In 2008, 228 cases of dengue fever were reported in Calasiao, Pangasinan, Philippines, the highest number since 1998. The local government declared a dengue fever outbreak in August 2008 and implemented response activities including education campaigns, larviciding, and fogging. These efforts aimed to prevent further spread of the disease despite challenges from floods and other health issues. The outbreak declaration was lifted in November once case numbers decreased below epidemic thresholds.

1. DENGUE FEVER CASES IN CALASIAO 2008

2. A total of 228 suspect cases of Dengue Fever were reported in Calasiao, Pangasinan from January to December of 2008 although there may be other cases not reported. The reporting on Dengue Fever cases is dependent on data coming from both government and private hospitals where majority of the cases are managed and treated. This report has served as a tool for intervention and response actions of the local government unit of Calasiao and the Health Office. There was one death reported in the month of July for case fatality rate of 0.44 %.

4. Of the 228 Dengue Fever suspect cases reported this year, one hundred twenty four (124) are males and one hundred-four (104) are females with the youngest at 5 ½ months old and the oldest at 56. All twenty-four (24) barangays of Calasiao have reported cases of Dengue Fever. Significant concern is in Barangay Buenlag having registered the highest number with 35 cases and has reported the most cases for August and September.

6. DENGUE FEVER CASES PER BARANGAY Based on Onset of Symptoms BARANGAY Jan. Feb. Mar. Apr. May Jun. Jul. Aug. Sept. Oct. Nov. Dec. TOTAL AMBONAO 1 1 3 5 AMBUETEL 2 2 1 5 BANAOANG 1 1 2 BUED 3 1 1 4 1 1 11 BUENLAG 2 1 4 11 17 35 CABILOCAAN 1 1 2 DINALAOAN 1 3 2 2 8 DOYONG 1 1 3 4 9 GABON 6 3 1 1 11 LASIP 1 2 8 6 17 LONGOS 3 3 2 2 10 LUMBANG 2 3 2 1 1 9 MACABITO 1 1 MALABAGO 1 1 7 5 1 15 MANCUP 3 1 2 1 7 NAGSAING 2 1 6 4 1 14 NALSIAN 1 9 3 1 14 POB. EAST 2 2 1 5 POB. WEST 2 2 0 4 QUESBAN 1 2 1 3 7 SAN MIGUEL 1 5 12 1 1 20 SAN VICENTE 3 1 4 SONGKOY 1 1 TALIBAEW 2 2 5 3 12 TOTAL 10 2 1 3 6 32 66 53 46 3 5 1 228

7. The number of reported Dengue Fever suspect cases of 228 is the highest recorded incidence of Dengue Fever since 1998 when Calasiao had a total of 271 cases with three deaths.

8. Based on the computation of the data of Dengue Cases in Calasiao for the past five years, the number of cases per month for the year showed that the situation has breached the epidemic threshold for the Dengue Fever statistics and this required greater efforts to control the Dengue Fever situation. The option for the declaration of a Dengue Fever outbreak was extensively evaluated validated, deliberated and verified involving representatives of the LGU, the local Health Office, the Pangasinan Provincial Health Office and the Center for Health Development for Ilocos. DENGUE OUTBREAK

9. Eventually, on August 20, 2008, the Local Government Unit of Calasiao, through a Sangguniang Bayan Resolution and upon recommendation of the Health Office and Mayor Roy T. Macanlalay, declared a state of Dengue Fever outbreak in Calasiao. The outbreak declaration serves to increase public awareness and involvement of the community in the control of Dengue Fever as well as intensify the intervention measures already being implemented by the LGU and the Health Office. DENGUE OUTBREAK

10. The month of August, based on previous data, is the month when the highest number of Dengue Cases occurs in Calasiao The computed epidemic threshold for August is 80 cases, this year’s data showed 53 cases for August 2008 and this data was considered in the recommendation to lift the Dengue Outbreak declaration. However, the lifting the Dengue Outbreak declaration was put on hold. Due to the following: DENGUE OUTBREAK

11. The rains and constant flooding brought about by the series of typhoons that have struck the country and the town has greatly hampered all efforts of the Local Government Unit and the Health Office. The Dengue Fever situation temporarily took a back seat due to the onslaught of Acute Gastroenteritis (AGE) and Cholera cases which affected Central Pangasinan. Calasiao has reported 4 cases of Cholera and 256 cases of AGE. DENGUE OUTBREAK

12. 3. Add to the dilemma is the problem brought about by the fire that burned to the ground the Municipal Building last September 15, 2008 which further depleted the limited resources for disaster and calamity situations in the town. Nonetheless, despite all the prevailing problems, the LGU of Calasiao is highly resolved not to waver in its efforts for the prevention and control of Dengue Fever in the town. DENGUE OUTBREAK

