Prevention of Dengue Fever
It is all about behaviour. In this world, there are mainly 2 types of behaviour, the good and the bad one. The spreading, persistent cycle, and recurrent infection of dengue fever endemic fall into human bad behaviour. We just keep having difficulty to dry up our boxes, flowerpots and don’t have any free time to clean up our home clogged drainage and a thousand other excuses.
Source: www.virology.wisc.edu
Malaysia Has All 4 types of Circulating Dengue Viruses
Dengue Virus is spread by Aedes mosquitoes either by A. Albopictus or A. Aegyti. There are 4 serotypes of Dengue Viruses known related to Dengue Fever, namely DEN-1, DEN-2, DEN-3 and DEN-4. Depending on location and world region, unfortunately all 4 serotypes circulate in Malaysia, which also means we can get infected by 4 different types of Dengue Viruses in our entire lives. The severity of the infection somehow depends on how many times we get infected with different strains of Dengue Viruses. Severe complications arise from infection of different serotypes, the term called secondary infection. A person with previous history of dengue fever will need to be extra cautious especially when staying or working near any endemic areas.
Please take MOH’s Message Seriously!
Why does the Ministry of Health really push us to search and destroy mosquitoes’ breeding grounds? Why is fogging alone not enough? The explanation for that is the ability of that virus to be transferred from the female adult mosquitoes to their eggs, the term called transovarial transmission. Failure to identify these breeding places instead of intensive fogging activities will result with next batch of mosquitoes that will carry the same virus within 2 weeks. About 70 – 80% of the eggs will be infected by this virus.
Dengue Mortality
I was in charge of finalizing dengue mortality reports in Selangor from 2008 till 2012, and very unfortunate that Selangor has become the champion of both occasions that were dengue morbidity and mortality in Malaysia. There will always be a bitter ending for each case. A good healthy daughter infected with dengue fever and 2 weeks later died of dengue shock syndrome and the same with a young mother that had just delivered her first baby boy, a 3 months old baby girl who was thought to have asthma, and other cases that resulted in death, due to dengue fever. Sadly, most cases were PREVENTABLE DEATH. You will not get dengue if you have not been bitten with Aedes mosquitoes.
The irony of this situation is that we have fought dengue for many years and many of us succumbed to this deadly virus, the number of cases are increasing each year, infecting and causing death in all age groups. We are beat up quite nicely by this virus. Then, we must be smarter than them in all aspects. So far, we are not smart enough.
It starts with our behaviour
If we want to end the dengue fever menace, we must first change our behaviour. Besides health-seeking behavior, we also need to instill clean-seeking behaviour. I think most Malaysians today will be very surprised if they enter a very clean park, wait in very clean bus stops, eat at very clean food stalls. Even we will be surprise if we enter a very clean construction workers’ hostels. I wish that all of this was true but unfortunately they are not. These are favorite sites or heavens for Aedes mosquitoes to breed.
Source: www.houselogic.com
In Selangor, we have listed a few places that are at risk to be potential breeding places. These places are recreational areas, shopping centres, food courts, bus , taxis or LRT stations, tourist sites. If you look closely, these are places where there is some density of human population. For your information, mosquitoes are attracted to carbon dioxide and in a crowd of people; the concentration of carbon dioxide is higher than usual thus attracts these mosquitoes that carry this dengue virus, to feed on human blood. It is the female mosquito that feeds on human blood. Most of male mosquitoes feed on fruits. They need each other to breed. So, it is okay to kill them both.
Feeding hours of these mosquitoes are mostly in early morning and at dusk. If you are planning to do some activities for example such jogging in a park and at dawn or dusk, proper attire such as long sleeves for shirts and long bottoms and mosquito repellant is advisable. Aedes mosquitoes are lazy mosquito; they won’t travel that far to bite a few humans. If you get bitten, chances that the breeding sites are just nearby.
I just mentioned a few of thr steps that we can take to prevent ourselves to be bitten by these mosquitoes. No short sleeves, shorts or skirts at dusk. Kindly use mosquito repellant if you are planning to go outside to crowded places. If you start having fever, kindly start to drink a lot of nutritious fluids such as coconut or barley water, fruit juices, soups or so forth. I heard “sup ketam” is so famous and have some correlation in treating dengue. If it contains the nutrition needed by the body, why not? Just do not believe it can cure dengue because there is no cure.
Lastly, please maintain a very good hydration status. Most doctors will look how well and hydrated you are if you are having dengue fever.
“Good behaviour = Good Health”
Dr. Sofwan Albar is the Assistant Director (Vector Unit), Selangor District Health Office.
[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.]