6-Month Dengue Death Toll Passes Total for 2006

The death toll from dengue fever for the first half of this year has already surpassed the total number of people who died from the virus in all of 2006, Health Ministry officials said Monday.

Ngan Chantha, the ministry’s dengue program manager, said that 182 people have died from the virus to date, compared to the 158 who died from dengue in 2006.

Government figures show 14,986 reported cases of dengue fever so far this year and the virus has yet to reach its annual peak of infections at the end of July.

Last year, there were 16,649 re­ported cases in total, Ngan Chantha said.

Dr Beat Richner, who said his four Kantha Bopha hospitals care for 90 percent of Cambodia’s deng­ue patients free of charge, said 145 children have succumbed to the virus in his hospitals alone this year.

About 90 percent of the fatalities, Richner said, died as a result of re­ceiving the wrong combination of drugs or too many drugs at another hospital prior to being admitted to Kantha Bopha.

Varun Kumar, medical adviser and senior pediatrician at Angkor Hospital for Children in Siem Reap town, said that his 50-bed hospital is at double capacity due to the overflow of dengue patients.

“In June alone, we had more than double the amount of dengue patients than we saw in all of 2006,” he said, adding that while the mortality rate is low, there is a significant strain on human resources at his hospital.

Kantha Bopha hospitals in Phnom Penh and Siem Reap are admitting between 180 and 200 new cases of severe dengue fever each day and the average cost of treatment is about $300 per patient, Richner said.

The warning signs for the current dengue outbreak were present late last year and health officials should have done more to prepare for the outbreak they knew was looming, he said.

Normally there are few or no dengue cases during the dry season, but last November Richner said his hospitals were already seeing some 20 new cases each day.

“I knew as soon as the rainy season starts, there will be an explosion,” he said, mentioning that a similar scenario arose with the last severe epidemic in 1998.

The current epidemic could have been minimized if health officials had neutralized the mosquito breeding territories in areas where they already knew the dengue mosquitoes were present, he added.

Ngan Chantha said the health ministry’s provincial network of officials did visit high-risk locations prior to the outbreak to spray insecticide and sprinkle the chemical abate—which kills mosquito larvae found in water.

“We prepared everything to take care of the dengue situation,” he said. “It spread everywhere in the country. How can you control?”

Ngan Chantha added that the ministry distributed about 200 tons of abate over the course of a year to help curb the outbreak, but that the virus spread beyond those areas, making it increasingly difficult to counter.

“It is not so easy to control be­cause breeding is at the household level,” he said, adding that families need to take responsibility for cleaning out and covering their water jugs.

Chang Mohseng, World Health Organization vector control scientist, estimated that there are 12 million water jars in Cambodia and emphasized the importance of villagers discarding water that gathers in old containers.

The Health Ministry did the best it could to prevent the outbreak given constraints on money, hum­an resources and technology, he said.

“They started early applying abate this year, but they have to continue,” he said, adding that abate is effective for up to three months at which time it needs to be reapplied.

Chang Mohseng said it is difficult to say whether the outbreak was avoidable or could have been further minimized, but he noted that other countries in Southeast Asia with more money have also had trouble containing the dengue virus.

The WHO is leading efforts to spray insecticide and train provincial teams how to use the anti-mosquito spray in Phnom Penh and other hard-hit provinces, including Kandal, Kompong Speu, Kom­pong Cham, Siem Reap and Ban­teay Meanchey.

“Phnom Penh is under control,” Chang Mohseng said, but added that the numbers of dengue cases are not likely to immediately fall, given the fact that July and August are traditionally when infections peak.

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