Community workers gassed a residential complex against Aedes Aegypti mosquitoes on May 6, 2020 to combat a dengue outbreak during the Covid 19 pandemic in Wanasari Village, Bekasi Regency, West Java Province.
Aditya Irawan | NurPhoto via Getty Images
There is no rest for Southeast Asian nations.
As health systems are already under pressure due to the coronavirus pandemic, countries like Singapore, Malaysia and Thailand are also struggling with another outbreak of infectious diseases: dengue fever.
"We are seeing an exploding number of dengue fever in Southeast Asia," said Dr. Leong Hoe Nam, a Singapore-based infectious disease doctor at Mount Elizabeth Novena Hospital, CNBC in an email.
Dengue fever is transmitted by mosquitoes and can cause fever, muscle and joint pain, severe headache and even death in its most severe form.
The National Environment Agency (NEA) in Singapore said last week that the island nation will exceed its previous year Record number of 22,170 dengue cases in 2013. By July 6, more than 15,500 dengue cases had been reported in Singapore, according to the NEA.
The more cases there are, the more likely it is that uninfected mosquitoes will bite the infected individual, causing the cases to spiral upward.
Dr. Leong Hoe Nam
Mount Elizabeth Novena hospital
"There is no doubt that it will be a bad year," Leong commented on the situation in Singapore before the NEA was announced.
In other parts of the region, Malaysia's general director of health warned last month of an increase in dengue cases across the country, local media reported.
In Indonesia, the most populous country in Southeast Asia, there were 68,000 cases of dengue throughout the country, according to local health authorities, at the end of June.
According to the United States Centers for Disease Control and Prevention, dengue risk in most Southeast Asian countries, with the exception of Singapore, is classified as "common / continuous".
Dengues & # 39; best spouse & # 39;
The surge comes at a time when the world is fighting the coronavirus pandemic, which has affected the global economy as a result of social distancing measures to contain the disease and protected millions at home.
"Unfortunately, dengue fever hit the best spouse – Lockdown," said Leong. "When people stay at home (because of Covid), more people are exposed to the dengue mosquitoes that breed in the neighborhood."
"The more cases there are, the more likely non-infected mosquitoes will bite the infected individual, causing the cases to spiral upward," he said.
Dr. Duane Gubler, founding director of the Signature Research Program for Emerging Infectious Diseases at Duke-NUS Medical School in Singapore, agreed.
"People who are constantly stuck at home are likely to have greater exposure to dengue mosquitoes," warned Gubler that "greater precautions" should be taken to control mosquito larvae.
In addition, Gubler pointed out the danger of construction areas and said that they are a "main breeding ground" for mosquitoes due to corona virus barriers.
"The Covid epidemic could very well affect dengue transmission," he said.
According to Johns Hopkins University, Indonesia currently has the highest number of coronavirus cases among the Southeast Asian countries with 70,736. The Philippines followed with 51,754 cases and 45,423 infections reported in Singapore.
Leong said countries that had better controlled dengue spread in the past might suffer more this time.
To compare infection rates, according to Leong, specialists use a metric known as "dengue seroprevalence at the age of 9".
"In Singapore, less than 9% of children aged 9 years had dengue," he said, referring to this metric. "The numbers in neighboring countries are much higher: 30-40% in Malaysia, 50-60% in Thailand and Indonesia, 90% in the Philippines."
For countries like the Philippines, Leong said, "I don't think it can get any worse."
Instead, countries like Singapore and Malaysia have "much more to lose," he warned. The lower herd immunity in the general population makes it easier for mosquitoes to find people without previous immunity and to spread the infection, Leong said.
Herd immunity refers to the situation in which a sufficiently high proportion of the community has become resistant to a disease through prior exposure to an infection, reducing the likelihood that it will spread from person to person.
"Critical" rainy season
Looking to the future, Gubler said that countries in the region above the equator "get into a critical time" when they enter the rainy season – usually between July and November. This period coincides with an increased transmission for dengue fever, said Gubler.
"My concern comes from the fact that countries do not have the public health infrastructure to cope with both diseases, particularly dengue," said Gubler.
With the exception of Singapore, most Southeast Asian countries have not controlled the spread of dengue fever.
"Every endemic country really has to take responsibility for building its own public health infrastructure to deal with diseases like dengue," said Gubler. People also need to be trained so that the programs that are introduced are sustainable, he added.