Dengue

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| Press release

Climate situation wreaks havoc in Asia Pacific; causing relentless floods, diseases, and life-threatening heat

Kuala Lumpur/Dhaka/Beijing, 10 August 2023 – Countries across Asia Pacific are reeling from multiple disasters that are wreaking havoc in the region and climate analysts attribute this to a phenomenon called El Niño. The International Federation of Red Cross Red Crescent Societies (IFRC) urges authorities and humanitarian organizations to brace for multiple disasters hitting simultaneously, with more intensity. These past few months, the IFRC has released eight Disaster Response Emergency Fund (DREF) allocations for climate related events – three for dengue to Bangladesh, Nepal, and Sri Lanka, three for floods, to Mongolia, Pakistan, and Afghanistan, one for a tropical cyclone to Bangladesh, and one for a cold wave event to Mongolia. Although the full impact of the phenomenon is expected in the months of September this year to March next year, many regions in Asia and the Pacific are already facing multiple hazards now, and they all point to a deteriorating climate situation. In Bangladesh, dengue infections have swarmed the nation and there have been almost 30,000 new cases this year, almost 5 times higher than last year's numbers. Moreover, local public health experts confirm that many people are being infected with multiple types of dengue, making the treatment complicated. Sanjeev Kafley, Head of IFRC Bangladesh Delegation says: "We are working closely with the Bangladesh Red Crescent Society (BDRCS) and health authorities to combat the situation. In 85 dengue hotspot wards in the cities of Dhaka, Chattogram, and Barishal, our volunteers are focusing on public awareness and prevention efforts. We are progressing to procure testing kits for our health authorities as well as supporting the availability of platelet concentrate through the blood banks of BDRCS. We are supporting in all intervention points, from life-saving areas to preventative measures." IFRC’s climate mitigation efforts at national levels in different countries are towards improving water management systems, curbing mosquito breeding, strengthening surveillance and monitoring systems to track outbreaks and increase health care capacity to managing cases and providing treatment. Olga Dzhumaeva, Head of IFRC East Asia Delegation says: “Torrential rains and floods hit East Asia severely this summer. North, northeast and some regions in southern China saw one of the largest rainfalls Beijing has experienced in the past 140 years. Capital city Ulaanbaatar and 13 provinces in Mongolia, central parts and many provinces of the Republic of Korea, and in the Kyushu region of Japan also suffered from severe impact of extreme rains in July. As a result, millions of people in East Asia were greatly affected and displaced, and roads, bridges, homes, and infrastructures were very badly damaged, many beyond repair. In responding to the situation, our colleagues and volunteers from National Societies in China, Japan, Mongolia and Republic of Korea have been deployed to the front lines, activating their emergency responses, making every effort to evacuate people trapped by the floods and debris, and urgently sending relief supplies such as blankets, tents, folding beds to the affected areas.” IFRC, National Societies, and its partners believe we equally need to focus on resilience building through inclusion of nature, anticipation, adaptation and mitigation. Early or anticipatory action, for example, whereby funds are proactively allocated based on weather forecasts to support people at risk before disaster strikes is an important emphasis in the context of rapidly increasing climate hazards. Luis Rodriguez, IFRC Asia Pacific, Lead for Climate and Resilience says: “These events were more intense than usual due to the prevailing warming conditions, and this brings heavier precipitations, triggering cyclones, rains, and floods. These climate factors also heavily influence the dynamics of infections. Increased rainfall creates new and conducive habitats for larvae or viruses, and increased temperature accelerates the development of insects carrying viruses and virus incubation time. Severe changes in temperature and precipitation patterns due to climate change will enable the spread and transmission of disease in areas that are currently considered low risk or dengue free. These are all not stand-alone events. They are connected.” In anticipation of more extreme weather events that will hit more regions in the Asia Pacific, national societies together with IFRC are carrying out heavy preparedness measures such as heatwave action planning, simulations and drills, prepositioning of relief stocks, and evacuation and rescue equipment, and urgent refreshers on procedures and regulations for volunteers, staff, and technical teams. Moreover, the DREFs ensure National Societies can act speedily and efficiently and this means millions of lives and livelihoods are saved. For more information or to request an interview, please contact:  [email protected] In Kuala Lumpur: Afrhill Rances, [email protected] , +60 19 271 3641 In Geneva: Anna Tuson, [email protected] , +41 79 895 6924

