology (DOST) that detects the dengue fever immediately even at the disease’s stage of incubation period.

“Because the government made this, it will be available cheaper than currently available commercialized [testing kits],” Tayag said.

So far, Tayag said, the test kit Biotek-M is in the process of clinical validation, or confirming whether the device complies with the regulatory requirement before distribution in the market.

Currently, the DOST is conducting a pilot test of the kit for accuracy and efficiency in the three public hospitals of Rizal Medical Center, National Children’s Hospital, and Philippine Children’s Medical Center.

Report from InterAksyon.com

For more than a decade that dengue mosquitoes have been attacking the country, the DOH has already institutionalized its dengue prevention and control program in public health and hospital services as well as in health promotion. But as the already-a-cliché goes, “the government cannot do it alone.” In dengue prevention and control, communities and the whole society should do their big part.

Since the first day of June, the DOH has alerted the country that it was Dengue Prevention Month. Although dengue is no longer a seasonal disease, epidemiologic data in previous years still show that the onset of the rainy season cause the disease to rise. On June 15, it was not only the Philippines that conducted a massive anti-dengue campaign, but the whole ASEAN (Association of Southeast Asian Nations) as well. ASEAN Dengue Day was declared this year and would be observed every year thereafter to foster more awareness about the disease. This year’s observance has for its theme, “Dengue is everybody’s concern, causing socio-economic burden, but it is preventable.”

On this day, the DOH urged top officials and leaders of the country’s public schools, churches, public markets, and communities to conduct search and destroy activities in their areas of jurisdiction to prevent dengue. Barangay officials, through the Liga Ng Mga Barangay, were also urged to seriously undertake government’s anti-dengue campaign by allocating a part of its budget for dengue prevention and control. At the launch ceremonies held in Kalookan City, Health Secretary Enrique T. Ona said, “Dengue is everybody’s concern, but with our concerted efforts, dengue can be controlled starting today.”

And then it happened. Towards the end of July, a sudden increase of dengue cases happened in Metro Manila, Central Luzon and the Ilocos region. The nation, as what was being reported in media, was alarmed when a surge of about 2,000 new cases occurred in the first two weeks of August. This incident prompted officials to declare health emergencies in a number of areas in Metro Manila and affected areas of the country.

Even with the Department of Health’s assurance that the total number of cases nationwide is lower than that of last year, the DOH National Epidemiology Center reported dengue cases at the National Capital Region, Region 1 and 2 nearly double, with 10,487 cases recorded in the first seven months of 2011 compared to 5,416 in the same period last year.

An off-the-cuff remark of a reporter in a DOH press conference of having a “Ilocano strain” of dengue went haywire in the news and even attributed Secretary Ona for it.

This sudden rise in cases caused pressure and panic among public health facilities in Metro Manila, especially at the Quirino Memorial Medical Center (QMMC), where it was shown on television numerous affected patients sharing beds, hallways were converted to wards, and temporary wards were made outside the hospital premises to house dengue patients, most of were children aged 0-15 years. Adding misery to QMMC at this time was the fact that the nearby government and private hospitals were partially closed due to damages caused by the recent floods.

On August 25, the DOH together with the Departments of the Interior and Local Government, Science and Technology, Education, Environmental and National Resources, and the Metro Manila Development Authority launched a new campaign against dengue dubbed, “Aksyon Barangay Kontra Dengue” (or ABaKaDa), in an effort to stir up community action that will be sustainable, target-driven and that can be adopted by LGUs with perennial threats of a dengue epidemic.

ABaKaDa seeks to reinforce the country’s drive against dengue by going back to the basics of comprehensive vector control supported by environmental manipulation and modification. ABaKaDa calls for regular weekly clean-up drives spearheaded by the barangay leaders and includes the active participation of community volunteers, civil society and others in government.

Lessons from past dengue epidemics showed that communities determine the dengue burden epending on their seriousness and commitment to eliminate mosquito breeding sites. Specifically, the campaign urges families, barangay leaders and youth councils (Sangguniang Kabataan) to do community clean-up drives and to aggressively seek and clean out possible mosquito breeding sites every week especially in areas that continue to experience clustering of dengue cases.

At about the same time, the DOH and PhilHealth (Philippine Health Insurance Corporation) introduced and began implementing effective September 1, the new case rate payment scheme, where members would be able to predict how much PhilHealth would be paying for the services provided. Included in the new case rates is dengue, classified into Dengue 1 (dengue fever and dengue hemorrhagic fever (DHF) Grades I and II) and Dengue II (DHF Grades III and IV) with reimbursement rates amounting to P8,000 and P16,000, respectively.

Complimenting the case-rate system is the no balance billing scheme which applies only to indigent patients covered by the national household targeting system for the poorest of the poor when they go to government hospitals only. Under this scheme, Philhealth beneficiaries no longer have to pay extra in case their medical expenses go beyond the amounts covered by the packages in the case rate system.

Everything has been done by government to minimize the impact that dengue brings to the country – from advocacy campaigns to dengue fast lane in health facilities to scientific research altering the genes of the dengue carrying mosquitos to  clinical testing of a potential vaccine against the disease. This is not inaction in the part of government. What may truly be wanting is for people to change their behaviors and practice the recommended cost-effective measures to prevent dengue.

Vision:                  Dengue Risk-Free Philippines

Mission:              To improve the quality of health of Filipinos by adopting an integrated dengue control approach in the prevention and control of dengue infection.

