After bird flu, dengue

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.