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Fighting Dengue fever in the time of COVID-19

By Fernando Gandarillas. Paraguay has the third highest incidence of dengue fever in the region. This is the third year in a row where there has been an intense outbreak of the disease. In 2020, the country has had the highest number of cases in its history (over 220,000 cases) and 73 people have died. The cities most affected are Asunción, Mariano, Limpio and Capiatá. The Paraguayan Red Cross has been working since the beginning of the year to support to the emergency in these locations; with the support of the IFRC they implemented dengue response projects reaching 1,280 families. The actions focused on generating educational activities for prevention, hygiene and sanitation, as well as the delivery of protection and hygiene kits. These activities suffered serious complications for their implementation with the appearance of the COVID-19 in the country. The COVID-19 pandemic has complicated the dengue work. "Due to mobility restrictions and social distancing measures, we were unable to continue with the activities we were carrying out in the communities," said Magali Paredes, Health Officer for Dengue and COVID-19 of the Paraguayan Red Cross. Much of the work with the community was done through community meetings, where workshops were used to share information. One of the most important tasks was the creation of community brigades to work on the prevention and response to dengue outbreaks at the local level. Some of the families living in affected areas work in garbage recycling. Many of the recycled items are stored by people in their backyards or in places close to where they live. This is where rainwater collects and where mosquito breeding takes place. Because of this direct link to people's ability to have income, the Red Cross projects were aimed at informing and training community members on how to prevent the spread of mosquito larvae without affecting economic activity. "We felt that there was always an important involvement and interest from community members because they knew that we are aware of this and that we want to work with them to find solutions," said Magali. Another piece of the work that the Paraguayan Red Cross has been doing focused on 12 schools in these cities. They work with children to teach them about dengue prevention measures. But, when the isolation measures were adopted, the children stopped going to school. Due to these circumstances the Red Cross is working to generate a process of training teachers. The Red Cross included a COVID-19 component in community actions since the outbreak of the virus. The creation of community brigades has been key to disseminating information and promoting prevention actions for both dengue and the new coronavirus. In addition, community surveillance mechanisms were created that involve coordinated work between community members and the local Family Health Unit (local public health care point) so that people can report, without fear of being discriminated against, if they have been in contact with people who have tested positive for COVID-19 or if they have been seriously exposed to the virus. "Many times people do not want to report their health condition, if they are showing symptoms or if they have been in contact with people with COVID-19 because they feel observed," said Magali. The Red Cross has worked as an intermediary between the community and this state entity to facilitate conditions that create security for informants. The National Society is working to share information around COVID-19 and dengue fever at the same time. The work carried out by the Paraguayan Red Cross has been sustained with the active participation of dozens of volunteers. One of the most important results of the project has been to achieve empowerment of the people in the affected communities.

