Public action urged to prevent dengue fever

JAKARTA (JP): Head of the city health agency Asman Lasman said the public does not understand the importance of preventing dengue fever.

Unless the people themselves start eliminating potential breeding spots for the aedes aegypti mosquito, which carries the arbovirus that causes the disease, the number of dengue fever cases this year could reach around 5,000 like last year, Asman said yesterday.

He said trouble spots are containers of clear standing water, such as vases placed on graves, discarded bottles and cans, and the bathtubs and other reservoirs left full but unattended at schools during the holidays.

He added that a high number of cases usually occurs in June and July because rain falls sporadically, leaving behind pools of water.

The aedes aegypti mosquito, which is active during the day, lays its eggs in fresh standing water.

Asman refused to cite the exact number of dengue fever cases reported in the city from January to June this year.

"There is an average of one case per month in each subdistrict throughout the year," he said.

There are 265 subdistricts in Jakarta. One percent of the people contracting dengue fever die.

Asman said that as of the middle of June, the figure for dengue fever cases in Jakarta remained below that of last year.

City Hall's public relations office has requested that figures on dengue fever cases not be released because this might negatively affect tourism, Asman said.

On June 3, the Director General of Communicable Disease Control and Environmental Health of the Ministry of Health, Hadi M. Abednego, reported more than 5,000 cases of dengue throughout Indonesia's 27 provinces in the first five months of this year. He said Jakarta ranked second, behind East Java, with 1,880 people hospitalized and 28 deaths in that period.

Dengue fever is considered endemic to 259 of Jakarta's 265 subdistricts, meaning that one or more cases of the fever have been found in these subdistricts for three consecutive years.

Staff members at the health agency said reports of dengue fever cases are coming in almost daily.

A nurse at Cikini hospital in Central Jakarta, who asked not to be identified, said several patients have been admitted there for dengue fever recently. A doctor treating a patient for the disease there said admissions for dengue fever were occurring in hospitals across the city.

Health ministry data indicates that in the last six months, East Jakarta has recorded the highest number of dengue fever patients, of which 20 have died.

Asman said the medical staff of all hospitals are trained in recognizing dengue symptoms, which are similar to those of the flu in its initial stages. He added that they are also adept at managing the fever.

Mira, a former dengue fever patient, told The Jakarta Post that she was variously diagnosed as suffering from typhoid fever, ulcer problems and stress in the three examinations she had before she was admitted to a hospital in serious condition.

"The fourth doctor I saw checked to see whether I had had the telltale sign of a rash, which other doctors at a hospital emergency unit in East Jakarta did not do," she said.

The symptoms of dengue fever are: a high fever that lasts from two to seven days, a rash which may appear only briefly a few days after the fever begins, bleeding from the nose, the vomiting of blood, abdominal pain, and, once the disease is advanced, signs of shock, such as clamminess of the extremities.

Asman stressed that dengue does not differentiate between rich and poor areas, or age, though statistics show victims are mostly youngsters.

He said spraying by officials only kills adult mosquitoes, while mosquito eggs are hard to detect.

He said the best way to prevent dengue fever is to "Close all open water containers, or to mix Abate powder, which can be purchased at pharmacies, into standing water to kill the larvae," he said, adding that his agency has issued a brochure listing ways to prevent the disease.

Eliminating the aedes aegypti mosquito's breeding ground is the only way to curb the spread of the fever as a vaccine has not been found.

Treatment of the disease centers around lowering the fever and containing the damage done by hemorrhaging.

In response to warnings that everyone is vulnerable, members of the Association of Real Estate Developers have helped to circulate the health agency's brochures, Asman said.

He also said the agency plans to research the causes of a shift in the outbreak pattern of dengue fever that has been observed since 1990. Between 1990 and 1995 the outbreak cycle of the disease peaked every two years, instead of every five years, which had been the pattern previously. (anr)