Thursday, August 18, 2011

Dengue Plague: A Man-Made Pandemic

Its time to write again - to share my ideas of contributing to solutions on dengue.

You may wonder my use of the term plague and pandemic. Plague, because the infected number has reached 200,000 people, more than double the threshold of 100,000 and pandemic, because of the very fast expansion or spread of the disease.

Let us analyze the problem, its root causes, and more importantly, why current solutions will not work. Why is Dengue is man-made.

1. you may have wondered why dengue and malaria did not infect our aborigines or even wiped them out as there were no anti-biotics and doctors to diagnose and hospitals to speak of. But they survived. Nature provided them with some sort of immunity by living with the mosquitoes over thousand of years. Presumably, there was only one serotpe of the dengue virus and humans before have developed immunity to it.

2. mosquitoes or exactly the species of Aedis egyptii were obligatory forest species. this means that before we started clearing our forests and turning them into agricultural lands and our cities, they were strictly confined to these places, in the highlands with cool temperature,dark places and high humidity. Thanks to our developmental mindset of clearing our forest, and changed the landscape, these mosquitoes with their virus, in order survive, has adapted to our way of life and without their forests and continue to evolved in different types.

3. we in the cities, have provided them with a perfect alternate biome: plastics that never rot that collects rain water and are logged in dark places with lower temperature and high humidity.

A man-made disease requires a man-made solution, but this is not happening because we fail to see this point. Let us look at some possible ideas.

1. Tracking of infected patients - As a pandemic virus, we humans are the host, the transporter of the disease. Which is why we need to track each and every patient exact location of his residence. If we could simply ask their exact residences,where they have traveled during the incubation period of the dengue, we will be able to follow the infection route. this is because all dengue carrying mosquitoes are permanent vectors, that means, once a mosquito is infected, every bite on any humans will get infected.

This information would allow a focused, comprehensive and well coordinated action to remove their habitats in places of incidence. Resources are simply too small for us to have a comprehensive cleanup while doing a random action will not solve the problem.

if we put all this information in digital format and map this out, this will be a powerful tool for government on where to focus its investment.

2. Avoid association with those infected - if we do the tracking of infection, we may be in for a surprise that some of the new infections could have come from places such as hospitals, malls, bus stops, places where you were even for a short period within the biting distance of another person that has dengue.

3. Ensure that infected people don't get bitten again - imagine a mosquito getting a bite in a hospital and infecting 200 others! how sure are our hospitals that these are mosquito free?Imagine an infected mosquito having a biting spree in the pediatric ward?

4. Be practical and wear protective clothes when going to high risk areas. the information on point number if done properly would provide the preventive measure.

5. Getting the right data - there are for serotypes of dengue - do we know the infection rates of each one, where each one occurs, how each serotypes develop in correlation with age, gender, etc? SHARE THE DATA - if incidences are recorded, lots of people with expertise in GIS mapping and other tools could help the DOH develop a predictive algorithm adnot just monitor on real time how this plague spreads.

6. Stop those silly gadgetry's that DOST is promoting like the mosquito trap, or a herbal cure (tawa-tawa). Scientist around the world are working on a vaccine that would not likely be in the market until 2015. According to Webster et al. 2009, the ideal vaccine is safe, effective after one or two injections, covers all serotypes, does not contribute to ADE (anti-dependent enhancement), is easily transported and stored, and is both affordable and cost-effective.

Vaccine development is a slow process of testing, and proclaiming that we are close to applying the vaccine would make us the ka-TAWA-TAWA to the whole word. SUSMARYOSEP!