By Henrylito D. Tacio
When four-year-old Nathan came down with a recurring fever and started complaining of stomach pains in April last year, his mother Stella thought he was just suffering from wind. Still, she took the boy to the doctor, who said some paracetamol should help ease his symptoms.
However, Nathan’s condition didn’t improve. Finally, when his breathing became rapid and his skin turned cold and clammy, Stella rushed him to a clinic, which immediately sent them to a nearby hospital. Nathan had fluid in his chest and his veins had collapsed.
Doctors, struggling to keep his rocketing blood pressure under control, moved him into intensive care. It was too late: less than two days after being admitted to hospital, Nathan died.
Nathan was a victim of a virulent form of dengue fever, a mosquito-borne contagion considered to be one of the country’s biggest health problems. “Dengue is a major public health concern throughout tropical and sub-tropical regions of the world,” reports the Geneva-based World Health Organization (WHO).
Although cases of dengue in Davao region dropped by 54% from January 1 to September 30 in 2015, still there were 11 deaths recorded, according to the Regional Epidemiology Surveillance Unit of the regional office of the Department of Health. Of the 6,715 cases, most of them were from Davao City with 1,253 cases.
“The parents now are very aware that they bring their children to the hospitals if they suspect they are infected with dengue,” Engr. Antonette Ebol, the department’s program manager of dengue/malaria center and other vector-borne diseases, was quoted as saying.
And there’s a good news. The world’s first dengue vaccine for human use has already been approved in three countries, including the Philippines, according to Sanofi Pasteur, the vaccines division of Sanofi. The two other countries are Brazil and Mexico.
“Approval of the first dengue vaccine in Asia, which bears 70% of global disease burden, is a major milestone in dengue prevention and public health,” pointed out Olivier Charmeil, president and chief executive officer of Sanofi Pasteur in a press statement.
The vaccine has undergone testing on more than 29,000 patients worldwide. The Philippines reportedly participated in all three phases of the clinical development of the vaccine called Dengvaxia®. The New England Journal of Medicine published the pooled efficacy and integrated safety analyses from the 25-month Phase III efficacy studies and the ongoing long-term studies.
“Prevention of dengue is an urgent and growing medical priority in the Philippines,” says Dr. May Book Montellano, president of the Philippine Foundation for Vaccination. And vaccination, she adds, “is widely accepted as one of the most cost-effective ways to reduce the spread of infectious diseases like dengue.”
The Scientific American reported that the vaccine, which is designed to coax the body’s immune system into making antibodies against all four forms of dengue, is a live virus comprised of an attenuated yellow fever virus. (Yellow fever virus and dengue virus have the same genus.) For the vaccine, however, the virus is genetically engineered to include genes encoding for dengue proteins.
The vaccine isn’t perfect but it could help. “In clinical trials it only reduced the chances of developing the disease by about 60 percent,” Scientific American said. “Also, it is only approved for use in people nine to 45 years old who live in dengue-endemic areas —not young children or the elderly. In fact, the vaccine seems to be least effective in children younger than nine years old, particularly among kids under 6, whose immune systems are especially vulnerable and might be part of the group who need the vaccines most.”
According to Sanofi, the vaccine prevents “9 out of 10 cases of severe dengue.” Cameron Simmons, a professor of microbiology and immunology at the University of Melbourne, told Al Jazeera: “The evidence from the vaccine trials is that it can prevent hospitalization for about 80 percent of those who get vaccinated.”
Also known as “break-bone” fever, dengue is the Swahili term for “a sudden overtaking by a spirit.” Caused by four distinct virus serotypes (varieties recognized as distinct by the immune system), it is a distant cousin of yellow fever.
Like death and taxes, dengue exempts no one: fat or thin, ugly or beautiful, rich or poor, educated and illiterate. Children, who are exposed in open areas while playing, are more prone although adults are not spared.
Take the case of Manuel, a Manila-based lawyer. To beat the heat during the summer season, he went to Baguio, where he contracted dengue. A few days after bitten, he suffered high fever, severe headache, and pain behind the eyes. There was also an outbreak of rashes in some parts of his body.
From Baguio, he was brought to Manila. But it was already too late. He suffered hemorrhage in the liver and died three weeks after being confined in one of the well-known hospitals in Makati City.
Even doctors die from it, too! There was a case of a lady physician whose daughter suffered from dengue. Unknowingly, a mosquito which bit her daughter had bitten the doctor. A few days after the daughter died, as a result of dengue, the doctor also showed manifestations of having dengue. She also died of the same disease.
The clinical features of dengue fever vary according to the age of the patient. The United Nations health agency says dengue fever usually starts suddenly with a high fever, rash, severe headache, pain behind the eyes, and muscle and joint pain. The severity of the joint pain has given dengue its other name. Nausea, vomiting, and loss of appetite are common. A rash usually appears three to four days after the start of the fever. The illness can last up to 10 days, but complete recovery can take as long as a month. Older children and adults are usually sicker than young children.
Most dengue infections result in relatively mild illness, but some can progress to dengue hemorrhagic fever (DHF). With DHF, the blood vessels start to leak and cause bleeding in the nose, mouth, and gums. Without prompt treatment, the blood vessels can collapse, causing shock.
Most people equate DHF with influenza and similar flu-like diseases. “There is usually rash in dengue while there is none in flu,” explains Dr. Allan Schapira, an epidemiologist who was then with the WHO regional office when interviewed by this author. “Fever caused by dengue tends to last almost a week, while that of flu disappear after 3-5 days.”
Sarah thought her 7-year-old son Justin had flu since he manifested such symptoms as fever, chills, headache, runny and stuffy nose, sore throat, and weakness. A day later, her son complained of muscle and joint pains. The fever was gone one day and returned the following day. By this time, there were rashes all over his arms and blood was oozing from his nose.
“There’s something wrong with our son,” Sarah frantically told her husband. The couple immediately brought Justin to the nearest hospital. The doctor conducted a blood test and confirmed Sarah’s observation. “Justin is suffering from dengue fever,” he said. “He is in need of type-B blood as his platelets have dropped to a critical level.”
“Children are much more like to get DHF than adults,” explained Dr. Schapira. “This is the reason why children are much more at risk of dying.” (To be concluded)
0 Comments
Oldest