Dengue Cases in Children Are Declining But Still Troubling

Statistics from the Min­is­try of Health show that so far this year, an esti­ma­ted 4,300 children across the coun­try have contracted dengue fever, and 68 of them have died of den­gue hemorrhagic fever—the lethal form of this mosquito-borne di­sease.

The death rate among children sickened by dengue is roughly half of the fatality rate during the same period last year, according to health officials.

“If we compare the situation with last year, we are doing better this year,” said Mam Bunheng, secretary of state for the Health Min­istry. “The management of the program is going well.”

In Siem Reap province, where a sig­nificant outbreak of dengue fe­ver oc­curred two years ago, health officials say that the lower num­bers are certainly welcome news.

“This year we are seeing about five or six cases a month of den­gue in our hospital,” said Ngoun Chan Theak­tra, medical director of Ang­kor Hospital for Children in Siem Reap, where a good portion of pa­tients from surrounding pro­vinces come for treatment. “We have not seen an in­crease in the past couple of years like we did in 2003.”

Mam Bunheng said that the low­­­er figures are testament to on­going den­gue prevention campaigns, in­cluding using insecticides to kill mos­quitoes and larvae, and educating Cambodian par­ents on how best to protect their young­sters from the disease-car­rying insects.

But health officials say the di­sease, also known as break-bone fe­ver and for which no antiviral treatment or vaccine exists, re­mains a sig­nificant concern.

“Right now, we observe the num­bers go down, but it’s still a pro­­blem,” said Ngan Chan Tha, deputy director of the National Malaria Center and manager of its dengue control program. “By the end of the year, we hope that the number of cases will continue to drop.”

This year, Banteay Meanchey pro­vince has been the hardest  hit by the black-and-white striped mosquitoes that spread dengue, said Ngan Chan Tha. Since the primary wea­pon against the viral disease is to kill the mosquito larvae in the stag­nant water where they breed, health workers distributed the larvicide Abate through the region, as well as in urban areas such as Phnom Penh and Kompong Cham town, from May through July, he added.

Unlike the malaria-carrying in­sect that strikes after dark, the Ae­des ae­gypti mosquito that transmits den­gue is most active in the early morning and late afternoon, making the di­sease tricky to fight. The best prevention is to reduce mosquito-breed­ing habitats.

According to the World Health Or­ganization, children have be­come the most common victims of the lethal form of dengue in South­east Asia, where its prevalence has increased dramatically in recent de­cades, making the disease an in­ternational public-health concern.

Public health experts say that Type 4 dengue, which tends to be the most lethal, commonly takes hold of children younger than se­ven. Epidemiologists say they can­not really explain why youngsters contract the Type 4 strain more readily.

Hot and wet weather provides ideal conditions for the virus, which puts the peak season for den­gue in Cam­bodia at the height of the rainy sea­son from May through August.

Experts believe that the in­creasingly mobile population traveling by cars, airplanes and other vehicles that can harbor infected bugs con­tribute to the spread of the disease from one region of the country to the next.

Dengue symptoms include high fever, bone pain, headache, nau­sea and  general weakness. The hemorrhagic form also in­volves high fever, li­ver enlargement and as the disease turns le­thal, circulatory failure when plasma in the blood leaks from capillary veins into body tissue.

Homeowners can carry out preventive measures on their own. They can inspect gutters, flower pots, air-conditioner trays and wa­ter con­tainers to ensure no wa­ter stagnates and can be a breeding site for mosquitoes. Trash pi­les al­so attract the insects, according to Ngan Chan Tha.

“We are encouraging people to clean their environment to protect themselves against dengue,” he said.






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