MANILA, Philippines — While the latest Department of Health issue was the number of firecracker casualties from the New Year celebrations, Dr. Rosario Z. Capeding, who heads the Dengue Research program at the Research Institute for Tropical Medicine (RITM) says that parents should not let their guard down against the constant threat of dengue in the country. “Whereas it used to be a seasonal disease, because of the kind of weather that we are experiencing, it has become a year-round issue.”

She further explains why, unlike before when outbreaks used to be prevalent in the provinces, one of the hardest hit places in recent times is the heart of Quezon City.

“The Aedes Aegypti mosquito is a domesticated insect. Mas gusto nila sa bahay or sa surroundings ng bahay. Quezon City became a perfect breeding ground for them because of the dense population and how the residents store their water.” Experts also discovered that these day-biting mosquitoes prefer to lay eggs in clean water, not in muck as was previously believed. And they lay eggs in the most surprising places Dr. Capeding enumerates the areas in the home where wrigglers have been found – flower vases, dish dryers, and even in the drip pans found under the refrigerator!

There are also four strains of dengue, and the bad news is that even if a person has already contracted one type, he is still prone to the other three. Common resorts, such as “smoking” them out, is not the way to go, “because the mosquitoes will simply move somewhere else. The only way to banish them is for the whole community to get their act together and clean their homes and surroundings,” Dr. Capeding advises.

Signs and symptoms

As with most diseases, children are more susceptible, because they have immune systems that are not as developed as the grownups. Dr. Capeding suggests that once there is a fever that has not gone down for two or three days, and especially of there is an outbreak in the area, one should be checked for dengue hemorrhagic fever through tests administered at the nearest medical facility.

She enumerates the symptoms of dengue as:

• At least two days of fever

• Frontal headache

• Joint pains

• Body malaise

• Flushed skin/Flushed face

• Nausea and Vomiting

• Poor appetite

• Measles-like rashes on chest and upper limbs

• Stomach pain and diarrhea may also be present

Monitoring is very important, she adds, because there are cases when the test may come out as negative at first.

Home management

“Timing is very important, and as soon as there is suspicion of dengue, the patient should be brought for testing,” she says. “And at the onset of fever, the patient should be rehydrated right away with lots of fluids.” Capeding says there are better rehydration alternatives to water, such as drinks that have compositions that are more akin to our regular body fluids. “There are drinks out there such as oral rehydration salts and commercial beverages such as Pocari Sweat that mimic our fluids with electrolytes and are more easily absorbed by the body. Rehydration is very important because the patient will lose fluids through sweat, vomiting and diarrhea, and the loss of appetite is also a concern.”

The impact of severe dehydration with dengue patients is that the blood gets thickened, marked by the increase of hematocrite figure from the blood test and the maturing process of thrombocytes delayed, marked by the decrease of thrombocytes figure from the blood test. This means that it is really important that dehydration be prevented by making the patient drink fluids that are easily absorbed.

According to the DOH, not all dengue cases need hospital confinement. “Milder cases can be treated at home with medication and vigilant monitoring,” Capeding assures. This will also prevent the overcrowding of patients in hospital wards as what was experienced last year at the height of the dengue outbreaks.