Goal:                     Reduce morbidity and mortality from dengue infection by preventing the transmission of the virus from the mosquito vector human.

Objectives:

The objectives of the program are categorized into three: health status objectives; risk reduction objectives; and services & protection objectives.

Health Status Objectives:

• Reduce incidence from 32 cases/100,000 population to 20 cases/100,000 population;

• Reduce case fatality rate by <1%; and

• Detect and contain all epidemics.

Risk Reduction Objectives:

• Reduce the risk of human exposure to aedes bite by House index of <5 and Breteau index of 20;

• Increase % of HH practicing removal of mosquito breeding places to 80%; and

• Increase awareness on DF/DHF to 100%.

Services & Protection Objectives:

• Establish a Dengue Reference Laboratory capable of performing IgM capture ELISA for Dengue Surveillance;
• Increase the % of 1° and 2° government hospitals with laboratory capable of platelet count and hematocrit; and
• Ensure surveillance and investigation of all epidemics.

Partner Organizations/Agencies:

The following organizations/agencies take part in the achievement of the program’s objectives:

• World Health Organization (WHO)
• United Nations children’s Fund (UNICEF)
• Department of Interior and Local Government (DILG)
• Department of Education (DepEd)
• United States Agency for International Development (USAID)
• Asian Development Bank (ADB)
• Philippine Health Insurance Corporation (PhilHealth)

Program Manager:

Dr. Lyndon L. Lee Suy

Department of Health-National Center for Disease Prevention and Control (DOH-NCDPC)

Contact Number: 651-78-00 local 2353

Email: donleesuymd@yahoo.com

DILG Secretary Jesse Robredo said village officials should spearhead and intensify the implementation of the Aksyon Barangay Kontra Dengue (ABKD) through regular clean-up activities in the communities.

ABKD is the government’s response to intensify the fight against dengue outbreak in order to reduce dengue cases and control its transmission.

“If we really want zero-dengue incidence, this should be a regular activity in all barangays that should be participated in by residents and other concerned sectors,” said Robredo.

A total of 25,533 dengue cases have been reported last year, which resulted to the death of 180 patients where most of the victims were children ages between 1 to 15 years old.

In his directive, Robredo enjoined city and municipal mayors to enact an ordinance on measures on dengue prevention and control.

City or municipal health officers are expected to conduct massive information campaign relative to the OL-Trap system; monitor the health situation; provide data on dengue cases to partner agencies; extend technical assistance in the conduct of training and orientation relative to dengue prevention and control; devise a scheme of providing support fund to ensure sustainability of dengue prevention and control; and ensure that dengue patients are provided with timely and proper medical attention.

The Ovicidal/Larvicidal Trap System or OL-Trap System, a device consisting of a tumbler, strips of plywood and pellets, can detect Aedes mosquito population and acts as an early warning signal to pre-empt any impending dengue outbreaks.

(Excerpt from Philippine Star, January 22, 2012)

A dengue outbreak at the onset of the rainy season claimed the lives of 591 persons as of November 2011.

Before the outbreak occurred, the DOH had been warning of the prevalence of dengue during the wet season. The water shortage cause by the El Niño phenomenon during the summer, however, forced people to store water in containers, many of which were uncovered, therefore becoming breeding grounds for dengue-carrying mosquitoes.

To control the outbreak, the DOH and other concerned government agencies — Department of Science and Technology, Department of the Interior and Local Government and Department of Education — launched an aggressive disease control program in schools and communities through weekly cleanup drives, fogging, spraying of insecticides and larvicides.

The number of dengue cases this year reached 110,257, including 591 deaths, still lower than the 166,818 cases (including 1,018 deaths) registered during the same period in 2010.

Disease experts attributed the decline to the circulation of four dengue strains – Type 1, 2, 3 and 4, thus providing many with immunity to any of the four strains.

This means that if a patient contracted a particular strain, he becomes immune to it for a period.

MANILA, Philippines – The Department of Health (DOH) committed yesterday to take a “more aggressive action plan” to prevent repeat of last year’s dengue outbreaks in Metro Manila.

In a statement, DOH director for Metro Manila Dr. Eduardo Janairo said his office “will not wait for dengue cases to accumulate and increase.” He said the agency is intensifying “initiatives” in strategic areas with numerous dengue cases registered last year.

“Routine cleanup activities among communities, integrated vector control and information campaigns will be started this month to avert possible widespread transmission of dengue in the community,” he said.

The DOH, he added, will coordinate with local health officials and “provide them with the necessary manpower and logistics to be able to provide essential measures in eliminating dengue in their respective localities.”

DOH records show that from Jan. 1 to Dec. 30, 2011, Metro Manila registered a total of 25,533 dengue cases, including 180 deaths. The figure is one percent lower compared to the 26,815 cases in 2010 but the region still accounts for majority of cases last year.

Majority of the cases were male and belonged to the under-15 age group (16,262 with 133 deaths). As for the other age groups, there were 9,671 cases with 15 deaths for those aged 16 to 44 years; 422 cases with three deaths for those aged 45 to 59 years; 145 cases with one death for those aged 60 to 74 years; and 33 cases among those aged 75 and above.

Quezon City had the most number of dengue cases at 8,174, followed by Manila (4,167), Caloocan (2,904), Valenzuela (1,561), Pasig (1,337), Parañaque (1231), Malabon (1,087), Taguig (795), Pasay City (780) and Muntinlupa (752).