Malaysian Government Increases Effort to Fight Dengue

Dengue fever is a severe epidemic in South East Asia and it is not hard to know why. Colonial eras see many immigrants and colonists fall prey to this tropical disease. The situation is aggravated by the lack of awareness among the Malaysian people about public cleanliness. Refuses and garbage not only pollute the drains,rivers and streams, but they clog them as well. Clogged waters are the best breeding grounds for Aedes mosquito.

As people continue to be ignorant towards a clean environment, it is no wonder that the dengue cases kept on rising, alarming the Malaysian government.

Below is a newspaper article in Malaysia detailing the situation.

PUTRAJAYA: The number of dengue cases and deaths has doubled and the Health Ministry is urging Malaysians to wage war against the disease immediately.

Its director-general Tan Sri Dr Ismail Merican said that from Jan 4-17 this year, there were 3,211 cases with eight deaths, compared with 1,514 cases and four deaths during the period in 2008.

“That’s a 212% increase,” he said at a press conference here on Monday.

The states with the most cases were Selangor and Kuala Lumpur, followed by Penang, Johor, Sarawak and Kedah, he said.

According to the statistics provided by the Ministry, there were four deaths in Selangor, one in the Federal Territories (Kuala Lumpur/Putrajaya), one in Perak and two in Johor.

Dr Ismail said the Ministry was discovering atypical or unusual symptoms with the more severe cases.

“Patients used to suffer from bleeding and low platelet count, but now you can get dengue encephilitis that affects the brain and people can come in with epileptic attacks, jaundice with pain in the abdomen, hepatitis and kidney or liver failure,” he said.

As the result of the atypical presentation, some of the diagnoses were made late, he added.

“We have informed all our doctors to add dengue testing if a patient has fever and weird symptoms in high dengue cases states,” he said.

The Ministry spent RM1.7mil on campaigns to create greater awareness of dengue and issued a total of RM3.4mil in fines last year on those found with mosquito larvae in their premises.

Dr Ismail urged community leaders to organise gotong-royong (communal) clean-up efforts and to keep the public abreast of the outbreak,

Doctors should inform state health departments immediately whenever there is a suspected case so that fogging can be carried out immediately in the affected area.

“Those with symptoms such as fever, rashes, muscle aches, vomiting and bleeding must seek treatment immediately,” he said, adding that the most critical phase of the infection is between 24 and 48 hours of the onset of the infection.

In KLANG, state health director Dr Rosnah Hadis said the main reason for the high incidence of dengue in Selangor was the large number of breeding sources.

These include homes as well as abandoned housing projects, she said.

State health committee chairman Dr Xavier Jayakumar said the Selangor government was carrying out clean-up operations through the local councils and is also working closely with the state health department.

He said the high population density in urban areas has led to a high concentration of breeding grounds for the aedes mosquito.

Abandoned projects as well as unoccupied residential and commercial premises have become breeding grounds, he noted, adding that Selangor residents must also cooperate when local council workers carry out fogging.

“People usually close their doors when fogging work is going on, but there is nothing to fear as the chemical used is harmless to people,” he said.

Dr Xavier also said he hoped the Health Ministry would approve the combination of chemicals used as a fogging agent in developed countries such as Singapore.

“This is a third generation combination of chemicals which has a human-friendly aroma and is very effective in eradicating mosquitoes,” he said.

He urged the Health Ministry to expedite the licensing of the product given the current situation.

In KUALA LUMPUR, Setapak recorded the most number of dengue cases in the Federal Territory last year as well as in January.

The constituency reported 78 dengue cases in January 2009, and 1,186 cases throughout 2008 from a total of 5,001 cases that were reported to the Kuala Lumpur City Hall (DBKL).

Out of the 5,001 cases in 2008, 2,563 were positive. There were 12 deaths reported as well, of which six were positive dengue cases, said an official for DBKL.

Last year, Cheras had a total of 1,014 cases followed by Kepong (890), Old Klang Road (806), Town centre (756) and Damansara (349).

DBKL is conducting fogging at suspected zones. Among those identified was Salak South New Village where DBKL organised a search and destroy operation to identify potential aedes breeding grounds on Jan 19.

In GEORGE TOWN, Penang Health, Welfare and Caring Society Committee chairman Phee Boon Poh said that as far as dengue was concerned, the situation in the state was under control.

“The Health Ministry’s figures are only based on the first two weeks of January, as compared with the corresponding period last year,” he said.

“We admit that in Penang there was a surge of dengue cases in the first week of this year but the figure has since dropped as the state health department and the Penang Municipal Council have been very proactive with health measures and clean-up.”

He said the surge in the first week was because some general practitioners in the Balik Pulau area were not alert and treated the situation as a normal viral attack.

“There must be follow-up, even it the doctor thinks it is a normal viral infection, as it could be dengue or chikungunya instead,” he said.

In JOHOR BARU, the state Health Department said it would be enlisting the help of community groups and private clinics in its war against dengue. Two deaths have been reported in the state this year.

Its director Dr Mohd Khairi Yakub said that department personnel would go down to the ground more to spread awareness within the community.

“We will be having more awareness programmes as well as gotong-royong activities to get the message across to the public.

“We will be working closely with community groups to ensure the effectiveness of the programmes,” he said when contacted here on Monday.

The department would also urge private clinics to cooperate by informing the department more quickly of patients infected with dengue.

Dr Mohd Khairi said that last year, there were 16 deaths from more than 3,000 cases reported statewide -- 80% of these cases were in Johor Baru.

“We will also intensify fogging operations, but public awareness is more important as fogging alone cannot solve the problem permanently,” he said.

HINTS & TIPS

From the World Health Organisation Q&A on dengue

Q: What is dengue and how is it treated?

A: Dengue is transmitted by the bite of an Aedes mosquito infected with any one of the four dengue viruses. Symptoms appear in 3–14 days (average 4–7 days) after the infective bite. Dengue fever is a severe, flu-like illness that affects infants, young children and adults.

There is no specific treatment for dengue fever. Dengue haemorrhagic fever is a potentially lethal complication but early clinical diagnosis and careful clinical management by experienced physicians and nurses often save lives.

More than 70% of the disease burden is in South-East Asia and the Western Pacific area. Africa and the Eastern Mediterranean are much less affected. In Latin America and the Caribbean, the incidence and severity of disease are increasing rapidly.

Increase in international air travel is facilitating the rapid global movement of dengue viruses. This increases the risk of dengue haemorrhagic fever epidemics by introducing new dengue viruses into susceptible populations.

Quoted from The Star