1. Dengue
Lyndon L. Lee Suy, MD
National Dengue Program Coordinator
Department of Health

2. Dengue & DHF
 Endemic in >100 tropical/subtropical
countries
 No specific treatment
 Spreads rapidly affecting mostly children
 An environmental issue
 Emphasis on emergency control during
epidemics rather than developing programs
to prevent epidemic transmission

3. Global Situation of DHF
 2.5 B at risk of dengue infection over
100 countries
 Annual dengue cases – 100 M
 DF/DHF/DSS admissions per year –
500,000 cases
 Mortality rate – 5%

4. Philippines Backgrounder:
 1953 – reported as H-Fever
 1958 – notifiable disease
 1966 – outbreak in Metro Manila
 Endemic in the country
 Increase in cases during the rainy
season

5. National Dengue Prevention
& Control Program
 1993: DOH initiated the program
 Pilot sites: Region VII & NCR
 1998: Nationwide implementation

6. Goal of the Program
Reduce morbidity and mortality from
dengue infection by preventing the
transmission of the virus from the
mosquito vector to human.

7. Health Status Objectives
By the end of 2004:
 Reduce incidence from 32/100,000 to
20/100,000
 Reduce case fatality rate by <1%
 Detect & contain all epidemics

8. Risk Reduction Objectives
Reduce the risk of human exposure to
Aedes bite by:
House Index of <5
Breteau Index of 20
Increase % of HH practicing removal of
mosquito breeding places to 80%
Increase awareness on DF/DHF to
100%

9. Services & Protection Objectives
 Establish a Dengue Reference
Laboratory capable of performing IgM
capture ELISA for Dengue Surveillance
 Increase the % of 1 and 2 government
hospitals with laboratory capable of
platelet count and hematocrit
 Ensure surveillance and investigation of
all epidemics

10. Dengue Cases & Deaths by Region
(Philippines, as of August 15, 2004)
REGION CASES DEATHS CFR (%)
I 83 0 0
II 158 0 0
CAR 194 0 0
III 1121 5 0.4
IV A 302 2 0.7
IV B 9 0 0
NCR 1438 7 0.5
V 269 6 2.2
VI 691 7 1
VII 383 5 1.3
VIII 420 1 0.2
IX 75 1 1.3
X 590 5 0.8
XI 1529 37 2.4
XII 97 1 1
ARMM 60 1 1.6
CARAGA 197 7 3.6
TOTAL 7616 85 1.1

11. Aedes aegypti Mosquito

12. Global Resurgence of Dengue
 Population growth;
 Uncontrolled urbanization;
 Lack of effective mosquito control;
 Increased air travel
(Gubler, 1998)

13. Color Codes for Dengue
No cases/clustering in an area.

14. Color Codes for Dengue
Clustering of cases:
More than 2 cases in a barangay.

15. Color Codes for Dengue
Hot Spot:
An area where an increase in
number of cases was observed
for 2 consecutive weeks even
though the number is still
within the expected range.

16. Color Codes for Dengue
Outbreak:
An area wherein the number of
cases is more than the
expected range.

17. Outbreak Controlled
When the number of cases has
decreased to within the expected range
for 2 consecutive weeks.

18. Preventive/Control Strategies
 Intensify IEC campaign on prevention &
control;
 Improve environmental sanitation;
 Entomologic survey;
 Mobilize residents of affected barangay & start
clean-up campaign;
 Start community surveillance; search for more
cases;
 Equip local health units for management
of cases

19. Maraming Salamat Po!!!