Make dengue top health priority

The rainy season brings floods and diseases, including dengue with cases in the country surging to almost 6,000 per week. This figure is higher than the 5,100 cases registered in pre-pandemic 2019, the last time the Department of Health (DOH) declared a national dengue epidemic.

In a statement, the DOH said a total of 208,965 dengue cases have been reported from January to Sept. 6, with 546 deaths. This is 68 percent higher than the 124,157 cases for the same period last year. Health Secretary Teodoro Herbosa said last month that he was set to declare a national dengue epidemic with cases reaching outbreak levels. Declaring an epidemic would help the national government identify where a localized response was needed and allow local government units access to their quick response fund to address the outbreak.

The rise in weekly infections should already raise the alarm. However, there appears to be no urgency and the national government has not made such declaration so far even though several areas have already declared a state of calamity including Bukidnon, Iloilo, Bohol, and the cities of Ormoc in Leyte and Calbayog in Samar. Cebu was already mulling a similar declaration earlier this month with eight dengue-related deaths from January to August. Soccsksargen has raised the alarm with 56 deaths reported since January this year.

Wolbachia bacteria

The DOH’s 4S strategy has been in effect for at least five years now and consists of searching and destroying mosquito breeding grounds; self-protection; seeking early consultation; and supporting fogging or spraying in local hotspots or outbreak areas. Herbosa said it was crucial that immediate and concerted actions be taken to address this situation and minimize the number of cases. “We know what works, and that is to kill mosquitoes,” the health secretary had said earlier.

The DOH is also considering the use of the Wolbachia bacteria to reduce dengue transmission. Per the World Mosquito Program, Wolbachia is an extremely common bacteria that “blocks viruses like dengue, chikungunya, and Zika from growing in the bodies of Aedes aegypti mosquitoes” and reduces their ability to transmit viruses to people. Breeding Wolbachia mosquitoes and releasing them in areas affected by mosquito-borne diseases could reduce dengue risk in communities.

Several Southeast Asian countries have used Wolbachia mosquitoes including Vietnam and Indonesia, which is planning to extend the program to longer than six months in case the mosquito population target is not met. Dengue cases dropped by up to 77 percent during the method’s trials in two Indonesian areas in 2022. The Philippine government must then fast-track its study to be able to implement this method asap.

World population at risk

Despite its small size, the mosquito is said to be the world’s deadliest animal because, aside from dengue, it spreads other diseases like malaria, yellow fever, Zika, and chikungunya, and has killed more people than any other creature in the world. The World Health Organization said about half of the world’s population is now at risk of dengue with an estimated 100–400 million infections occurring each year. Experts said attaining zero dengue deaths, at least within this decade, is ambitious despite progress in addressing it.

Inquirer columnist and pediatrician Fatima Ignacio Gimenez, in a column last June, cited the many factors that impact dengue control, namely, “a thorough understanding of the virus and the vectors, climate change, human behavior, poverty, lack of leadership, and the political will to seriously effect change.”

Preventing dengue is not just the government’s responsibility but should also be everybody’s concern. The public, starting from households, must do its part in ensuring a clean environment and eliminating areas that contain stagnant water where mosquitoes can breed. The public must also be reminded that being infected once does not mean immunity to dengue as the virus has four serotypes.

Innovative strategies

Gimenez pointed to more funding for research and innovative strategies and seeking cross-border collaborations as crucial in fighting the disease, as well as getting the support of the private sector to invest in new technology that can offer long-term and sustainable solutions “rather than resorting to quick-fix tools.”

Indeed, given our climate and infrastructure, the government must continue to look for innovative approaches to complement its existing dengue strategy. The Food and Drug Administration must also look into health experts’ appeal to approve a second-generation vaccine against dengue that can be given to those who have not been infected. Vaccination, however, remains a touchy issue and the government must double down on its efforts to educate the public on how vaccines not only protect them from viruses but can also reduce the severity of a disease and lessen the possibility of hospitalization that many poor Filipinos cannot afford.

As Gimenez said: About time the government made dengue a top health priority.