When six-year-old Cassie was brought to a town hospital in Bansalan, Davao del Sur, she was very weak. She complained of headache and an off-and-on high-grade fever, which continued for three consecutive days. The attending doctor thought the girl was having sort of flu.
On the third day of her confinement, Cassie complained of abdominal pain. She vomited every now and then. She developed measles-like rashes in his hands. The doctor became suspicious. So, on the fourth day of admission at the hospital, the doctor did platelet count of the patient’s blood. It was up at 8:30 in the morning and went down by 5 in the afternoon.
The lady physician became more alarmed when Cassie became restless and complained of chest pains and difficulty in breathing. More so when blood started oozing from her nose and blood streaks were found in her saliva.
It was 10 at night when the doctor referred the patient to Digos City, which has hospitals that are more equipped to handle such cases. The trip took about 30 minutes. After transfusions of blood and intravenous fluids, Cassie began to feel better. Nine days after, the little girl was back in her home. Her siblings welcomed her with big hugs.
Cassie was lucky. Not too many children survived such ordeal.
About 20 million cases of dengue occur each year and require 500,000 hospitalization, the Geneva-based World Health Organization (WHO) estimates. But in recent decades, “the incidence of dengue has grown dramatically around the world,” it says. “The actual numbers of dengue cases are underreported and many cases are misclassified.”
Actually, there are two types of dengue: dengue and severe dengue. The latter, also known as dengue hemorrhagic fever (DHF), was first recognized in the 1950s during dengue epidemics in the Philippines. “Today, severe dengue affects most Asian and Latin American countries and has become a leading cause of hospitalization and death among children in these regions,” the WHO reports.
Climate change
As global temperature continues to rise due to climate change so are dengue cases. “Climate change endangers human health,” declares Dr. Margaret Chan, WHO director-general.
Health scientists pointed out that should earth’s thermostat continues to increase, human health problems will also become more frequent and severe. “The warming of the planet will be gradual, but the effects of extreme weather events will be abrupt and acutely felt,” said Dr. Chan. “Both trends can affect some of the most fundamental determinants of health: air, water, food, shelter and freedom from disease.”
Dr. Paul Epstein, in a recent study entitled Human Health and Climate Change, echoes the same concern: “Climate change will have wide-ranging and mostly damaging impacts on human health.”
According to Dr. Epstein, a warming climate, compounded by widespread ecological changes, may be stimulating wide-scale changes in disease patterns. His study suggests that climate change could have an impact on health in three major ways.
First, by creating conditions conducive to outbreaks of infectious diseases; second, by increasing the potential for transmissions of vector-borne diseases and the exposure of millions of people to new diseases and health risks; and lastly, by hindering the future control of disease.
Climate change may also accelerate the spread of disease primarily because warmer global temperatures enlarge the geographic range in which disease-carrying animals, insects and microorganisms – as well as the germs and viruses they carry – can survive.
“Deadly diseases often associated with hot weather, like the dengue fever… are spreading rapidly throughout Asia because increased temperatures in these areas allow disease carriers like mosquitoes to thrive,” the study said.
Endemic in 100 countries
Before 1970, only nine countries had experienced severe dengue epidemics. The disease is now endemic in more than 100 countries, with Southeast Asia and the Western Pacific regions as among the most seriously affected.
Dengue is found in tropical and sub-tropical climates worldwide, mostly in urban and semi-urban areas. “Dengue is the world’s most important viral disease transmitted by mosquitoes,” declares Dr. Duane Gubler, health administrator of the US Centers for Disease Control and Prevention. “The mosquitoes become infected when they feed on someone who has the virus.”
The dengue virus is transmitted to humans through the bite of infected mosquitoes – either Aedes egypti or Aedes albopictus. Most Aedes mosquitoes are found indoors rather than outdoors. The Aedes aegypti prefers to rest in shaded places while Aedes albopictus prefer to rest in shrubs and trees.
Signs and symptoms
The clinical features of dengue fever vary according to the age of the patient. The United Nations health agency says the symptoms are like that of the flu. It is characterized by high fever, severe headache, pain behind the eyes, muscle and joint aches, and the outbreak of rashes.
But DHF is another story. “Dengue hemorrhagic fever is a potentially complication that is characterized by high fever, hemorrhagic phenomena – often with enlargement of the liver – and in severe cases, circulatory failure,” the WHO says.
Generally, dengue fever starts with a sudden rise in body temperature, accompanied by facial flush and other nonspecific constitutional symptoms. The fever usually persists for two to seven days and can be as high as 40 to 41 degrees Centigrade, possibly with febrile convulsions and hemorrhagic phenomena.
In moderate dengue fever cases, all signs and symptoms abate after the fever subsides temporarily. In severe cases, the patient’s condition may suddenly deteriorate after a few days of fever. The temperature drops, followed by signs of circulatory failure, and the patient may rapidly go into a critical state of shock and die within 12 to 24 hours, or quickly recover following appropriate volume replacement therapy.
Death often results from bleeding in the brain, intestines or other organs.
Most of those who die of severe dengue are children, but adults are at real risk too. “Dengue is a big problem among children because it is a major cause of illness and deaths,” says Dr. Lulu Bravo, professor at the University of the Philippine College of Medicine. However, “the risk of dying is higher among older children and early adolescent (5-14 years old).”
Among the famous adults who have been “victims” of dengue fever include KC Concepcion (October 2014) and Michael V (August 2013). Ryan Agoncillo, Jodi Sta, Maria and Gwen Zamora were also reported to have been dengue patients in 2013. – (To be continued)
