The alarming rise in the number of dengue cases in the Philippines has prompted the Department of Health (DOH) to declare a national alert. From January to July of this year, the number of Dengue cases reached 115,986. That’s 83 percent more than the same period in 2018. There have been 491 reported deaths as well.
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According to a DOH report, several regions have exceeded the “epidemic threshold”—these are MIMAROPA (Region IV-B), Western Visayas (Region VI), Central Visayas (Region VII), and Northern Mindanao (Region X). Meanwhile, the following regions are being monitored closely due to the rising incidence of dengue cases—Ilocos, Cagayan Valley, CALABARZON, Bicol, Eastern Visayas, Zamboanga Peninsula, Davao, Bangsamoro Autonomous Region in Muslim Mindanao, and Cordillera Administrative Region.
We talked with Dr. Ryan Llorin, an Infectious Diseases expert from St. Luke’s Medical Center, for some answers.
What caused the spike in Dengue cases?
Adult mosquitoes have a short life span, they live from two to four weeks only. But their eggs remain viable during dry season. When it rains, the eggs resume their life cycle, and the mosquitos lay new eggs. There is an increase in dengue cases during rainy season because the mosquitoes multiply rapidly during these months.
There are some regions that have already declared a Dengue outbreak. What makes an area more prone?
Places where there are a lot of stagnant, dirty water, canals or waterways, those with abandoned or unmaintained houses or structures are more predisposed to become breeding grounds of Dengue-carrying mosquitoes. Environmental cleanliness is a big factor. The infection is also easily spread in densely populated areas.
Are we safe from Dengue inside our homes?
The common misconception is we could only get bitten by Dengue-carrying mosquitoes outdoors, particularly in dirty places. Fact is, these insects can breed indoor and outdoor—wherever there is stagnant water. If you’re stocking up on water—which is the case in places where there’s water interruption—make sure your containers are covered. It’s also important to keep the canals around your homes clean.
Can Dengue infection spread from person to person?
Dengue is spread through the bite of the female mosquito (Aedes aegypti). The mosquito becomes infected when it takes the blood of a person infected with the virus. After about one to two weeks, the mosquito can then transmit the virus while biting a healthy person. The virus isn’t transmitted directly from person to person.
Is it possible to get infected more than once?
Yes. In fact, a second, third, or fourth infection could be more serious on a patient. If you have had dengue before, your immune system tends to remember this. So when you get infected again by the virus, your body will fight well, but this could be detrimental to your condition because your immune system will overreact.
Who are more prone to suffer from severe dengue?
Children are more prone to get infected because they usually go outside to play in the streets, where there could be mosquitoes. Kids less than six years old are more prone because of their low immunity compared to adults. Malnourished persons are also susceptible to severe Dengue.
What happens when you get infected by Dengue?
The infection has three phases: the febrile phase, the critical phase, and the recovery phase. The Febrile phase usually lasts five to seven days. At this point, you have fever, headache, eye pain, vomiting, body aches, muscle pain, joint pain, body malaise—the feeling of general discomfort, uneasiness, or pain—and a loss of appetite.
The critical phase overlaps with the later stage of the febrile phase. It occurs around day three to day five. It’s about 48 hours before and after the fever disappears. Fever starts to go down, patient gets better, and the platelet starts to go down also. There are warning signs: patient feels lethargic or restless, severe vomiting, severe abdominal pain, bleeding, rashes, low blood pressure. During this phase, organ failure can occur. Though, only a small percentage of dengue cases—about five percent—lead to organ failure. The usual course is after the fever, there is the recovery period. The fever goes away, you feel better.
How does the body recover?
There’s no medication to reverse the course of Dengue. The main form of treatment essentially is hydration, or drinking water. This is just to make sure that you maintain your blood pressure, adequate urine output, and that you don’t get dehydrated. Take paracetamol for the fever, and eat as much as possible and have ample rest.
What are the tests needed for an accurate diagnosis?
There are two key tests, and the type of test one should get will depend on the phase of the illness. During the febrile phase, you should get a Dengue NS1 antigen test, which detects a protein specific to a dengue virus. Around day four to five, during which the fever is gone, you should get the Dengue IgM/IgG tests, which detects the antibodies developed in the body in response to the infection. It’s important to know what type of test to take because if you take the wrong one, you might come up with a falsely negative result; you’d think you don’t have Dengue.
How much do these tests cost?
Around P2,000 to P5,000 for each test. Most hospitals are capable of providing them.
Can taking vitamins or supplements protect us from Dengue?
The best measure for Dengue prevention is environmental cleanliness. Vitamins can help strengthen your body’s immunity, but not immediately. It won’t have an instant effect.
Can anti-mosquito lotions protect us?
Anti-mosquito lotions that contain the chemical DEET—look for diethyltoluamide on the label—can repel Dengue-carrying mosquitoes.
What should we do if there are cases in our neighborhood?
Keep your environment clean, be watchful for any news of Dengue in the neighborhood so you can take precautions properly. If there’s any suspicion of Dengue, especially in young children, get a consultation immediately. The major cause of morbidity and mortality in Dengue is late recognition of the illness.
Similarly, the DOH currently emphasizes that the most effective way to prevent Dengue is the 4S strategy—Search and destroy mosquito breeding places, Self-protective measures like wearing long sleeves and use of insect repellent, Seek early consultation on the first signs and symptoms of the disease, and Say yes to fogging if there is an impending outbreak.
To get in touch with Dr. Llorin, visit StLukesMedicalCenter.com.ph, or call 789-7700 local 7108