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Aguilar: Outbreak

Snowy Owl

Retired in 2010, In Memoriam
Aguilar: Outbreak
http://www.sunstar.com.ph/static/bac/2006/09/27/oped/george.aguilar.rational.animal.html

FROM Wikipedia; "dengue" is a Spanish term that attempted to express a Swahili phrase "ki denga pepo", that meant, "cramp-like seizure caused by an evil spirit". It first came out during a Caribbean outbreak in 1827-1828.

Outbreaks of dengue fever have been reported throughout history. The first case report dates back from 1789 and is attributed to Benjamin Rush, who coined the term "break bone fever" because of the symptoms of myalgia and arthralgia.

But it was only in the 20th century that people began to understand the role of mosquitoes in the transmission of the disease.

Significant outbreaks of dengue fever tend to occur every five or six years. There tend to remain large numbers of susceptible people in the population despite previous outbreaks because there are four different strains of the dengue virus and because of new susceptible individuals entering the target population, either through childbirth or immigration.

Dengue is caused by the Flavivirus virus and transmitted to humans by the mosquito Aedes aegypti. Aegypti is a medium sized black mosquito with striking white stripes that can be found in Bacolod City. Don't let any black and white insect bite your children from now on.


Only recently an outbreak was reported in the country. From January to August, 2006, at least 13,468 cases have been reported with 167 dead. Don't look now but all the symptoms of an outbreak in Bacolod are present.

Hospitals in Bacolod are full these days with many of the cases children diagnosed with the dreaded Dengue disease.

I was at Riverside hospital for a majority of last week caring for my wife. While there I happen to meet parents of grade school, high school, and college students whose children have dengue. I raised this issue with acquaintances and friends and found out that indeed the same have had family members who have or have recovered from dengue. I wonder why the City Government is hesitant in declaring an outbreak of dengue in Bacolod City. Even if the rising number of dengue cases has not reached epidemic proportions, our people can prepare for the worst. Why wait?

Symptoms: Dengue is manifested with by a sudden onset of fever, severe headache, muscle and joint pains, and rashes. The dengue rash is characteristically bright red and usually appears first on the lower limbs and in the chest then spreads to cover most of the body. There may also be abdominal pain, nausea, vomiting or diarrhea. Some cases develop much milder symptoms, which can, when no rash is present, be misdiagnosed as just a flu or other viral infection. The rule of thumb is this. If a family member gets a fever for two days or more, have him or her checked out for dengue at once. Patients with dengue can only pass on the infection through mosquitoes or blood products while they are still febrile.

Primary prevention of dengue mainly resides in eliminating or reducing the mosquito vector for dengue. Public spraying for mosquitoes is the most important aspect of this vector. Application of larvicides to standing water is essential top beat the bug.

Initiatives to eradicate pools of standing water such as in used tires have proven useful in controlling mosquito-borne diseases. Promising new techniques have been recently reported from Oxford University on rendering the Aedes mosquito pest sterile. Personal prevention consists of the use of mosquito nets, repellents, cover exposed skin, and avoiding endemic areas.

Dengue patients are encouraged to keep up oral intake, especially water.
If the patient is unable to maintain oral intake, supplementation with intravenous fluids may be necessary to prevent dehydration and significant blood concentration. A platelet transfusion is rarely indicated if the platelet level drops significantly or if there is significant bleeding.

(September 27, 2006 issue)
 
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