Thu, Aug 30, 2018 - Page 8 News List

Prevention key to halting dengue

By King Chwan-Chuen 金傳春

As global climate changes, public health decisionmakers have put more emphasis on the prevention of mosquito-borne infectious diseases.

This year, cases of indigenous dengue fever have been confirmed in New Taipei City, Taipei, Taoyuan, Taichung and Chiayi County.

By contrast, Kaohsiung, Tainan and Pingtung County have kept indigenous cases to less than four in the past two years, after having dealt with severe outbreaks in Kaohsiung from 2014 to 2015 and in Tainan in 2015.

Dengue fever in Taiwan has the following epidemiological characteristics:

First, most epidemics begin with cases imported from abroad, and local epidemics are likely to persist in places where there is infection and mosquito breeding sites.

Second, if a few infected cases slip through controls right after the Lunar New Year, the first wave of the epidemic is likely to break out between April and May. At that time, if preventive efforts are further compromised, the number of cases is likely to soar from June to August.

If an investigation fails to pinpoint the source of infection and mosquito breeding sites, or if people delay in seeking medical care and continue to move around, especially in large crowds, the epidemic will spread quickly and eventually spin out of control.

Third, epidemics are larger in scale and more severe in southern Taiwan and Penghu County, where there are Aedes aegypti mosquitoes. Northern and central Taiwan experience small and medium-sized outbreaks, and another species of dengue-transmitting mosquito — Aedes albopictus — can be found in Taipei, New Taipei City and Taichung.

Fourth, most dengue patients are adults, but more severe cases and deaths often occur among people aged 65 or above, while younger adults often play a large role in transmitting the virus.

There is clearly much room for improvement in health education regarding preventive measures for college students, young adults and senior citizens. Particular attention should be paid to Taipei and New Taipei City, which accounted for the two highest numbers of imported dengue cases for the past two years.

Of the 44 confirmed cases so far this year, New Taipei City accounted for 20, Taichung for 18, Taipei two and Chiayi two, compared with one case in Kaohsiung, and none in Tainan and Pingtung County.

Aedes albopictus mosquitoes inhabit and breed in a variety of outdoor conditions. It is extremely important to conduct an epidemiological investigation whenever a dengue case is confirmed, as well as to properly install in-house and outdoor autocidal gravid ovitraps, and to examine the traps regularly.

In summer, a special effort should be made to clean up mosquito breeding sites on campuses.

More importantly, prevention and reduction of mosquitoes should start at one’s own house, garden and balcony. When there are older people or patients with diabetes, kidney or heart disease living at home, multiple preventive measures should be taken, such as installing window and door screens to avoid mosquitoes entering the house.

Furthermore, local communities should convene every weekend to conduct collective preventive measures.

Recent global trends stress the importance of repelling and controlling mosquitoes and reducing epidemiological risk factors. Key tasks are often planned out beforehand so as to popularize preventive measures and allow them to take root in local communities.

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