His eyes are groggy. His legs bear patches of dark rashes. His gums show signs of bleeding as he opens his mouth for the doctor to examine.“Nanginginig ako at masakit ang ulo ko nang isugod ako sa ospital (I was shivering and had a headache when I was rushed to hospital),” says 22-year-old Jomar Lauta, a tricycle driver.
Lauta is one of more than a hundred patients confined for dengue fever at San Lazaro Hospital in Manila. About 90 percent of those receiving medication are children.
Dengue is a flu-like viral illness spread by an infected female mosquito, the Aedes aegypti. Dengue hemorrhagic fever, like that of Lauta, is a severe, often fatal, complication of dengue fever.
The Department of Health (DOH) is worried with the onslaught of the rainy season. Dengue cases usually shoot up when it rains. Stagnant, but clear, water is the favorite breeding ground of Aedes mosquitoes that sting during daytime.
In the first twelve days of the year, dengue cases at San Lazaro Hospital alone nearly tripled compared to the same period last year. Five of the 380 patients died.
In Metro Manila, several villages in at least three cities – Manila, Quezon and Caloocan – were identified for dengue clustering, meaning two or more cases have been registered in a span of two weeks.
In 2007, the Philippines recorded an all-time high in the number of dengue cases. Of the 43,938 dengue cases last year, 407 patients died.
Quezon City had the most number of villages that had clustering of dengue cases. More than 2,000 people from 18 villages were hospitalized for dengue.
Mayor Sonny Belmonte was quick to emphasize that the city is one-fourth of Metro Manila in terms of population. The city is home to about 2.5 million people, more than 50 percent of whom live in slums where household water storage is common and where solid waste disposal services are inadequate.
“It’s no wonder why we lead in the list,” says Belmonte, adding that the city was not amiss in its efforts to solve the problem. He said dengue cases in the city have gone down by three percent in 2007 compared to the previous year.
Belmonte authorized village leaders to tap the government’s calamity fund, which is five percent of the village budget, to the fight against dengue.
Barangay Batasan Hills lead the list of dengue areas with 144 cases. One of its residents, Mary Grace Provido, still remembers the pain and the fear she felt when her daughter, Jenilyn, who was five years old then, was hospitalized for dengue in July.
“Alam ko kasi na nakamamatay ang dengue (I know that dengue kills),” says Provido.
She says she’s still stuck in debt for the P6,000 hospital bill. She has no work and her family of five relies on the meager income of her husband who works at a construction site.
Beyond gov’t control
The Health department has done its best to fight dengue, claims Health Secretary Francisco Duque III. It has forged partnerships with the Education department and local government units. It has also managed to convince the private sector to fund projects to fight the spread of dengue-carrying mosquitoes.
Despite the government’s efforts, dengue seems to be out of control.
Duque says there are factors beyond the government’s control, including global warming and population explosion.
He says erratic weather patterns and higher temperatures brought by global warming favored the penetration of mosquitoes.
Rapid population growth and poverty translate to thicker crowds in depressed areas that consequently allow mosquitoes to spread.
Duque also blames people’s attitude. Albeit they know what to do, they don’t act until they become victims and get to see the disease face-to-face.
“It’s every Filipino’s responsibility to fight dengue,” Duque says.
From monkeys to humans
The World Health Organization reveals that there are studies that show monkeys were infected by dengue and perhaps served as source for uninfected mosquitoes, which passes the virus to humans.
The virus incubates in the system of an infected mosquito from eight to 10 days when it is already capable, during blood feeding, of transmitting the virus to susceptible individuals.
It may also transmit the virus to its offspring by transovarial (via the mosquitoes’ eggs) transmission.
For infected humans, the virus circulates in the blood for two to seven days. During this period the victims have fever. WHO studies show that Aedes mosquitoes can get the virus from the victim when they feed. Then the cycle goes on.
Due to the absence of a vaccine to prevent dengue, WHO says the prevalence of the disease, which was first discovered in the 1950s in Thailand and in the Philippines, has grown dramatically in recent decades.
The disease is now endemic to more than 100 countries, expanding to Africa, the Americas, Eastern Mediterranean and the Western Pacific. Some 2500 million people, two-fifths of the world’s population, are now at risk from dengue, a big leap from only nine countries having dengue epidemics in 1970.