DengueLyndon L. Lee Suy, MD

National Dengue Program Coordinator

Department of Health

Dengue & DHFDengue & DHF Endemic in >100 tropical/subtropical

countries No specific treatment Spreads rapidly affecting mostly children An environmental issue Emphasis on emergency control during

epidemics rather than developing programs to prevent epidemic transmission

Global Situation of DHF 2.5 B at risk of dengue infection over

100 countries Annual dengue cases – 100 M DF/DHF/DSS admissions per year –

500,000 cases Mortality rate – 5%

Philippines Backgrounder:1953 – reported as H-Fever1958 – notifiable disease1966 – outbreak in Metro ManilaEndemic in the country Increase in cases during the rainy

season

National Dengue National Dengue Prevention & Control Prevention & Control

ProgramProgram1993: DOH initiated the programPilot sites: Region VII & NCR1998: Nationwide implementation

Goal of the ProgramGoal of the ProgramReduce morbidity and mortality from

dengue infection by preventing the transmission of the virus from the

mosquito vector to human.

Health Status ObjectivesHealth Status ObjectivesBy the end of 2004:Reduce incidence from 32/100,000 to

20/100,000Reduce case fatality rate by <1%Detect & contain all epidemics

Risk Reduction Risk Reduction ObjectivesObjectives

Reduce the risk of human exposure to Aedes bite by:House Index of <5Breteau Index of 20

Increase % of HH practicing removal of mosquito breeding places to 80%

Increase awareness on DF/DHF to 100%

Services & Protection Services & Protection ObjectivesObjectives

Establish a Dengue Reference Laboratory capable of performing IgM capture ELISA for Dengue Surveillance

Increase the % of 1° and 2° government hospitals with laboratory capable of platelet count and hematocrit

Ensure surveillance and investigation of all epidemics

Dengue Cases & Deaths by Region

(Philippines, as of August 15, 2004)

REGION CASES DEATHS CFR (%)

I 83 0 0

II 158 0 0

CAR 194 0 0

III 1121 5 0.4

IV A 302 2 0.7

IV B 9 0 0

NCR 1438 7 0.5

V 269 6 2.2

VI 691 7 1

VII 383 5 1.3

VIII 420 1 0.2

IX 75 1 1.3

X 590 5 0.8

XI 1529 37 2.4

XII 97 1 1

ARMM 60 1 1.6

CARAGA 197 7 3.6

TOTAL 7616 85 1.1

Aedes aegypti Mosquito

Global Resurgence of DenguePopulation growth;Uncontrolled urbanization;Lack of effective mosquito control; Increased air travel

(Gubler, 1998)

Color Codes for Dengue

No cases/clustering in an area.

Color Codes for Dengue Clustering of cases:

More than 2 cases in a barangay.

Color Codes for Dengue

Hot Spot:

An area where an increase in number of cases was

observed for 2 consecutive weeks even though the number is still within the expected range.

Color Codes for Dengue

Outbreak:

An area wherein the number of cases is more than the

expected range.

Outbreak Controlled

When the number of cases has decreased to within the expected range

for 2 consecutive weeks.

Preventive/Control Strategies Intensify IEC campaign on prevention & control; Improve environmental sanitation; Entomologic survey; Mobilize residents of affected barangay & start

clean-up campaign; Start community surveillance; search for more

cases; Equip local health units for management

of cases

Maraming Salamat Po!!!