Thailand is currently facing a severe dengue fever outbreak as the rainy season and El Niño approaches, posing a significant threat to public health. The number of cases has surged to alarming levels this year, with the Ministry of Public Health (MoPH) warning that it could reach a three-year high. To combat this this disease, health authorities are urging local agencies to intensify efforts in curbing the breeding cycle of mosquitoes, which are the carriers of dengue.
Alarming Rise in Dengue Cases:
Thailand has witnessed a staggering rise in dengue fever cases this year, with more than 24,030 infections and over 20 deaths reported since January 1 (as of June 21, 2023). The infection rate is 4.2 times higher than the previous year, with the majority of cases concentrated in Nong Bua Lamphu, Pichit, Pathum Thani, Chai Nat, Narathiwat (as of June 27, 2023). Weather conditions, including increased rainfall and El Niño, can impact mosquito density and transmission potential, contributing to a potential dengue resurgence warned by the World Health Organization (WHO) due to inadequate surveillance and urbanization.
Dengue cases in Thailand have cyclical patterns, with outbreaks happening every two to three years. The comparison of dengue cases this year with the low numbers during the COVID-19 period from 2020 to 2022 is causing concern. There are various reasons why dengue transmission and reporting were low during the COVID-19 period, but the longer-term trend indicates that dengue cases are returning to levels similar to those post COVID-19.
The yearly reported cases range from 40,000 to over 100,000 during outbreak years. However, there was a significant decline in 2021, possibly due to the impact of the COVID-19 situation. © DVBD MoPH.
Understanding Dengue and COVID-19's Impact on Vulnerable Groups:
COVID-19 and dengue virus can both cause widespread infections, with shared symptoms like fever, headache, and muscle pain. However, dengue is known for causing bleeding tendencies, while severe COVID-19 can lead to blood clot formation. Elderly individuals with underlying conditions like diabetes and obesity, are more susceptible to severe dengue cases, as they often delay seeking medical care and resorting to self-medication. Early diagnosis of dengue fever can be challenging due to symptom overlap, highlighting the importance of public awareness for accurate diagnosis and treatment. Individuals should protect themselves, seek medical attention for symptoms, and avoid self-medication for proper diagnosis and treatment.
The Manifestations of Dengue: The Symptoms and Impact on the Body © CDC
From 2014 to 2023, the death rate for dengue ranged from 0.06 to 0.13. Since 2017, more adults have been dying from dengue compared to children © DVBD MoPH
MoPH Surveillance Efforts and Targeted Prevention:
The MoPH focuses on three key measures to prevent dengue: collection, prevention, and disease control. This includes covering water storage containers, proper garbage disposal, and environmental improvements. Initiatives like "BIG CLEANING DAY" are effective. The Department of Disease Control sets specific goals for high-risk areas, and actively monitors rainfall forecasts, mosquito breeding sites and densities, reported dengue cases and deaths, and public compliance with prevention measures to assess outbreak risks. This information allows the ministry to implement targeted preventive measures and allocate resources effectively to combat dengue transmission.
Successful Initiatives:
In Phichit province, public health volunteers in Pak Thang sub-district have kept villages dengue-free for three years. Since the 2011 flood, volunteers have led a campaign to eradicate mosquito larvae. Non-compliant households face fines that contribute to the village fund. Where green flags mean no larvae, red flags mean larvae present. Volunteers face double fines for larvae in their homes, and village heads and sub-district chiefs face quadruple fines.
WHO Recommendations:
The WHO provides several recommendations for dengue prevention and control, including implementing Integrated Vector Management (IVM) strategies, ensuring early case detection and diagnosis, providing comprehensive case management, establishing surveillance systems, engaging and mobilizing communities, conducting health education campaigns, considering dengue vaccines, enhancing IVM activities, implementing personal protective measures, and maintaining surveillance and public health messaging.
Thailand's current dengue outbreak demands immediate attention and comprehensive action to implement preventive measures, enhance healthcare infrastructure, and raise public awareness. With a strong commitment to a multi-faceted approach and collaboration across government agencies, healthcare providers, and the public, Thailand can effectively combat the rising dengue cases and protect the health and well-being of its population.
Private institutes and government part work together as MOU to prevent and control Dengue and other arbovirus in Thailand © DVBD, MoPH