Deaths from dengue fever have nearly tripled in Malaysia this year compared to the same period in 2013, sparking a stepped-up campaign to control the mosquitoes that spread the virus.
Mosquito Issue in Malaysia
Malaysia Health Minister S. Subramaniam says as of this week, 22 people had died from dengue in 2014 – compared to eight deaths over the same stretch last year. While still early in the year, at the current pace the numbers would surpass 2010 – the deadliest year on record, when 134 people died from the illness. A total of 11,879 cases had been reported as of Monday, up nearly four-fold from the same period in 2013.
“I think the number of cases will increase,” Mr Subramaniam said. “We urge the public to play their role. The spike in cases is putting a strain on our medical services.” More than 43,000 cases were reported in 2013, with 92 deaths, up from 35 dead the year before. “Every three to four years, we witness a peak in the cycle,” Mr Subramaniam said. Dengue fever is a flu-like illness marked by symptoms including nausea, headache, and severe muscle and joint pain that gives rise to its nickname “break-bone fever”.
In severe cases, it can cause internal bleeding, organ impairment, respiratory distress and death. Dengue is transmitted by the Aedes aegypti mosquito, which can pick up the virus from an infected human and transmit it to the next person it bites. According to the World Health Organisation, which has labelled dengue one of the fastest-growing viral threats globally, the disease may be infecting up to 50-100 million people each year. There is no vaccine, so prevention focuses on mosquito control.
Malaysian authorities have stepped up a nationwide campaign to fumigate or eliminate mosquito breeding hotbeds in standing water, garbage dumps and construction sites. This includes what authorities have called the first large-scale use in Malaysia of the biological agent bacillus thuringiensis israelensis, or BTI, a naturally-occurring bacterium used in insect control. The government also has ordered local clinics in dengue “hot spot” areas – which have been concentrated in and around the capital Kuala Lumpur – to extend their operating hours to accommodate the roughly 2,000 new cases emerging weekly. “Hot spot” residents also are being advised to wear long sleeves and use mosquito repellent. Researchers estimate around three billion people live in regions of the world susceptible to dengue.
What have been done?
The Ministry of Health (MOH) and local authorities has made a lot of effort and taken action to prevent and control dengue transmission in the community. These include space spraying of insecticide to kill adult mosquitoes, larvaciding, mass premises inspection for breeding places, enforcement of Destruction of Disease-Bearing Insects Act, 1975, producing guidelines, health educations campaigns, conducting activities to facilitate community participation such as COMBI (Communication for Behaviour Impact) and development of special task force at ministerial, states and district level. Dengue has been made a permanent agenda in Cabinet Committee on Cleanliness and Health meeting chaired by Deputy Prime Minister since 2006. RM 50 million had been allocated for dengue control and prevention programme. In 2009, the National Strategic Plan on Dengue Prevention and Control was initiated.1 The thrust of the plan includes priority on dengue prevention and control in the Klang Valley, optimising the Integrated vector management strategy, social mobilisation through involvement of all parties including public and non-governmental organisations (NGO), full government commitment, availability of standard dengue management protocol, adequate resources including financial, manpower and capacity building, fast and effective outbreak management, utilisation of research findings and using new methods and technique in dengue control activities. Dengue Task Force Committee for combating dengue was formed in 2013 to monitor and provide guidance in implementation of the plan. However, the impact of the strategic plan has yet to be fully observed. There was indeed a decline in dengue incidence from year 2009 till 2012, however an increase has been noted in 2013 and 2014. In March 2015 MOH has introduced a pilot project in Klang Valley using Indoor Residual Spray, a technique used in malaria control programme to control adult Aedes mosquitoes. The result of this effort is yet to be seen.
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