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| Press release

17.5 million affected by floods and threatened by disease in South Asia

Dhaka/Kuala Lumpur, 6 August 2020 – Monsoon floods are robbing millions of people of their homes and livelihoods, with mounting risk of more deadly disease outbreaks when health resources are stretched to breaking point by COVID-19. So far almost 17.5 million people have been affected and more than 630 killed by major floods in India, Bangladesh and Nepal according to government figures. Half of Bangladesh’s districts are underwater, leaving nearly 1 million families stranded and cut off in their villages. Flooding and landslides in Nepal have left almost 200 people dead or missing. In India, almost 12 million people are affected by the floods mainly in the northern states of Assam and Bihar. Feroz Salah Uddin, Secretary General, Bangladesh Red Crescent said: “This is one of the biggest monsoon floods we have faced in many years and the worst may be yet to come as we face growing risks of malaria, dengue, diarrhea as well as this worsening COVID-19 pandemic.” The monsoon season floods mean a high proportion of the population in South Asia is vulnerable to diseases such as dengue, malaria, leptospirosis and cholera. In 2019, Bangladesh experienced its deadliest outbreak of dengue with more than 101,000 cases and almost 180 deaths. India reported 136,000 people were infected with the disease and many were hospitalised. Previous years show how devastating these diseases can be for communities in South Asia, so Red Cross and Red Crescent teams in the region are urgently ramping up their flood response activities, which include distributing mosquito nets and working with communities to reduce their exposure to diseases like malaria and dengue. COVID-19 restrictions have hampered efforts to destroy mosquito-breeding sites and raise awareness in communities of how to prevent the spread of diseases like dengue and malaria, ahead of this year’s monsoon season. At the same time, restrictions on movement of people and increased screening for COVID-19 may be helping to keep other diseases from exploding for now. Dr Abhishek Rimal, Regional Emergency Health Coordinator, Asia Pacific, International Federation of Red Cross and Red Crescent Societies (IFRC) said: “Vast inland seas of stagnant water create an ideal breeding ground for mosquitos, with soaring risk of diseases like dengue and malaria. Millions of people are also gathered in confined spaces or sleeping in temporary shelters with limited access to food, safe water and protection from mosquitos, creating the perfect storm for the spread of mosquito and water-borne diseases.” The majority of limited hospital beds, doctors and health resources have been redirected to focus on COVID-19 response as India deals with more than 50,000 recorded cases a day. Bangladesh and Nepal have surpassed 240,000 and 20,700 confirmed cases respectively. South Asia now has more than 2.2 million cases of COVID-19 cases with fears that the total number of infections is much higher. Dr Rimal, said: “The critical focus on saving lives in this pandemic and preventing the further spread of COVID-19 has diverted their resources from prevention activities such as dengue and malaria are going untreated. We are seeing evidence that people are reluctant to go to health facilities because they fear catching COVID-19 and getting more sick.”

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Dengue fever another blow for the Pacific Islands

As the Pacific Islands battle to keep Covid-19 out, and continues to reel from the aftermath of the Tropical Cyclone Harold, they are fighting another battle; Dengue Fever. More than 4,000 cases of dengue fever have been reported in both Fiji and the Marshall Islands, but several more islands are at risk. There are now 700 confirmed cases of dengue fever in areas of Fiji that were most affected by Tropical Cyclone Harold. The majority of new cases are children under the age of 18. As of 12 May, the Marshall Islands has reported more than 3,388 cases of dengue-like illness, of which more than 1,576 have been laboratory confirmed. Dr. Dewindra Widiamurti, Red Cross Pacific Health Manager, says: “In Fiji, the destruction by the cyclone resulted in water sources being contaminated, and increased challenges with wastewater removal. People who lost their homes are now living in evacuation centres, where social distancing is difficult, if not impossible, potentially making it easier for mosquitos to spread the virus.” This situation is coupled with a shortage of safe water, which increases the health risks to displaced people, not only from dengue fever but also from other waterborne and mosquito-spread diseases. If COVID-19 entered these evacuation centres, it could also create an increased risk of spread, as lack of hygiene also facilitates the transmission of COVID-19. Following the first confirmed COVID-19 case in Fiji, the Government responded immediately by isolating the person and carrying out thorough contact tracing, as well as tightening its national and international travel. Although Fiji has not reported a new COVID-19 case since 20 April 2020, the Government is advising the community to remain vigilant and international travel restriction continues. Tropical Cyclone Harold hit the country in early April, at the same time as the COVID-19 response was rolling out. The dengue outbreak has further complicated the health situation. TheMarshall Islands dengue feveroutbreak began in July 2019 and is considered the worst outbreak in the country’s history. Dr Widiamurti says: “We hope the outbreak is declining, as dengue fever is unpleasant and possibly life threatening. Two people have died of the fever since the outbreak started. We are concerned that COVID-19 might become a double burden to the affected communities. Hygiene advice, shared by the Red Cross volunteers is vital in the effort to prevent the spread of these diseases and limit mosquito breeding sites and the risk of being bitten.” Since the outbreak was first reported, the Marshall Islands Red Cross Society has been actively visiting villages and communities to build awareness and promote measures to reduce the risk of mosquito bite. The Fiji Red Cross have now also mobilised trained volunteers to conduct health education and hygiene promotion. They visit villages throughout the high-risk areas to build awareness and knowledge, simultaneously sharing COVID-19 hygiene precaution measures. Since the outbreak was first reported, The Marshall Islands Red Cross has been actively visiting villages and communities to build awareness and promote measures to reduce the risk of mosquito bite. The Fiji Red Cross have now also mobilized trained volunteers to conduct health education and hygiene promotion. They visit villages throughout the high-risk areas to build awareness and knowledge, simultaneously sharing COVID-19 hygiene precaution measures.