13. While the lifting of the Dengue outbreak declaration was on hold, education and information campaigns still went on, clean-up drives were being undertaken by the barangay officials despite the constant interference of rains and floods; and fogging operations were still being conducted in households of suspect Dengue Fever cases and adjoining houses. DENGUE OUTBREAK

14. The lifting of the state of Dengue Fever outbreak will have to be considered with utmost prudence to ensure that all factors in regards to Dengue Fever prevention and control are in place and will remain functional and operational through the rest of the year. Dengue Fever, now considered as an endemic public health concern, should be addressed for the long term in Calasiao, Pangasinan. Lifting of the Dengue outbreak declaration was finally done on November 2008. DENGUE OUTBREAK

15. Consultative meetings with representatives of the Pangasinan Provincial Health Office and from the Center for Health Development for Ilocos before the declaration of Dengue Outbreak. DENGUE OUTBREAK AUGUST 7, 2008

16. Final consultative meeting with Pangasinan PHO represented by Dr. Wilda Silva and from the CHD for Ilocos , Dr. George Calugay and Mrs. Lolita Quinto., prior to the actual declaration of Dengue Outbreak. . DENGUE OUTBREAK AUGUST 19, 2008

17. A Special Session was called by the Sangguniang Bayan presided by Vice-Mayor Galang, to facilitate the Resolution declaring the Municipality of Calasiao under the state of a Dengue Outbreak... DENGUE OUTBREAK AUGUST 20, 2008

18. The media was called to inform the public on the Dengue Fever outbreak in Calasiao. Mayor Roy Macanlalay being interviewed by Charisse Victorio of GMA Amianan, the MHO being interviewed by Cris Zuniga of ABS CBN NorthCentral Luzon. DENGUE OUTBREAK AUGUST 20, 2008

19. RESPONSE ACTIVITIES I. PROMOTION AND INFORMATION /EDUCATION COMMUNICATION CAMPAIGN - LGU officials - Liga ng Mga Barangay - MHO Staff - Dep Ed Principals and Teachers - Barangay Health Workers - Tri-media outlets - Student Affiliates’ Barangay Visits - Philippine National Red Cross

20. RESPONSE ACTIVITIES PROMOTION AND INFORMATION /EDUCATION COMMUNICATION CAMPAIGN Regular updates to Mayor Roy T. Macanlalay and other LGU officials on the Dengue Fever situation in Calasiao and on the interventions being implemented.

21. RESPONSE ACTIVITIES PROMOTION AND INFORMATION /EDUCATION COMMUNICATION CAMPAIGN Updating the members of the Sangguniang Bayan, headed by Vice Mayor Ferdinand Galang on the Dengue situation in Calasiao.

22. RESPONSE ACTIVITIES PROMOTION AND INFORMATION /EDUCATION COMMUNICATION CAMPAIGN May 16, 2008. The BHWs of Calasiao, being at the forefront of health service delivery, are regularly updated on the Dengue Fever. The emphasis is always on the important role of early detection and referral of suspect Dengue Fever cases and the importance of cleanliness and environmental sanitation in the fight against Dengue.

23. RESPONSE ACTIVITIES PROMOTION AND INFORMATION /EDUCATION COMMUNICATION CAMPAIGN June 23, 2008 MDCC convened by OIC Mayor Ferdinand Galang, to assessed the damage brought about by Typhoon Frank. It also served as a venue to evaluate and discuss the measures to be undertaken to address the present Dengue Fever problem

24. RESPONSE ACTIVITIES PROMOTION AND INFORMATION /EDUCATION COMMUNICATION CAMPAIGN June 23, 2008 After the MDCC meeting, OIC Mayor Ferdinand Galang, and the MHO met with the Barangay Captains to ask for their support on the activities that were planned to combat Dengue Fever in the town of Calasiao.

25. RESPONSE ACTIVITIES PROMOTION AND INFORMATION /EDUCATION COMMUNICATION CAMPAIGN July 4, 2008 The MHO conducted a lecture about Dengue Fever for the DepEd principals and teachers of both Districts I and II. This aims to give the teachers the necessary information for them to impart to their students as part of the community effort to control Dengue Fever in Calasiao.

26. RESPONSE ACTIVITIES July 6, 2008 As a result of the MDCC meeting last June 23, OIC Mayor Galang led the municipal employees on a Sunday morning in conducting a municipal-wide cleanliness campaign dubbed” Kalinisan Para Sa Kalusugan” to increase public awareness on the importance of proper environment sanitation in the fight against Dengue Fever. PROMOTION AND INFORMATION /EDUCATION COMMUNICATION CAMPAIGN

27. RESPONSE ACTIVITIES PROMOTION AND INFORMATION /EDUCATION COMMUNICATION CAMPAIGN June, July, August 2008 The Health Office, the Barangay Officials and the community participated in the several community assemblies gathered in order to educate and inform the people about Dengue Fever.

