Number of Dengue Cases, Deaths Lower Than Feared

By Paul Vrieze 10 September 2013

RANGOON — Several months ago, health authorities warned that Burma could be facing a dengue fever epidemic. As the rainy season begins to wind down, officials say the number of dengue cases and related deaths have been lower than expected. But some 16,000 cases and 75 deaths have still been recorded so far this year, most of them children.

“Nationwide, the trend is decreasing, and July had the highest [number of cases]. Since August it’s decreasing,” said Dr Ni Ni Aye, deputy director of the Health Ministry’s Dengue Program. “Now, most of the townships have decreasing cases. But in some regions [in central Burma], such as Mandalay, Magwe and Sagaing, it is still slowly increasing.”

Ni Ni Aye said the number of recorded dengue cases stood at more than 16,000 patients by late August and 75 people had died from the disease. “Most of the deaths are children under 5 years,” she added.

Ni Ni Aye said the current total number of patients is the highest in three years, but added, “Mortality is less… than in 2010, when there were 118 deaths… We now consider this an average year; it’s not very bad like in 2009.”

A few months ago, health authorities warned that dengue had been spreading rapidly in Rangoon and Irrawaddy divisions and in Mon and Karen states early in the rainy season. By late June, the total number of infections had surpassed the total of the whole of 2012, and health officials feared that infections would continue to rise and reach epidemic proportions.

Burma’s most deadly dengue outbreak was recorded by the Health Ministry in 1994, when 444 people died from the virus, while a 2001 epidemic killed 204 patients.

Dengue cases occur mostly during the monsoon season when the mosquitoes that transmit the disease can easily breed in clear water. These mosquito species feed during the day, putting children at school playgrounds at particular risk of infection. The disease can be fatal when it escalates and causes hemorrhaging in patients.

According to Ni Ni Aye, the lower-than-expected mortality figures this year indicate that medical treatment of dengue is improving in Burma, while the public is becoming more aware of the need to seek early treatment.

“Most of the deaths are due to late referral… They arrive in the hospital late and they experience [medical] shock syndrome already,” she said. “Some of the patients cannot go to the hospital on time; most of them are from rural areas.”

Dr Aung Myint Lwin, medical superintendent at Yankin Children’s Hospital in Rangoon, said his hospital also recorded a decline in the number of child patients with dengue in the second half of the rainy season.

“We noticed in July there was very much a decline in admission rates,” he said, adding that by late August, the hospital had treated 1,595 children for dengue, while 10 children had died from the disease.

Aung Myint Lwin said the drop in the number of new infections in Rangoon Division was in part due to preventive measures that authorities took following initial reports of a surge in dengue cases.

“We started preventive measures actively through our health departments and other sectors, especially from administrative departments, NGOs like the Red Cross and other organizations,” he said. “We were destroying the mosquitoes’ breeding areas and their larvae… we used chemicals.”

Aung Myint Lwin said growing public mindfulness about the risks of the disease was a key factor in reducing dengue deaths. “This year the mortality rate is a little bit lower because of increasing awareness of the people. Then they will come to the hospital early, before their condition becomes worse,” he said. “Most important is the realization among the common people of the danger.”