Dengue Fever in Singapore Is on the RiseDengue fever is not an uncommon virus, The World Health Organization estimates that there are around 390 million cases of dengue fever annually. The majority of these cases were reported in Asia with only 30% of these cases occurring outside of the continent. In 2019, it is estimated that Asia had 273 million cases of dengue fever. Dengue fever in Singapore has been rising since 2018, however, there has been a sharp increase of reported cases throughout 2020.

Dengue fever is spread by female mosquitoes and is most prominent in tropical areas. The severity of dengue fever can differ largely. In mild cases of dengue fever, the infected person may experience severe flu-like symptoms such as joint pain, fever, vomiting and headaches. However, severe dengue fever is associated with internal bleeding, decreased organ function and the excretion of plasma. Severe dengue fever, if left untreated, has a mortality rate of up to 20%.

Dengue Fever in Singapore

Singapore has experienced many dengue fever epidemics. The most recent epidemic occurred in 2013. It was the largest outbreak in Singaporean history. However, in 2020, Singapore has exceeded the 22,170 dengue fever cases reported throughout the 2013 outbreak. As of July 2020, the number of dengue fever cases reported in Singapore was higher than 14,000. This exceeds the number of cases reported in July during the 2013 outbreak and is almost twice as many cases reported in July 2019.

The National Environment Agency of Singapore reports that the number of cases being reported continues to be on an upward trend, suggesting this may be the worst outbreak of dengue fever in Singapore’s history. Singapore has also reported that there are 610 active dengue fever clusters as of October 3, 2020. A dengue cluster is where there are two or more confirmed dengue fever cases reported in a localized area within 14 days. As of October 5, there were more than 30,800 cases of dengue fever in 2020.

Changes in Dengue Fever

The 2020 outbreak of dengue fever has been driven by the virus serotype DenV-3. There are four major serotypes of dengue fever with DenV-3 being one of the least common. The prevalence of the serotype DenV-3 increased from the beginning of 2019 where nearly 50% of cases were reported to be DenV-3. This means there is lower population immunity, causing higher rates of infection and an increased likelihood of severe dengue fever development.

The typical season for dengue fever in Singapore is from June to October. However, Singapore had a major rise in cases in mid-May 2020, increasing the season length by two to three weeks. The sudden rise in dengue fever in Singapore has been attributed to a decrease in preventative measures due to the lock-down caused by COVID-19. Singapore imposed a lockdown on April 7 to minimize the spread of COVID-19. As a result, more people have neglected taking preventative actions such as removing still bodies of water around their homes to decrease mosquito breeding.

How Singapore Can Stop the Spread

The spread of dengue fever in Singapore can be decreased by mobilizing the Singaporean population to take active measures in preventing mosquito breeding. Removing stagnant water from gardens and gutters will help remove the breeding ground for mosquitoes. Also loosening hard soil and spraying pesticides in dark corners of the home will stop mosquitoes from laying eggs in these areas. The Singaporean government is also urging people to use insect repellent throughout the peak dengue fever season to stop the infection.

The Singaporean government has highlighted that the dengue fever outbreak in Singapore is a major health concern that needs immediate attention. With two significant health concerns, COVID-19 and dengue fever outbreaks occurring simultaneously, preventative measures must be taken to ensure the healthcare system is not overrun. With compliance to the National Environment Agency’s guidelines, the Singaporean people will be able to reduce the number of dengue fever infections.

Laura Embry
Photo: Flickr

Mosquito Breeding Sites With a Data Analytics App
In Colombia, 27% of people live in poverty and more than 7 million are considered internally displaced people (IDPs). These people fled their homes because of a long-running civil war and guerrilla attacks. Alongside rampant poverty and displacement, Colombia struggles with mosquito-borne diseases, reporting 1,400 cases of Zika in a single year and more than 84,664 cases of dengue fever. Worldwide, more than 1 million people die of mosquito-related illnesses each year. Premise, a company that specializes in data analytics, partnered with Colombia’s government and the United States Agency for International Development (USAID) to fight Colombia’s deadly Zika outbreaks and mosquito breeding sites with a data analytics app.

