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  Channel NewsAsia 23 Jul 07
Asia braces for new dengue outbreak

MANILA - From rich and squeaky-clean Singapore to impoverished Cambodia, public health officials are warning of a possible epidemic of dengue fever in Asia this year.

The World Health Organisation (WHO) believes 2007 could be on a par with 1998, when nearly 1,500 people died in Asia of the mosquito-borne disease.

This year dengue has already killed more than 1,000 people in Indonesia alone. In many other places the death and infection rates through June had already surpassed the totals for 2006.

"There is a strong possibility this year could be one of the worst," said John Ehrenberg, adviser for malaria and other diseases at the WHO's regional office in the Philippines. "We are seeing major spikes in reported cases around the region," he told AFP.

Dengue fever is nowhere near as deadly as malaria, which kills an estimated 2.7 million people around the world every year. But there is no known cure or vaccine to fight dengue fever, which is transmitted by a bite of the white-spotted mosquito known as Aedes aegypti.

Most of those killed tend to be children and old people who have a weak resistance to the virus, and die as a result of internal bleeding.

Officials say the best way to fight the spread of dengue is to control the mosquito's breeding grounds -- areas where water collects and stagnates -- but that can prove difficult once the annual rains begin.

The early arrival of the rainy season in much of Asia has been blamed for the upsurge in outbreaks this year, experts said.

"The Aedes aegypti mosquito thrives in the tropics with its rich mixture of warm weather and wet seasons. So you will see a close correlation between dengue spikes and a country's rainy season," Ehrenberg said. "The warmer the temperature the greater the risk of a serious outbreak."

Throughout Asia, cases of the disease are soaring.

Thailand has recorded 19,000 cases and 18 deaths for the first six months of the year. "This year is more serious than last year because of the earlier arrival of the rainy season, which brought forward the hatching period," Vichai Stimai, of Thailand's health ministry, told Bangkok's Nation newspaper.

In Cambodia, deaths this year have already eclipsed fatalities in 2006 as the country battles one of the worst outbreaks of the disease in a decade. Some 182 deaths have been recorded for the six months of the year out of nearly 15,000 cases, said Ngan Chantha, director of the health ministry's dengue programme. Last year 152 deaths were reported.

Vietnam has reported almost 20,000 cases with 21 deaths, seven more than in the same period last year, the health ministry said. Than Winn, a senior Myanmar health ministry official, told the Myanmar Times newspaper the number of cases in his country was also rising dramatically.

"In the first six months of this year there have been about 3,000 cases of the disease and 30 deaths. This is much higher than the first six months of 2006," Than Winn said.

While poorer countries with less developed public health systems are prone to dengue outbreaks, rich countries like Singapore are not immune. Dengue has now become a major health issue in Singapore and the government has stepped up its public awareness campaign and efforts to eradicate mosquito breeding grounds.

There have been nearly 3,600 cases of dengue infection reported so far this year in the city-state -- more than double the number in the period in 2006.

"This was a disease we used to associate with overcrowding in major urban centres," the WHO's Ehrenberg said. "But today it is even finding its way into remote rural areas as well."

In Malaysia the Health Ministry's director of disease control, Hasan Abdul Rahman, said 44 people had died in the first four months of 2007 from 16,214 cases reported, compared to 21 deaths and 10,244 cases in the same period last year. "We are concerned over the increase and we need everyone to cooperate with the authorities to fight the menace," Hasan said.

One country bucking the regional trend is the Philippines, where deaths in the first half of the year are down from 139 last year to 81 this year.

But officials warn that dengue fever can spread quickly. According to the WHO, only a handful of countries had experienced epidemics before 1970. But now the disease is endemic in more than 100 countries around the world.

"It has been a neglected disease relative to malaria, tuberculosis and now HIV/AIDS, all of which are major causes of fatalities worldwide," Ehrenberg said. "With viruses you never know which way they will go. They can change and can become mass killers."

Five facts about dengue fever

-- Dengue fever is a flu-like illness spread by the bite of an infected mosquito. Unlike the mosquitoes that cause malaria, those carrying dengue bite during the day.

-- Four different but related viruses cause dengue fever. If you survive any one of them, you are immune to that virus for life. But there is evidence that you are more likely to die if infected again by any of the other three.

-- Although only a relatively small percentage of dengue infections end up being fatal, there is no known cure. More than 1,000 people have already died this year in Indonesia alone.

-- The illness has spread rapidly around the world in recent decades. Only a handful of nations had dengue fever epidemics before 1970. Now the disease is endemic in more than 100 countries.

-- Dengue fever is most common in cities, and cases are almost never found in mountainous areas more than 4,000 feet (1,250 metres) above sea level. - AFP/ir
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