Joe Lowry, International Federation in Bangkok and Sharil Dewa, International Federation in Manila
The early arrival of the rainy season in much of Asia is being blamed for a surge in mosquito-borne infections across the region. South-East Asia, in particular, is recording record levels of dengue fever, a malaria-like disease that has already claimed hundreds of lives.
Dengue – also known as breakbone fever and bonecrusher disease due to the muscle and joint pains it brings – is spreading at an alarming rate. Thailand has recorded almost 24,000 cases, Cambodia 17,000 and Indonesia 68,000, with 748 deaths in the first half of the year. Myanmar, Singapore, Vietnam and the Philippines have all seen dengue rates soar by more than 30 per cent over last year’s figures.
A first outbreak of dengue can be highly unpleasant, but is usually not fatal. However, a second episode can, in some cases, develop into dengue haemorrhagic fever, which can be deadly.
The region’s Red Cross and Red Crescent Societies are responding to this worrying increase in infections by scaling up public information work, participating in clean-up campaigns and distributing bed nets.
In Myanmar, Red Cross volunteers conduct house-to-house visits to provide families with information on protection and prevention, as well as offer useful tips, like adding larvae-eating fish to ponds. Stagnant canals, buckets, old tyres, bins, tins and bottles – all perfect breeding grounds for Aedes aegypti, a daytime-biting mosquito with distinctive tiger-like markings – are being cleared away by volunteers.
Indonesian Red Cross branches are conducting clean-up campaigns in many parts of the country and training people how to spray insecticide. They are also working with World Health Organisation, Unicef and the ministry of health to distribute mosquito nets.
Anette Cramer, regional health delegate in the International Federation’s Southeast Asia delegation, agrees that action on dengue is urgently needed, but cautions against spreading panic.
“It is a very severe outbreak, but we know that dengue is cyclical and tends to peak every three years or so,” she says. “The situation needs close monitoring, good data collection, and most importantly, a combination of prevention and protection. The simplest advice is still the best – try not to get bitten.”
The Cambodian Red Cross is placing special emphasis on children with dengue, as they are among the most vulnerable. The National Society is directly helping 370 sick children in the national paediatric hospital and expects to expand this assistance. Dengue awareness and prevention messages have been broadcast on local television and radio. In addition, public information materials have been developed by Thai Red Cross, supported by American Red Cross.
In the Philippines, dengue is on the rise, as is malaria, which is being seen for the first time in a generation, in some communities. Its spread is being countered with the door-to-door distribution of mosquito nets and information campaigns.
“This may seem time consuming, but we wanted to make sure that vulnerable people have the proper knowledge on how to use the mosquito nets and really explain to them how these nets can prevent them from contracting malaria,” said Bles Casiño, a community health and nursing service representative with Philippines Red Cross.
“We appreciate the support from the volunteer doctors and nurses since it allowed them to rapidly identify and treat those with malaria. Many people really don’t have the resources to make the journey to the city to get tested.”
This region was hit by its worst dengue epidemic in 1998, when 328,000 people fell ill due to the virus and 1,484 people died, according to the WHO. In 1991, there were 118,000 dengue cases, and 1999 saw 46,000 cases.
Many commentators have linked the spread of dengue with two 21st century phenomena: increased urbanisation and climate change.