The Problem

At the beginning of 2016, South America was in the midst of Zika and dengue fever outbreaks. In 2019, more than 2 million South Americans contracted dengue, and at least 720 people died. Both Zika and dengue are mosquito-borne diseases that Aedes aegypti mosquitoes primarily spread. Aedes aegypti mosquitoes are also the main transmitters of yellow fever and chikungunya. These mosquitoes contract the virus by biting into people who already have an infection. Then, the mosquitoes spread the virus further by continuing to bite others. Only female mosquitoes are able to bite people, which is why only female Aedes aegypti mosquitoes transmit the virus.

In 2015-2016, Colombia had the second-largest Zika outbreak in the world. Cali, a city of 2.4 million people, accounted for more than 20% of the country’s cases. Some Colombians live in slum areas that lack proper sewage and garbage disposal systems, sanitation and running water. These areas are especially attractive to mosquitos, and during heavy rainfall, the health situation worsens because the slums experience flooding, creating stagnant water and puddles close to people’s homes.

Premise’s Mission

In 2017, Premise, a predictive data analytics company based in San Francisco, conducted its first phase of internal vector monitoring of Cali. The company records, georeferences and photographs mosquito breedings sites with a data analytics app, aiming to increase awareness across Colombian cities and give communities a way to fight mosquito-borne diseases. During the first phase, Premise digitally recorded 40,000 sewers and put them into the system; in the second phase, which began in 2018, Premise received funding from USAID.

As part of Premise’s work in Colombia, 7,000 people participated in a citizen network project, through which the community actively collaborated in monitoring and destroying mosquito breeding sites. Soon after Premise took off, 108,000 homes received inspections and more than 70,000 mosquito breeding sites were demolished — often by app users, who poured chlorine on the sites. The average number of breeding sites in people’s homes decreased from three to less than two in only one year.

Premise’s data science led to organized mosquito-management practices, such as vector control (killing larvae to decrease the population of male mosquitoes) and vector surveillance (keeping mosquito densities under close watch). Premise recorded 54,000 direct sewage openings that had a high likelihood of mosquitoes, and thanks to data granularity, locations of mosquito breeding sites were outlined down to the street intersections. The data analytics app not only tracked down mosquito hotspots and the origins of disease transmission but also gave civilians access to key records and methods to reduce mosquito breedings sites.

Citizen Participation

One reason for Premise’s success was the participation of local communities in its Citizen Network pilot project. Citizens directly contributed to monitoring Zika outbreaks and expanded the frequency charts and other collected data. In 2018, 2,911 citizens in Cali were actively engaged in Premise’s project, and thousands of people continue to complete Premise’s tasks each month, such as taking pictures of mosquito breeding sites, for small money prizes, which Premise sends via Bitcoin or bank deposit.

With the support of the USAID and local Colombian citizen networks, Premise is able to monitor and control Aedes aegypti mosquito breeding sites with a data analytics app. This innovative app decreases dangerous and deadly epidemics across Colombia, and soon, Premise may expand its mission across South America to help other nations in need of mosquito-borne disease control.

Anna Sharudenko
Photo: Flickr

Mosquito-Spread DiseasesMosquito-spread diseases such as malaria and dengue fever have plagued tropical regions for centuries. Most recently, the Zika virus emerged as a high profile danger to those living below the poverty line. Both malaria and dengue fever have higher mortality rates than the Zika virus. However, Zika causes birth defects. As a result, it promises to leave lasting effects on generations to come.

Origin of Zika Virus

Scientists first discovered the Zika virus in Rhesus monkeys in Africa in 1947. In 1948, the virus made the jump to mosquitos, which would lead to the first reported case in humans by 1952. A rash is what characterizes the contraction of this virus. It also associates with Guillain-Barre syndrome and microcephaly in unborn children because of their increased risks.

How These Diseases Affect Global Poverty

The Zika virus made headlines in 2016 as it threatened the Olympics, though they were able to carry on. This press helped to demonstrate the power and danger posed by mosquito-spread diseases in countries like Brazil.

Zika is a disease of poverty, meaning that although the disease is preventable, prevention is often sequestered to wealthy regions. These regions can afford to take extensive preventative measures, such as the widespread dispersal of mosquito nets and extermination.

