For the first time in history, Penang has been badly hit by the floods. Never have I witnessed so many of our loved ones and friends being hit as badly as this time. Rain water and floods can cause an increased risk of potentially fatal diseases such as dengue fever. According to an article statement by our DG (Director-General) of Health, floodwaters are contaminated and can cause various infectious diseases such as diarrhoea, typhoid, hepatitis A and leptospirosis. Direct contact with contaminated floodwater can cause infections to the wounds, skin, eyes, ear nose and throat.
“The threat of water-borne diseases is a big concern with over 10,000 people displaced from their homes. Floods directly lead to an increase in vector –borne diseases through the expansion in the number and range of vector habitats. Standing water caused by heavy rainfall or overflow of rivers can act as breeding sites for mosquitoes especially the Aedes aegypti which is the cause of the spread of dengue disease. Initially the flooding may flush out the mosquito breeding, but it comes back when the water resides.” – Bharati Suresh Chand, Allied Against Dengue Trainer and also the Vice President of the Malaysian Pharmaceutical Society
Dengue is a serious viral infection transmitted from one person to another by the Aedes mosquito. As the fastest spreading vector-borne viral disease in the world, the threat of dengue is ubiquitous and immense, with almost 40% of the world’s population estimated to be at risk. South East Asia alone carries the highest prevalence of dengue, affecting 3.9 million people annually. Usually in the tropics or subtropics, it causes 500,000 hospitalisations annually with 2.5% of those infected will die. Children are generally more susceptible to severe disease than adult.
Whilst recent national statistics suggest that overall dengue cases have fallen in comparison to the year before, the impact of dengue and its potentially devastating consequences remain a persistent threat across Malaysia. Latest research has shed new light on the nation’s perception of dengue, revealing it to be the number one concern amongst common infectious diseases, with 80% of Malaysians feeling worried about the disease.
From 1st January to 9th November 2017, we have had a total of 76,497 reported cases of dengue with 162 deaths nationwide. In Penang, the number of dengue cases has reduced since last year to 2227 thousand reported cases and 11 deaths. Nevertheless, dengue is still a major concern in Malaysia.
We, from the Malaysian Pharmaceutical Allied Against dengue (AAD) team wishes to inform the public to be more alert towards the symptoms of dengue. Dengue fever usually occurs 4 -7 days after an incubation period. For those affected by the floods and have a high fever with any of these two symptoms such as diarrhoea, pain behind the eyes, vomiting and abdominal pain, rash, muscle and joint pain or bleeding nose and gums, please seek immediate advice from your nearest doctor or community pharmacists. We, the pharmacists, would like to inform you that in case of a dengue fever, one can only take paracetamol (as recommended by WHO) to keep the fever down and patients are advised against taking antibiotics which are useless against dengue virus. Steroids and certain painkillers, such as aspirin and ibuprofen should also be avoided as they will increase your risk of bleeding and may lead to dengue haemorrhagic fever. There is no medicine available for dengue and current management involves treating the symptoms with lots of fluids and rest.
There are 3 phases in dengue fever: febrile phase when we have fever, critical phase when symptoms get worse but with no fever followed by the recovery phase. The warning signs of dengue which requires medical attention are; severe abdominal pain, persistent vomiting (with or without blood), bleeding of the nose and gums, difficulty in breathing which happens due to internal bleeding (reduced blood volume means less oxygen supply to the lungs), drowsiness, confusion and seizures (due to low blood volume and bleeding), pale appearance, cold and clammy hands or feet (drop in plasma volume).
We would like to advise the public to maintain good personal hygiene, put on long clothing to prevent mosquito bites in addition to using mosquito repellents.
Community pharmacists are easily accessible to the public and I would like to urge the public at large to seek free advice and screening from our pharmacists. . Meanwhile, doctors and pharmacists are currently working hand in hand to serve the community affected by the floods by rendering the best health care services to all.
- Management of Dengue Infection in Adults (3rd Edition)