Sat, 21 Feb 2004

Dengue hits 19 provinces

The Jakarta Post, Jakarta

The dengue fever outbreak has spread to 19 of the country's 32 provinces, with the death toll from the outbreak approaching 200.

The secretary-general of the Directorate General of Communicable Diseases, Syafii Ahmad, told The Jakarta Post that as of Friday the government had recorded 10,140 dengue cases with 195 deaths, mostly in Central Java, East Java and Jakarta.

Syafii said that despite the escalation of the outbreak, the government had no plans to declare it an epidemic.

"The law requires us to maintain the level of the outbreak as an extraordinary occurrence or national catastrophe because the death toll this year is still around double last year's figure. It is not that easy to change the status," Syafii said.

An epidemic can be declared only if the casualty rate surges to 10 times higher than the previous year, Syafii said.

Dengue cases have been found in all five mayoralties in Jakarta, and the disease has affected 29 out of 35 regencies/mayoralties in Central Java and more than half of 38 regencies/mayoralties in East Java.

The disease has also spread to West Java, Banten, Yogyakarta, Bali, West Nusa Tenggara, East Nusa Tenggara, South Sulawesi, North Sulawesi, East Kalimantan, South Kalimantan and Jambi.

Syafii said the health ministry had obtained Rp 150 billion (US$17 million) in emergency funds to fight the outbreak.

"We have already secured the emergency funds and we will use the money to purchase more insecticides for spraying, sero-survey research and to conduct a public education campaign," he said.

He said regional governments could ask the ministry for financial aid to contain the disease.

Jakarta Health Agency head Chalik Masulili said his office would take the health ministry up on its offer of money to purchase equipment for spraying mosquitoes.

"Ideally, each village needs three or four devices but we cannot afford to buy that many," said Chalik.

The provincial health agency in Jakarta has received Rp 500 million to battle the dengue outbreak, with each municipal health agency receiving Rp 100 million.

Because a national catastrophe has been declared, poor dengue patients are entitled to treatment at no charge.

Meanwhile, a dengue expert at the University of Indonesia said domestic and foreign scientists were developing a vaccine for the virus, but it would be at least three years before the vaccine was complete.

"It is difficult to create a vaccine that can kill all of the different types of the virus," said Prof. R.H.H. Nelwan, head of tropical and infectious diseases at the university's School of Medicine.

Dengue and dengue hemorrhagic fever are caused by one of four closely related, but antigenically distinct, virus serotypes: DEN-1, DEN-2, DEN-3 and DEN-4. The most virulent of these serotypes, DEN-3, is blamed for the current outbreak.

"We can't just give a DEN-3 vaccine to cure people who are infected with DEN-1 serotype because it would only worsen the disease. It will be no use to use a DEN-3 vaccine if another serotype virus attacks," he said.

Separately, the head of the Arbovirology Department at the Ministry of Health, Rita Kusriastuti, said flooding in Jakarta and other areas of the country could help curb the spread of the virus.

"The floodwaters can sweep away larvae and eggs, decreasing the number of mosquitoes. However, we must remain vigilant as they could return in one or two weeks after the flooding is over," she said.

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