Brazil is on par with the global average GDP per capita. However, this nation and many others in South and Central America are also plagued with wealth disparity. This means that although some communities within Brazil can enforce preventive measures against Zika and malaria, many others cannot.

Zika, malaria and dengue fever spread through the bite of mosquitoes that are infected. These mosquitoes typically come from the Aedes species. Any humid areas with heavy rainfall are likely to attract mosquitoes and be at risk of these diseases. Communities that lack proper infrastructure are also likely to have large pools of standing water. This, coupled with the tendency to overcrowd in urban areas, has left the impoverished and working-class people of South America, Africa and Southwest Asia susceptible to these diseases. This is not simply a health issue, but a class issue as well.

The Good News

After years of research, the International Atomic Energy Agency (IAEA) announced another breakthrough in the prevention of mosquito-spread diseases in June 2020. To prevent such diseases, scientists have pioneered the Sterile Insect Technique. This method takes male mosquitoes and uses radiation to sterilize them. They are released into a wild population where they mate with female mosquitoes. Eventually failing to produce allows the diseases carrying species of mosquitoes to die off. This technique promises to reduce the percentage of disease-spreading mosquitoes over the course of several mosquito generations.

The major issue with the plan is dispersal. As the IAEA notes, mosquitoes have delicate legs and wings that can easily be crushed in mechanical transport. This means that the sterilized males need to be hand released. This drives the cost up, makes the process slower and relegates it only to areas within a walkable distance (IAEA, June 2020).

However, in June, the IAEA tested a new sort of drone that promises to change the game. This drone flies smooth and consistently enough to release the mosquitoes without damaging them. As a result, there can be a great reduction in the treatment cost. Now, a variety of environments would be able to use it. These methods will also be able to reduce the amount of pollution and pesticides associated with mosquito nets in communities all over the world.

 

Allison Moss

Photo: Pixabay

Leading Diseases in Sri Lanka
A 6-year-old boy cried from pain from a small room in an overcrowded ward. The small child had a fever and rash and pointed to the different parts of his body that hurt. Hannah Mendelsohn, a medical volunteer from Haifa, Israel, tried to distract the boy with games of tic-tac-toe and peekaboo.

The child displayed classic symptoms of dengue fever. Doctors diagnosed him with the virus at Karapitiya Teaching Hospital in Galle, Sri Lanka during the summer of 2015. “[The boy] had luckily gotten to the hospital when he was still in an earlier stage of the disease,” Mendelsohn told The Borgen Project. “There were a few times I heard doctors tell patients with dengue that there were no options for life-saving care.”

While non-communicable diseases are the main causes of death in Sri Lanka, many still consider certain infectious diseases, including dengue fever, threats to public health. Here are five leading diseases in Sri Lanka.

5 Leading Diseases in Sri Lanka

  1. Dengue Fever: Dengue is a mosquito-borne virus that is endemic to Sri Lanka. A person can contract dengue any time of year. However, the risk elevates during the monsoon season. This is the time of year when dengue-bearing mosquitos are most common, and severe storms often inhibit travel for care. The year 2019 saw double the cases when compared to the previous year with over 99,000 reported cases and 90 deaths. The World Health Organization (WHO) is currently working with Sri Lanka’s Ministry of Health, Nutrition and Indigenous Medicine to control the spread of dengue fever by enhancing dengue surveillance and training health care workers dengue case management and prevention. Among the suggested prevention strategies, WHO advises keeping neighborhoods clean and using mosquito netting and repellents to prevent bites.
  2. Acute Lower Respiratory Infections: Acute lower respiratory infections (ALRI) are leading causes of childhood mortality and morbidity in Sri Lanka; they are responsible for 9 percent of deaths of children under age 5. Poor access to health care, food shortages, lack of safe water and poor sanitation elevate the risk and disease burden. Fortunately, the political prioritization of public health has led to increased administration of vaccinations. This has reduced the impact of contracted ALRI. In 2014, Sri Lanka’s government enacted a national immunization policy which guarantees every citizen the right to vaccination. A separate line in the national budget aims to ensure the continuous availability of immunizations.
  3. Typhoid Fever: Typhoid is a bacterial infection that has a high mortality rate when a person does not receive treatment. Between 2005 and 2015, Sri Lank had 12,823 confirmed cases of typhoid fever. The risk of typhoid is related to overcrowding, food shortages and poor water quality. Sri Lanka’s prevention strategy has largely focused on disease surveillance and health education. Every medical practitioner has to notify the government of any typhoid fever diagnosis. Health education has involved the promotion of proper sanitation and immunization campaigns.
  4. Meningitis: Meningitis, a bacterial disease, was the 20th leading cause of premature death in Sri Lanka in 2010. Malnutrition, poor access to health care and poor sanitation are risk factors for infection and disease severity. Since 1990, the annual number of deaths due to meningitis in Sri Lanka has decreased. It was formerly the 16th leading cause of premature death. Experts largely attribute this to the growing accessibility of the Haemophilus Influenzae B vaccine.
  5. Tuberculosis: Tuberculosis was the 21st leading cause of premature death in Sri Lanka in 2010. The estimated number of cases has progressively increased from 10,535 in 1990 to 11,676 in 2007. The National Strategic Plan for Tuberculosis Control 2015-2020 states that Sri Lanka has successfully maintained a high treatment rate for tuberculosis. Because tuberculosis transmits from person-to-person, a high treatment rate reduces the risk of transmitting further infections. Additionally, Sri Lanka has received funding from the Global Fund for AIDS, Tuberculosis and Malaria. The funds are for raising awareness and increasing access to medication.