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Community action against Dengue

In the courtyard of a health centre in Managua, Nicaragua, a mother and daughter share a supportive smile. Their expressions convey joy and confidence. They have just shared with us a story of survival and empowerment. Having had a very hard personal experience with dengue fever, both are now community volunteers in a Nicaraguan Red Cross vector control operation. In 2019, the Central American region suffered the most extensive dengue epidemic of the decade. More than one million people have been affected by the outbreak, with the highest numbers of cases reported in Honduras and Nicaragua. The Red Cross is working in these two countries, as well as in Costa Rica, El Salvador and Guatemala, to empower local communities to cope with both the current crisis and possible future outbreaks. With the support of the International Federation of the Red Cross and Red Crescent (IFRC), National Societies are working alongside communities in the most affected areas to equip them with the information and materials necessary to control and mitigate the effects of the current outbreak, and prevent future ones. This community-based approach is known as Community-Based Epidemiological Surveillance (CBES), and has been used in the region before with positive results in other epidemic crises, such as zika in 2016. This strategy allows community members themselves to identify risks in their environment and take action to eliminate or mitigate them, empowering them to become active agents of change. The first step of CBES is to identify social leaders who, working together with National Societies, organize community groups. Once these groups are formed, the Red Cross provides them with information on the outbreak so that they can identify warning signs and know what referral routes to health care are available if a potential dengue case is identified, as well as what hygiene and sanitation measures should be taken to prevent and mitigate outbreaks. Based on this information, communities create risk maps and plans to implement preventive and mitigation measures. The final step of CBES is the implementation of these plans through breeding site identification and elimination campaigns, home visits in which they replicate the information learned about dengue prevention, and outreach activities in schools. A life-changing disease At a recent activity with community volunteers in Managua, Karen Rodriguez, a Nicaraguan Red Cross volunteer, shared her experience with dengue fever. Her daughter, Jade Gámez, had suffered from dengue three times, at the age of 11, 12 and 13. The last of those times, Jade had been diagnosed with severe dengue, and the girl suffered kidney and liver damage as well as a preinfarction. Children under the age of 15 are a particularly vulnerable group. In August 2019, 66% of the deaths reported in Honduras as part of the current outbreak were under 15 years of age, and in Guatemala, 52% of the severe dengue cases reported were also in this age group. Having survived such a serious illness, mother and daughter are now volunteers with the Nicaraguan Red Cross. As part of the current operation, their work consists on replicating the information received among their neighbors, as well as carrying out clean-up campaigns to eliminate breeding grounds in their community. "We both do the same thing - when one can't go to the clean-up activities, the other one goes," says Karen. For them, this is an opportunity to help their neighbors avoid going through the same experience they went through years ago. "Now that I am supporting the Red Cross and I can help people, I feel calm, I feel happy," says Karen. "More than anything, so that people don’t go through the same experience I went through," adds Jade. Dengue fever outbreaks are cyclical and peaks occur around the world every year during rainy seasons, with extensive epidemics occurring at a frequency of every four to five years. In 2019, the World Health Organization recognized dengue as one of the top ten threats to global health, with an estimated 40% of the world’s population currently at risk. Epidemics can have a devastating effect on the most vulnerable groups, such as children. That is why it is important for National Societies to work on advocacy and capacity building to continue to empower communities in preparing for and responding to dengue and other vector-borne diseases such as zika and chikungunya.

