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Dengue overview
1. Dengue
Lyndon L. Lee Suy, MD
National Dengue Program Coordinator
Department of Health
2. Dengue & 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
3. 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%
4. Philippines Backgrounder:
1953 – reported as H-Fever
1958 – notifiable disease
1966 – outbreak in Metro Manila
Endemic in the country
Increase in cases during the rainy
season
5. National Dengue Prevention
& Control Program
1993: DOH initiated the program
Pilot sites: Region VII & NCR
1998: Nationwide implementation
6. Goal of the Program
Reduce morbidity and mortality from
dengue infection by preventing the
transmission of the virus from the
mosquito vector to human.
7. Health Status Objectives
By the end of 2004:
Reduce incidence from 32/100,000 to
20/100,000
Reduce case fatality rate by <1%
Detect & contain all epidemics
8. Risk Reduction Objectives
Reduce the risk of human exposure to
Aedes bite by:
House Index of <5
Breteau Index of 20
Increase % of HH practicing removal of
mosquito breeding places to 80%
Increase awareness on DF/DHF to
100%
9. Services & Protection Objectives
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
10. 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
12. Global Resurgence of Dengue
Population growth;
Uncontrolled urbanization;
Lack of effective mosquito control;
Increased air travel
(Gubler, 1998)
14. Color Codes for Dengue
Clustering of cases:
More than 2 cases in a barangay.
15. 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.
16. Color Codes for Dengue
Outbreak:
An area wherein the number of
cases is more than the
expected range.
17. Outbreak Controlled
When the number of cases has
decreased to within the expected range
for 2 consecutive weeks.
18. 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