Non-communicable diseases currently represent a larger health burden. However, the continued incidence of infectious diseases ­­in Sri Lanka highlights the burden of poverty. For many of these five leading diseases in Sri Lanka, vaccinations are widely available and accessible in developed countries. Yet, reports of cases and fatalities in Sri Lanka still occur.

Still, for infectious diseases where vaccines remain elusive, poverty is a prominent risk factor for infection and severity of illness. Poverty affects the ability to receive adequate nutrition, sanitary housing, health care and more.

“Around the clock, patients died from diseases that are definitely preventable,” Mendelsohn said. “Coming from a developed country where medical care is among the best in the world, it was hard for me to accept that, just a continent away, people were still dying of infectious diseases to which the cures had already been found.”

– Kayleigh Rubin
Photo: Pixabay

Dengue FeverAccording to the World Health Organization, dengue fever is one of the ten major global health threats of 2019. The mosquito-borne illness results in flu-like symptoms that can kill up to 20 percent of those infected. Approximately 390 million cases of dengue fever are reported each year across 100 different countries, although, many cases go unreported. Cases of dengue fever have also increased 30 times in the last 50 years, meaning that today, 40 percent of the world’s population is at risk of contracting the disease.

Why the Increase?

While dengue fever used to be concentrated in countries with extreme tropical climates, such as India and Bangladesh, the disease is now prevalent in countries that have more temperate climates, such as Nepal. With higher than average temperatures, rainy seasons are lasting longer which creates the perfect environment for the Aedes mosquito, the carrier of the disease. Unfortunately, the geographic regions that the Aedes mosquito inhabits coincide with low and middle-income countries. Many of these countries do not have sufficient health care systems to cope with this major health issue. Therefore, the effects of dengue are even more severe.

Protection from Mosquitoes

The World Health Organization is leading efforts to reverse the increasing threat of dengue fever. One common tactic used is immunization. The first immunization for dengue fever was approved in 20 countries in 2015. However, follow-up data from 2017 showed that the vaccine was actually harmful to those who had never contracted the disease, putting people at a higher risk of more severe cases of dengue. Now, the vaccination is recommended as a measure for those who have already been affected.

In addition to immunization, people can inhibit the Aedes mosquito’s survival and procreation by properly disposing of human waste, and not leaving out any stagnate, uncovered containers of water, as mosquitoes thrive and lay eggs in both environments. It is also advised to use spray insecticide to repel bugs and invest in screened windows and sleeping nets for protection in homes.

Combatting the Threat

The World Health Organization is partnering with local organizations and governments in affected countries to ensure that the number of deaths caused by dengue fever will decrease by 50 percent in 2020. In order to reach this goal, however, additional funding and research are needed so that the scope of dengue fever is properly understood. Health care providers also need the training and resources to properly address the issue and detect the disease in its early stages as well. If dengue fever is diagnosed before the symptoms become too severe, mortality rates of the disease become much more optimistic.

