Dengue Fever Claims 83 while Cases Climb

Health officials expect this year to be a bad one for dengue fever, and the latest figures bear out their fears.

As of Sunday, nearly 800 cases had been reported in Banteay Meanchey, Pursat and Kompong Chhnang provinces. Eighty-three of the victims died, a death rate of more than 10 percent.

With prompt and proper treatment, health officials say, no more than about 1 percent of those infected should die.

In Banteay Meanchey’s Thma Puok district alone, 49 of the 251 cases referred to the hospital died, said Neil Hawkins of CARE Cambodia. “That’s a fatality rate of 20 percent, and that is really very, very high,” he said Sunday.

Jesse Rattan, CARE’s health sector coordinator in Cambodia, called it unacceptably high. “The high fatality rate is probably due to late presentation,” meaning people delay seeking treatment until it is too late, she said.

Dengue is also a complex illness to treat, and some medical personnel in the provinces may not have sufficient training to treat it properly when people do seek help, Rattan said.

The World Health Organ­ization compiles data on dengue from all 24 provinces. An update on those countrywide statistics is expected later this week. The last report, issued in early May, said 348 people nationwide had dengue; 12 people died from it.

Dengue is transmitted by tiger mosquitoes, which breed in clean, still water such as that collected in water jars at many Cambodian homes. The black-and-white striped mosquitoes have a small range, which has traditionally meant more dengue outbreaks in cities, where people live crowded together.

The dengue season usually peaks in July and August, when heavy rains provide many places for mosquitoes to lay their eggs. This year’s outbreaks are worrisome because the disease is cropping up in rural areas as well as cities.

The WHO and the National Malaria Center are providing Abate larvacide to treat water jars in target areas, but the work of distributing the larvacide door-to-door is costly and time-consuming and has not yet been completed.

The disease is expected to be worse than usual this year because it peaks every three years and the last epidemic was in 1998, when more than 16,000 people were hospitalized and 475 died. The disease strikes hardest at those between the ages of six and 14 and at foreigners, who have not built up an immunity.

CARE Cambodia is working with the Ministry of Health in Banteay Meanchey, Pursat and Kompong Chhnang provinces, along with the WHO and the National Malaria Center.

Symptoms of dengue include a sudden high fever, headache, intense body pain and a pinpoint rash. Most people will survive, and once stricken, a person can expect to be relatively immune for three years.

But in severe cases, the virus breaks down the walls of blood vessels so that blood leaks throughout the body, causing shock and requiring immediate blood transfusions.

CARE’s Rattan said the best treatment is good prevention, which includes: treating standing water with larvacide; emptying rainwater any place it accumulates, such as tires, plastic bags, or coconut shells; checking water jars for larvae and destroying them; and protecting children from mosquitoes just after dawn and just before sunset, when the bugs are most likely to bite.

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