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| Press release

Dengue spreads across Central America, Red Cross scales up response

Panama/Geneva, 27 September 2019–-As dengue spreads rapidly across Central America, the International Federation of Red Cross and Red Crescent Societies (IFRC) is scaling up emergency assistance to help countries contain the mosquito borne viral disease. In Honduras, more than 71,200 people have been affected by the disease making it the worst outbreak in the country’s history. Nearly one quarter of the cases reported were classified as severe dengue and more than 65 percent of the 128 deaths so far are children under 15. Guatemala, Nicaragua, El Salvador and Costa Rica are also reporting massive increases in dengue cases compared to previous years. Dr Maria Franca Tallarico, Head of Health at IFRC’s Regional Office for the Americas said: “Dengue is endemic across the Americas, but what is very concerning in this outbreak is that the majority of the cases and deaths are occurring in children under 15. This is due to a lack of immunity in young people to the deadliest of the four strains of dengue currently circulating in the region.” A combination of seasonal rains and warming temperatures are being blamed for dengue’s rapid spread--creating more stagnant pools that are perfect breeding grounds for mosquitoes. There are rising concerns that this will make the outbreak will be harder to contain. According to the World Health Organization (WHO), rising global temperatures rainfall patterns linked to climate change could significantly modify vector-borne diseases and their effect on human populations—making epidemics more difficult to predict and control. Teams of Red Cross volunteers in affected Central American countries have been supporting government efforts to slow the outbreak—providing door to door awareness raising about the disease and how to prevent it. With their unique access to affected communities, the Red Cross volunteers are helping to clean up mosquito breeding sites or accompanying health workers to identify cases. Dr Tallarico said: “The size of this outbreak is unprecedented across Central America. Dengue is a disease that affects the most vulnerable--those who live in places where there is poor sanitation and where mosquitoes thrive. But the disease can be contained if governments and communities work together to raise awareness, access medical care and clean up the environment. This is what the Red Cross teams across affected countries are focused on doing.” The IFRC has launched a regional appeal seeking a total of 2.9 million Swiss francs to support the National Red Cross Societies in Central America to deliver assistance and support to 550,000 people for 12 months. The appeal will focus on community health, water and sanitation and promoting behaviours changes that prevent the decease. Dengue cases have increased 30-fold over the last 50 years, according to the World Health Organization. As one of the world’s fastest growing diseases, dengue is endemic in 100 countries infecting up to50-100 million people a year.

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Philippines: Urgent action needed to halt deadly dengue outbreak

Manila/Kuala Lumpur/Geneva, 26 July 2019 – Urgent action is needed to contain a dengue outbreak in the Philippines as cases continue to soar and an unprecedented nationwide emergency alert is issued, the International Federation of Red Cross and Red Crescent Societies (IFRC) and Philippine Red Cross are warning. The Philippines is experiencing an alarming dengue outbreak with more than 115,000 cases reported since the beginning of the year – 85 per cent more than during the same period in 2018. To date, dengue has already led to 491 deaths, 30 per cent of them children between the ages of 5 and 9. The significant spike in dengue is particularly alarming as the monsoon season is only starting in the country. Dengue cases peak during and after monsoon rains, raising concerns that a severe epidemic may threaten the nation in the coming months. The Philippine Red Cross is supporting government efforts to stem the outbreak. Philippines Red Cross Chairman and CEO, Richard Gordon said: “Dengue is one of the fastest spreading viral diseases and children are particularly vulnerable. Tens of thousands of patients are streaming into overcrowded hospitals. Our 2 million volunteers across the country are in the communities raising awareness about preventing infections and when to seek treatment, organising clean-up drives for mosquito breeding sites and supporting overcrowded hospitals.” The IFRC has released nearly 150,000 Swiss francs (7.2 million Philippine peso) from its Disaster Relief Emergency Fund to support the Philippine Red Cross scale up dengue treatment tents at ten hospitals and provide volunteer nursing staff to care for up to 15,000 patients and their family members. The Red Cross is targeting 300,000 people in at-risk communities with critical information on getting early treatment. Chris Staines, the Head of IFRC’s Philippines office said: “We need to work together to save lives and contain the outbreak which we fear will worsen during the monsoon. Dengue can be stopped in its tracks, but families need to protect themselves from mosquito bites and seek medical treatment if they experience any symptoms such as high fever, headaches, nausea and joint pains.” The current spike in dengue infections comes at the same time as the Philippines continues to deal with a deadly measles outbreak that has stretched healthcare capacities across the country. Elsewhere in South-East Asia, Red Cross teams in Cambodia, Laos, Thailand and Vietnam are also responding to spiking dengue cases.

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