 

Madeline Lyons
Photo: Flickr

10 Facts About Life Expectancy in Palau
Palau is a small country in the Pacific Ocean that attracts tourists from all over the world with its amazing scuba diving sites, stunning rock islands and gorgeous beaches. With a population of about 21,000 people, Palau is continuously working towards improving life on the island by bringing focus to some of its biggest issues such as lack of funding for non-communicable diseases, and drug and alcohol addiction in children and adults. Here are 10 facts about life expectancy in Palau.

10 Facts About Life Expectancy in Palau

  1. According to the CIA World Fact Book, life expectancy in Palau was 70.4 years for men and 77 years for women as of 2018. The life expectancy has stayed relatively the same over the years with only a two-year decrease since 1995.
  2. The leading causes of death in Palau are non-communicable diseases (NCD) with cardiovascular disease, cancer, chronic respiratory diseases and diabetes being the four main causes of death in the country. Because of the lack of funds going into the prevention and treatment of these diseases, President Tommy Remengesau Jr. signed a law in 2016 to set 10 percent of the revenue raised from alcohol and tobacco taxes aside to finance NCD prevention.
  3. Dengue fever is a mosquito-borne disease which can cause high fever, headache, vomiting and skin rash. Palau is no stranger to this disease and the Ministry of Health has been educating and bringing awareness to the public ever since its biggest outbreak in 2008. In December 2018, the Ministry of Health reported its first-ever cases of the Dengue Serotype 3 virus which the small country had never seen. It immediately issued an alert and urged the public to search for and kill mosquitos in and around homes, wear clothes to cover skin and use bug repellant. Fortunately, the country did not report any deaths from dengue fever and it had only 250 cases as of June 2019.
  4. Both children and adults in Palau have a dependence on drugs, cigarettes and alcohol. The country has created many educational efforts and protective laws for children, but despite these efforts, 70 percent of children chew on a drug called betel nut. The betel nut which has been a part of cultural practices since the 1970s is a popular and accessible drug on the island. According to the Alcohol and Drug Foundation, ingesting this drug can lead to oral cancers, stomach ulcers and heart disease when used regularly.
  5. Estimates determined the infant mortality to be 14 deaths to 1,000 live births as of 2015 in Palau, which was a 55 percent decrease since 1990.  Palau’s National Health Profile explains that 75 percent of expecting mothers used betel nut and tobacco during their pregnancy between 2007 and 2013. These were the main causes of the high rate of preterm complications that resulted in deaths of newborns. Along with these two risks, the health profile also highlights that overweight and obese mothers had a higher risk of preterm delivery as well. Because health services have become more available, mothers are now receiving education and given prenatal care preventing the infant mortality rate from going up.
  6. Health care and health services are becoming accessible to more and more families and children which has caused the mortality rate to decrease on the islands. Obesity still remains a problem for 24 percent of children, though. Many children do not have any knowledge of good eating habits and do not participate in any physical activity. Humanium reports that only 10 percent of children are eating fruits and vegetables in Palau.
  7. Palau reportedly has approximately 300 children with special needs on the registry with the Health Department but only around 189 are receiving special education services. Most special needs kids will receive health care, education and social services up until the age of 21. Once they reach 21 years of age there are not many resources on the small country to assist them in adapting and transitioning into the adult life which leaves these families without any aid.
  8. Although crime rates are low in Palau, emergencies do happen and getting help from police officers or medical personnel can be very difficult. The ability for police officers and ambulances to respond to crimes and medical emergencies can sometimes be very limited because of the lack of essential equipment, response vehicles and roads on the island. Ambulances often do not have proper equipment or staff. In rural areas receiving ambulance services is much more limited.
  9. Pollution affects 25 percent of the available drinking water in Palau. Groundwater pollution is caused by poorly maintained septic tanks and saltwater intrusion while land-based pollution, gasoline and oil from motors and ships impact coastal waters. Due to the ongoing development of the country, further pollution from sewages, chemicals and oil spills will be unavoidable if people do not control them which could greatly affect the country’s population.
  10. Seventy-one percent of the population in Palau live in urban areas on the islands of Koror and Airai. People without land rights must lease houses from the government which are usually one or two-story homes made of wood or cement with tin roofs. Living conditions are improving, however, due to the work of the International Union for Conservation of Nature and the National Development Bank of Palau. They have been working together to create homes which will use less energy and reduce dependence on petroleum fuels that are imported to the island every year. Although this is an ongoing project having built only 60 homes, the improvement in living conditions will not only help the environment but also the people of this small country.

