Dengue fever still a risk in cyclone-hit south

Health experts have credited effective interventions for preventing an increase in dengue fever in Myanmar’s cyclone-hit south, but warn that risks remain.

“Dengue haemorrhagic fever (DHF) seems to be under control as the occurrence was quite low compared to last year,” Osamu Kunii, chief of health and nutrition at the UN Children’s Fund (UNICEF), told IRIN in Yangon, the former Burmese capital.

Reported cases were low in July, traditionally a peak time for the deadly disease, though the most up-to-date figures had not yet come in from health authorities, he explained.

The Early Warning, Alert and Response System (EWARS) disease surveillance bulletin for week 33 (10-16 August 2008) has not reported any major change in the status of DHF compared to previous weeks.

Risk factors

The category four storm (Cyclone Nargis) left behind favourable conditions for the mosquito that carries the flu-like viral disease.

Storm debris - including cracked pots, tins, buckets, bottles, jars, vases, pot plant dishes, destroyed boats, tyres, roofs, tarpaulins and plastic - and stagnant pools of water provide suitable places for the Aedes mosquito to live and breed.

The disease, which results in severe fever, headaches, rashes, muscle and joint pain, is especially dangerous for children and the elderly. There is no vaccine for dengue, nor its more severe form, DHF.

Unlike mosquitoes which cause malaria, dengue carrying mosquitoes bite their victims in the day.

While people can probably prevent themselves from being bitten by malaria mosquitoes at night by sleeping under a bed net or by applying mosquito repellent, the fact that the Aedes mosquito bites in the daytime places cyclone survivors at greater risk, Kunii warned.

Photo: Lynn Maung/IRIN

Earlier fears of an increased incidence of dengue in the Delta did not materialise, but the risk remains. Two patients receive treatment for dengue fever in cyclone-affected Bogale

In the first five months of 2008, the Health Ministry’s anti-dengue department reported 2,110 dengue cases in the storm-hit areas. Of these, 1,005 occurred from January to April, and 1,105 in May.

Traditionally, dengue takes its greatest toll in the second half of the year, as soon as the rainy season starts. In Myanmar, the rainy season begins in mid May and ends in mid September, with its peak in July and August.

Of the 15,000 dengue cases registered in 2007, 100 people died nationwide, according to Myanmar health officials.

Generally, Yangon sees the greatest number of cases as the mosquito that carries dengue breeds well in urban and semi-urban locations.

Over 35 percent of dengue cases usually occur in Yangon Division, the country’s most populous, although Ayeyarwady, Bago, Sagaing, Mon and Mandalay divisions are also vulnerable.

Health experts continue to warn that a serious outbreak of dengue could happen if the municipal authorities fail to destroy the mosquitoes’ breeding grounds - mainly pools of stagnant water.

Anti-dengue measures

Health officials are taking measures to mitigate the risks, including running public awareness campaigns on how to prevent and control the disease. The focus is on the hygienic use of drinking water, combating larvae, week-end sanitation activities and education on dengue fever.

The World Health Organization (WHO) and UNICEF, in cooperation with the Myanmar Maternal and Child Welfare Association and the Myanmar Red Cross, have launched a US$700,000 anti-dengue-fever campaign in 11 storm-hit townships in Yangon and Ayeyarwady divisions.

WHO says the anti-dengue-fever campaign will benefit over 900,000 households.

According to WHO and UNICEF, the anti-mosquito measures taken include fumigation with insecticide to kill adult mosquitoes; the application of Abate (a kind of insecticide) in water for domestic consumption; and community participation to remove mosquito breeding places.

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