With dengue cases on the rise, it is important to inform yourself adequately about this viral infection.

DENGUE fever has been a major public health concern in Malaysia and in many other countries around the world for decades. The first documented major outbreak of dengue fever occurred in Penang in 1962.

The total number of fatalities from dengue fever recorded in Malaysia in 2010 stood at 134 cases, an increase of 54% from 2009. The number of reported dengue cases rose by 12% to 45,901 in 2010.

As of June 16, 11,063 dengue cases have been reported since January. This marks a 17% (1,610 cases) increase compared to the same period last year.

Selangor came out with the highest number of reported cases between January to May 12, with a total of 4,161; of which 10 cases resulted in death.

The World Health Organisation (WHO) estimates that 50 to 100 million dengue infections occur yearly, causing 22,000 deaths, mostly among children.

Dengue, in general, is a viral infection that is transmitted by the female Aedes aegypti mosquito. You can contract dengue fever from a single bite of a striped Aedes mosquito that carries the virus.

Dengue fever usually occurs in the tropical and sub-tropical areas of the world, mostly in urban and semi-urban areas.

Beware the signs

After being bitten by an infected Aedes mosquito, symptoms of the infection usually begin to appear within four to seven days, and typically last between three to 10 days.

The main symptoms of dengue are high fever (104°F, 40°C), and at least two of the following:

·Severe headache

·Severe eye pain (behind the eyes)

·Joint pain

·Muscle and/or bone pain

·Backache and rash

·Mild bleeding manifestation (nose or gum bleeding)

·Nausea and vomiting

·Low blood pressure and heart rate

After one to two days of fever, the patient will develop a rash with discoloured spots, often described as “isles of white in a sea of red” on the arms, legs and the entire body.

The palms of the hands and soles of the feet may be swollen and appear bright red.

A patient with dengue fever could take up to a week to recover, and once recovered, he or she will have antibodies in the bloodstream that will prevent them from having a relapse for about a year.

Oftentimes, the patient presents with fever only, and the only abnormality is an abnormal blood result.

Halt the disease

There is no specific treatment for dengue fever.

Although the Health Ministry is still testing out genetically-modified Aedes aegypti mosquitoes and a dengue vaccine to combat the spread of this disease, the best prevention methods still lie in your own hands.

The best way to reduce mosquitoes is to clear away the places where the mosquito lays eggs, like containers that hold water inside and around the home.

Aedes aegypti breeds primarily in man-made containers like earthenware jars, metal drums and water storage barrels, as well as flower pots and vases, discarded plastic food containers, used car tyres, and other items that collect rainwater, like pet and animal water containers.

Use mosquito repellent sprays, and add appropriate insecticides, such as larvacide, to water containers to prevent mosquitoes from breeding.

Additionally, make sure that your drains are always clean to ensure that they are not blocked, especially during the rainy season.

If you notice fogging being done in your neighbourhood, you can be sure there has been a case of dengue among your neighbours.

Be extra vigilant and clear your garden of breeding areas, and get tested if any family member has a fever.

The insects will fly into your house if fogging is done on the outside only.

Because these mosquitoes like to bite humans during the day, protect yourself by using a mosquito repellent on your skin while out gardening or on evening walks.

Wear loose and light-coloured clothes as mosquitoes find it hard to bite through loose clothes. Mosquito nets help too, even though the Aedes mosquito feeds during the day.

Prevention against the bite of an Aedes mosquito is extremely important, so that we don’t become human carriers, and multipliers of the virus by serving as the source of the virus for uninfected mosquitoes.

While awaiting the development of dengue vaccines, be vigilant in combating the spread of Aedes mosquitoes in order to save your loved ones and yourself.

Even though it has been shown worldwide that vector control by itself will not control dengue fever and deaths, it is the only means of protection we have until the vaccine is available in the very near future.

■ Datuk Dr Zukifli Ismail is a consultant paediatrician and paediatric cardiologist. This article is courtesy of the Positive Parenting programme by the Malaysian Paediatric Association. The opinions expressed in the article are the views of the author. For further information, please visit www.mypositiveparenting.

Dengue complications

Dengue itself is rarely fatal, but dengue haemorrhagic fever (DHF) can be a serious complication.

Symptoms of this fever are initially similar to dengue fever, but the haemorrhagic form is more severe, and causes loss of appetite, vomiting, high fever, headache and abdominal pain, faintness, and possible internal bleeding.

This may then lead to failure of the circulatory system and dengue shock syndrome, and if untreated promptly, can result in death.

There is no specific medication for DHF.

If an early diagnosis is made, a medical professional can treat DHF using fluid replacement therapy.

Hospitalisation is required to adequately manage DHF.

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