These 10 facts about life expectancy in Palau show progress within its 340 islands. Government officials are putting many efforts into fixing the issues that Palau and its people are facing. By creating programs to help aid the disabled, providing education on health issues, passing laws to receive the funds necessary for treatments and starting new projects such as the building of energy-efficient homes, Palau is on the right track to bettering life on its islands.

– Jannette Aguirre
Photo: Flickr

dengue fever in the Philippines

The Philippines Department of Health declared a national dengue fever epidemic. The southeast Asian nation is experiencing one of the worst outbreaks of the disease in years with over 160,000 cases this year. This is an increase of 97 percent from this time last year. The surge in cases has caused over 600 deaths, already doubling the amount from 2018.

What is Dengue Fever?

Dengue fever is spread by the Aedes mosquito that lives primarily in tropical and subtropical regions. Once bitten, it takes four to seven days before flu-like symptoms set in. These symptoms include headaches, joint and muscle pain, rash and fever. If left untreated, some severe cases can lead to dengue hemorrhagic fever or dengue shock syndrome, which can lead to death. The median age of those infected in the Philippines is 12 years old. Most of the deaths in the Philippines are children between the ages of 5 and 9.

There is no known cure for dengue fever, once infected a person can only manage the symptoms until they dissipate. This is done by keeping a patient well hydrated with IV fluids and the use of pain medications with acetaminophen. Dengvaxia, a vaccine for dengue was discovered in 2016 but it is currently not licensed in the Philippines.

Philippines Hospitals Overwhelmed

With 1800 hospitals taking care of a population of over 108 million people, the Philippines struggles to deal with the rising cases of dengue fever. Of those hospitals in the Philippines, there are only 19 in the five regions that have been hit hardest by the epidemic. Southern Tagalog, Bicol Region, Western Visayas, Zamboanga Peninsula and Northern Mindanao are past the epidemic threshold. West Visayas, Zamboanga Peninsula and Bicol Region are also three of the poorest regions in the Philippines and struggle with the cost of care for its citizens.

Over the past 50 years, dengue fever cases rose, according to the World Health Organization(WHO). In the past five years, there have been over 200,000 cases of dengue fever in the Philippines. This includes just over 1000 deaths in that same time period. The country may exceed these numbers by the end of 2019 alone.

Global Forces Rally Against Epidemic

The European Union donated 100,000 euros in humanitarian aid to help treat those already infected and to help with prevention. These funds will help the Philippines Red Cross to provide emergency medical units, nurses and wards at hospitals specific to treating dengue fever in the Philippines. It is expected that this funding will benefit 300,000 people that are living in some of the poorer and infected areas.

The WHO and the government of the Philippines are currently taking the steps needed to prevent the increase in fatal cases. The government also tries to educate its citizens on what they need to do to prevent the Aedes mosquito from continuing to breed and how they can protect themselves. This includes cleanup efforts that help reduce the stagnant water areas where the mosquitoes breed. The WHO advised the people to wear insect repellant and long sleeve pants and shirts at all times. The organization also recommends fitting every bed and crib with mosquito nets to provide protection while sleeping.

Despite the ever-growing danger imposed, the fight continues around the world to protect and prevent dengue fever in the Philippines. Simple measures can be put into place at home and around communities that can minimize those who are infected and provide a safe and healthy environment.

– Sam Bostwick
Photo: Flickr

Dengue Fever in Burkina Faso
Dengue is a viral infection transmitted by the Aedes Aegypti and Aedes Albopictus female mosquitos. There are four different types of the virus currently known as DENV-1, DENV-2, DENV-3 and DENV-4.

Almost half of the people infected with dengue exhibit no specific symptoms, especially since the virus causes flu-like symptoms such as high fever and muscle pain. When left untreated, these symptoms progress to the deadly dengue hemorrhagic fever and cause vomiting, abdominal pain, uncontrolled bleeding, convulsions and circulatory system failure. Dengue is diagnosed by serological or molecular tests. Early and accurate diagnosis is crucial to saving lives and preventing the progression of the infection.

