The Philippines has been experiencing a surge in dengue cases over the past few years, with the country declaring it a national epidemic in 2019. While dengue fever is not relatively new to the country, this remains a serious public health concern despite the government’s efforts to control the spread of this disease. Dengue fever is caused by a virus transmitted by the Aedes mosquito. Its symptoms include high fever, severe headache, joint and muscle pain, and skin rash. In severe cases, dengue can lead to hemorrhagic fever, shock, and even death. The rise of dengue cases in the Philippines is attributed to various factors, including poor sanitation, climate change, and lack of public awareness.

History of Dengue in the Philippines

Dengue is one of the most feared mosquito-borne disease in the country. The first recorded outbreak of the disease in the country was in Manila in 1954. Since then, dengue fever has become a recurring public health problem.  There have been cyclical outbreaks over the previous ten years, with 2019 being one of the worst years yet with over 400,000 documented cases and almost a thousand fatalities.

Despite the COVID-19 pandemic, more than 100,000 cases of dengue were reported in 2020, roughly 80,000 in 2021, then it surged to over 200,000 by the end of 2022, as the COVID restrictions are being lifted.

In a latest report by the World Health Organization, there are almost 40,000 dengue cases in the country with 127 recorded deaths for the period January 1 – April 29, 2023. The number of cases is 43% higher than the cases recorded around the same period last year.

Understanding Dengue: Signs and Symptoms

Dengueis transmitted to humans by a bite of an infected mosquito (Aedes aegypti or albopictus). These mosquitoes live in tropical, subtropical, and in some temperate climates. Symptoms usually appear 4-10 days after the bite and lasts from 2-7 days. These include:

• high fever (40°C/104°F)
• severe headache
• pain behind the eyes
• muscle and joint pains
• nausea
• vomiting
• swollen glands
• rash

Most dengue patients have minor to no symptoms and recover in 1-2 weeks. In severe cases, dengue can be fatal.

Reinfected patients are at higher risk of severe dengue. These symptoms of severe dengue usually appear after the fever has subsided:

• severe abdominal pain
• persistent vomiting
• rapid breathing
• bleeding gums or nose
• fatigue
• restlessness
• blood in vomit or stool
• being very thirsty
• pale and cold skin
• feeling weak

People with severe symptoms mentioned above must be sent to the hospital for immediate treatment.

Causes of Dengue Outbreaks

There are environmental and societal factors that contribute to dengue outbreaks. The Aedes mosquito, which spreads the dengue virus, thrives in warm, humid conditions. It is because of this that dengue epidemics are more frequent in tropical and subtropical areas. Poor sanitation and waste management also contribute to the spread of dengue fever. Mosquitoes breed in stagnant water, so places with poor drainage and inadequate waste disposal are more vulnerable to outbreaks.

Treatment and Management of Dengue

Most cases of dengue fever can be managed at home with pain relievers. In severe cases, hospitalization may be necessary. Still, the best way to avoid dengue is preventing mosquito bites. Dengue has no known cure and the treatment only involves the management of the symptoms.

For those infected with dengue at least once and is living in dengue high risk areas, a vaccine called Dengvaxia is available.

Dengue Vaccines: Are They Effective?

As a part of the country’s attempts to combat dengue, the Dengvaxia vaccine was introduced in 2016.

Unfortunately, about two years after the campaign began, Sanofi, the vaccine manufacturer, warned that Dengvaxia may cause “more severe disease” in those who have never had dengue fever. A public outcry followed the indiscriminate vaccination of over 800,000 kids at this point, and lawsuits were brought against Sanofi and different government figures over allegations of child deaths from the vaccine and political corruption. The subsequent lack of confidence in the public health sector caused immunization rates to plummet, which led to a measles outbreak in 2019.

To this day, following a clearer guideline and warning, Dengvaxia is the only vaccine that has received national approval and authorization. However, this vaccine can only provide protection to people who have a history of dengue infection.

Preventive Measures Against Dengue

Dengue prevention calls for a multifaceted strategy that integrates community and individual activities. Here are some precautions you can take to ward off dengue and safeguard the people you care about:

1. Get rid of stagnant water in your surroundings as this is where mosquitoes inhabit and breed.
2. Wear clothes that cover as much of your body as possible.
3. Use mosquito nets if sleeping during the day, ideally nets sprayed with insect repellent.
4. Use mosquito repellents (containing DEET, Picaridin or IR3535), coils, and vaporizers to ward off mosquitoes.
5. Make sure your windows have proper window screens to prevent mosquitoes from entering your home.

Sources:

Dengue home | CDC. (2023, February 9). Centers for Disease Control and Prevention. https://www.cdc.gov/dengue/index.html

Ong, E., Obeles, A. J. T., Ong, B. a. G., & Tantengco, O. a. G. (2022). Perspectives and lessons from the Philippines’ decades-long battle with dengue. The Lancet Regional Health – Western Pacific, 24, 100505. https://doi.org/10.1016/j.lanwpc.2022.100505 World Health Organization: WHO & World Health Organization: WHO. (2023). Dengue and severe dengue. www.who.int. https://www.who.int/news-room/fact-sheets/detail/dengue-and-sever