After bird flu, dengue

Doctors' confirmation on Tuesday of suspicions a new, previously unknown sub-variant of the dengue virus is responsible for a virulent outbreak accross the country adds to the graveness of a situation already rated "extraordinary" by the government. This is all the more so because the Asian bird flu has yet to be brought fully under control.

What led the government -- in this case, the Ministry of Health -- to issue the "extraordinary situation" rating was the dengue death rate, which by mid-month reached more than 1 percent of the number of patients treated. Dengue cases during the past few weeks were more than twice the number recorded over the same period last year.

Dengue hemorrhagic fever deaths normally peak in more or less regular cycles of between five and six years and are therefore usually taken in stride by the public and authorities alike.

Although the statistics made available still continue to change, a few simple figures may illustrate the seriousness of the outbreak this time around. Since Jan. 1 at least 8,135 people have been hospitalized with dengue fever across the country, a 200 percent increase on last year.

The disease has so far affected at least 2,046 people in Jakarta, of whom 16 have died, with more having succumbed in the areas surrounding the capital city. In West Java, the province bordering on Jakarta, at least 1,076 people have been infected with dengue, and at least 20 have died. Cases of dengue hemorrhagic fever have also been found in the tourist destinations of Yogyakarta and Bali. Nationwide, the latest death toll yesterday was 161.

Given the seriousness of the situation, health authorities have called on the public to get checkups from a competent doctor as soon as they feel a higher-than-ordinary fever beginning to develop. Many of the patients who have died, especially babies and the under-fives, have succumbed because the disease was diagnosed too late. Hospital doctors have admitted that being unaware of the speed with which the current dengue virus could replicate, they had been wrong in their initial diagnosis of the disease. Doctors have been instructed to give priority to the treatment of dengue patients to save lives and to stop the disease from spreading uncontrolled.

At this stage of developments, research is continuing to identify the precise nature of the virus responsible for the current outbreak. That, and taking precautionary measures such as issuing warnings, educating the public and fumigation, especially in poor and crowded neighborhoods, appears to be all the authorities can do. This falls short of the provisions contained in Law No. 23/92, which says the government is responsible for totally eradicating preventable diseases.

One can understand, of course, that financial and other constraints are currently limiting the government's ability to fully undertake this responsibility. Besides, if it is true that a new strain of the dengue virus is involved, one can also understand the government being caught off guard by its virulence.

Still, given the fact that dengue fever fatalities tend to reach their peak in cycles, Indonesians are justified to ask why no steps were taken to at least soften the deadly impact of the present outbreak.

Against the background of the authorities' apparent lack of preparedness in facing the recent SARS and bird flu outbreaks, the question seems a pertinent one.