28. RESPONSE ACTIVITIES PROMOTION AND INFORMATION /EDUCATION COMMUNICATION CAMPAIGN The media, including television and radio outlets, were tapped to help in the information dissemination of the Dengue Fever status in Calasiao.

29. RESPONSE ACTIVITIES PROMOTION AND INFORMATION /EDUCATION COMMUNICATION CAMPAIGN August 11, 2008 The CHD and PHO assisted the MHO in the fight against Dengue. Shown are the personnel from the MHO, CHD and PHO meeting with the Punong Barangays of Calasiao to schedule the IEC and fogging activities.

30. RESPONSE ACTIVITIES PROMOTION AND INFORMATION /EDUCATION COMMUNICATION CAMPAIGN The Philippine National Red Cross, Pangasinan- Dagupan City-San Carlos City Chapter launched last Aug. 29, 2008 an educational and information campaign, their “D…ATS” and “Brigada Linis” projects, in all 24 barangays of Calasiao from September 1-18, 2008

31. RESPONSE ACTIVITIES II. REPRODUCTION AND DISTRIBUTION OF INFORMATION MATERIALS - Health Advisories on Dengue Fever - Posters on the 4 O’Clock Habit - Posting of Streamers June 2008 The Health Office, aware of the importance of health education in the control of Dengue Fever, drafted, reproduced, distributed and posted information materials for people to better understand the Dengue Fever problem.

32. RESPONSE ACTIVITIES REPRODUCTION AND DISTRIBUTION OF INFORMATION MATERIALS Several reams of health advisories on Dengue Fever, the 4 O’clock habit and flyers were reproduced and distributed to all barangays of the municipality.

33. RESPONSE ACTIVITIES REPRODUCTION AND DISTRIBUTION OF INFORMATION MATERIALS Several posters were reproduced and posted in strategic areas of the municipality.

34. RESPONSE ACTIVITIES REPRODUCTION AND DISTRIBUTION OF INFORMATION MATERIALS Streamers were also reproduced and posted in strategic areas of the municipality.

35. RESPONSE ACTIVITIES III. TECHNICAL AND LOGISTIC ASSISTANCE Fogging of houses where suspected Dengue Fever cases reside and its adjoining houses Larvicidal spraying in prioritized areas. The Center for Health Development for the Ilocos Region augmented the MHO anti-Dengue Fever supply The Provincial Health Office provided materials and manpower for the IE campaigns Provision of transportation allowance for the epidemiological investigations by the LGU The Philippine National Red Cross, Pangasinan-Dagupan City-San Carlos City Chapter provided IEC materials and educational information campaign from September 1 to 18, 2008.

36. RESPONSE ACTIVITIES TECHNICAL AND LOGISTIC ASSISTANCE May 26, 2008. Anti-Dengue activities in Calasiao were started when the rainy season set in. Shown here are health personnel of the MHO and CHD-I doing health education and fogging operation in Barangay Talibaew where early reported cases came from.

37. RESPONSE ACTIVITIES TECHNICAL AND LOGISTIC ASSISTANCE June –July 2008 Larvicidal spraying were done in areas where there is pooling of water in order to destroy larva and breeding places of mosquitoes.

38. RESPONSE ACTIVITIES TECHNICAL AND LOGISTIC ASSISTANCE August 11-15,, 2008 The CHD and PHO supported the MHO in the fight against Dengue through the assistance on the IEC and fogging activities. .

39. RESPONSE ACTIVITIES TECHNICAL AND LOGISTIC ASSISTANCE August 29, 2008 The launching of the Philippine National Red Cross, Pangasinan- Dagupan City-San Carlos City Chapter’s educational information campaign in all 24 barangays of Calasiao from September 1-18, 2008

40. RESPONSE ACTIVITIES IV. MONITORING AND EVALUATION - Fever cases surveillance - Epidemiological investigations and regular reporting - Monitoring of anti Dengue activities and evaluation of performance

41. RESPONSE ACTIVITIES MONITORING AND EVALUATION The Health Office continuously performed surveillance and monitoring of reported Dengue Fever suspect cases and ocular inspections during epidemiological investigations.

42. RESPONSE ACTIVITIES MONITORING AND EVALUATION The MHO, with LIGA Pres., AJ Bauzon, regularly updates members of the Liga ng mga Barangay on the Dengue Fever situation during their monthly meeting. This serves as the evaluation of the anti-Dengue Fever activities being undertaken in all the affected barangays.