As in most tropical regions with prolonged rainy seasons, the climate of Burkina Faso makes it an optimal breeding ground for mosquitos. Dengue is considered an endemic illness. In recent years, the country has faced outbreaks of this disease in 2016 and 2017. In 2016, there were almost 2,000 suspected cases with 86 percent of cases concentrated in the central region of the country. In the 2017 outbreak, the number of suspected cases jumped to almost 7,000 with 64 percent of infections, again, concentrated in the central region.

Urbanization and Dengue

The central region of Burkina Faso includes the capital city of Ouagadougou. Ouagadougou’s rapid urbanization over the last 30 years has contributed to increased cases of dengue fever in Burkina Faso. From 2000 to 2010, the city’s population grew from 800,000 to 1.9 million. This growth is expected to rise by 81 percent to a staggering population of 3.4 million by 2020.

Increased migration to Ouagadougou from rural regions and nearby countries led to spontaneous settlements uncontrolled by the authorities. Between 2004 and 2009, unplanned residential areas grew by 60 percent. These settlements are prone to overcrowding and poor sanitation infrastructure. Stagnant water from the rainy season also makes the settlements more susceptible to mosquitos and dengue.

Response to Dengue Outbreaks

During both the 2016 and 2017 outbreaks, the Burkina Faso Ministry of Health declared a state of emergency that allowed for assistance from The Alliance for International Medical Action (ALIMA) and World Health Organization (WHO).

In 2016, ALIMA provided 2,100 Rapid Diagnosis Tests (RDTs) to help doctors to accurately diagnose dengue and begin surveillance of the outbreak. The more widespread outbreak of 2017 required a greater response from WHO. The organization provided 15,000 RDTs and 1,500 insecticidal nets to hospitals. WHO also trained 5,500 community volunteers that worked to destroy mosquito-breeding sites in Ouagadougou. These interventions allowed for the slow decline of cases and the continued spread of dengue infections.

Future of Dengue in Burkina Faso

In both outbreak years mentioned above, the financial burden of the outbreak response was shouldered by WHO and ALIMA. The Ministry of Health has identified the importance of strengthening the health care surveillance system so that there are early warnings of future outbreaks of dengue fever in the country.

Vector control methods such as the destruction of mosquito-breeding sites and proper sanitation infrastructure in susceptible areas of Ouagadougou are necessary to prevent continued outbreaks. Finally, early and accurate diagnosis of dengue will save lives through timely treatment and medication.

These targets are the core focus of the Integrated Research Program for the Control of Dengue Fever in Burkina Faso. This program began in 2015 as a five-year collaborative research effort between medical schools in Ouagadougou and Japan. The Japanese Agency for Medical Research and Development plans to invest more than $650 thousand each year to reach the targets by 2020.

As of September 2017, the research program has developed a new detection device that allows for easy virus inspection of mosquitos. This technology will assist detect potential infections and avoid outbreaks. The program is currently working to develop a strategy to limit the replication of dengue in mosquitos which will also help to prevent outbreaks.

The dengue fever has been a very serious problem in Burkina Faso in the past years. The joint effort of various nongovernmental organizations and the country’s government has helped eliminate the crisis in the past two virus outbreaks. This effort will help change the future of dengue fever in Burkina Faso and allow the country to equip itself to properly respond to any new potential outbreaks.

– Chinanu Chi-Ukpai
Photo: Flickr

Dengue Track: How Mapping the Spread of Disease May Help to Stop It
Dengue is a notoriously malicious mosquito-borne virus that has seen an uptick in recent decades with the expansion of urban environments. But a new tool called Dengue Track is trying to change that.

Dengue fever causes flu-like symptoms, minor bleeding and a characteristic full-body rash. The disease used to be confined primarily to tropical regions, but the World Health Organization estimates that about half the global population is now at risk. It is rarely fatal but nonetheless constitutes a leading cause of illness and death among children in some developing countries. Though a vaccine has been developed, its use has only been approved in three countries so far, and it is not yet widely available anywhere.

Dengue is a disease that is uncommonly hard to fight. Because it has an incubation period of four to 10 days, mosquitos can be spreading it in an area for weeks before officials start to realize that they have an epidemic on their hands. What’s more, as globalization intensifies and people and goods travel more broadly than ever, it’s nearly impossible to keep infections localized or to judge where they might develop next.

Illnesses that, like dengue, are transmitted by blood-sucking insects are called “vector-borne” diseases, and when vaccines are not available, the only way to protect human populations is through methods known collectively as “vector control.” These include strategies for reducing the insects’ breeding areas, creating tools like nets to keep them away from vulnerable people or killing them with pesticides.

Vector control, however, is most effective when the movement of the disease can be plotted on a map. The trouble is that dengue, which is most prevalent in developing countries around the equator, is dramatically underdiagnosed and underreported, and systems to share what little information there is are inefficient, unstandardized, or nonexistent.

Dengue Track, a crowdsourced tool that tries to map the epidemiology of the disease, is an initiative from an organization called Break Dengue. Drawing information from cell phone conversations, social media, and an online chat system, it plots cases of the illness across the globe to try to predict where it may surface next.

It is a low-cost method that relies on tools common in developing countries, where only one-third have access to the internet but over 95 percent own mobile phones. This means that it is particularly well-suited to places where the national health system does not have the ability to track outbreaks itself.

“Thousands of lives are lost every year in developing countries for failing to detect epidemics early because of the lack of real-time data on reported cases,” said Lakshminarayanan Subramanian, a professor at New York University who helped to develop Dengue Track. This app might prove a useful model for identifying such epidemics early in the game and taking the appropriate steps to head them off.

Madeleine Read

Photo: Flickr

Dengue Epidemic in India
The dengue epidemic in India is a reoccurring plight — new hoards of mosquitoes hatch during the wet monsoon season. These insects carry a number of diseases that citizens have been unable to protect themselves against. From this yearly mosquito infestation, dengue is one of the most commonly contracted. It manifests as a harsh influenza, but can quickly turn into severe dengue, and will sometimes result in death.

There are four different strains of dengue, meaning that one individual can get dengue up to four times before building an immunity to each strain. That is only if the person makes it that far; every time an individual contracts more than one strain, there is a greater risk of severe dengue.

The problem with eliminating mosquito-borne diseases is that the insect is highly adaptable. It thrives wherever water is available; eggs can lay dormant for more than a year and hatch immediately when exposed to water. Mosquitos themselves are evolving as well, and have begun to prefer the taste of human blood more than the blood of other mammals. They are also becoming intelligent enough to hide in homes during the day to bite unsuspecting sleepers at night.

The World Health Organization (WHO) claims that the best way to prevent mosquito-borne illnesses is to kill mosquitos in all stages of life. As it stands now, citizens in India can only stunt the spread of the dengue epidemic through fogging, disposing of standing water and maintaining a clean living space.

However, citizens alone cannot destroy all mosquitoes. Hence, the best tactic to approach the dengue epidemic in India is to supplement individual actions with other means of mosquito prevention. Thankfully, the elimination of mosquitos is a mission that researchers are working hard to accomplish.

The International Atomic Agency has been able to suppress insect populations extensively in other areas by sterilizing male mosquitos with low doses of radiation, making the eggs they fertilize unviable. Similarly, there has been notable success with a new form of mosquito suppression that uses the Wachovia bacteria, a bacteria that does not infect humans, but prevents eggs fertilized through infected males from hatching.

Surprisingly, the Centers for Disease Control and Prevention (CDC) does not believe that efforts to suppress mosquito population on a large scale will likely be realized through the sterilization of male mosquitos. This is because large numbers of infected mosquitos need to be affected to properly address the problem. However, when it comes to those who have made little to no headway in stemming the growing mosquito population, even some relief is welcome.

As Ila Patnik of the Indian Express points out, the burden to control the mosquito population cannot rest on citizens alone. Suppressing the mosquito population may take time, but at least it is a means to an end. Mosquito sterilization is a worthy course of action in decreasing the dengue epidemic in India, at least until a more effective solution presents itself and more people have access to the newly tested dengue vaccines.

Amy Whitman

Photo: Pixabay