Alarmed at the number of people who contracted dengue fever in the first four months of this year, the Public Health Ministry's Disease Control Department launched a nationwide campaign in May to rid the country of as many mosquito breeding grounds as possible. At the time, the number of those known to have contracted the virulent, flu-type disease this year totalled nearly 8,000 with nine deaths. Now, a full four months into the campaign, the number of those infected has reached 38,500, of whom 42 have died, five in the last week alone.
These are scary figures that should galvanise our health authorities into reviewing the benefits achieved by the kind of drastic action taken by Singapore and other countries after suffering major epidemics of this viral disease. The most effective appears to be the carrot and stick approach. This involves teaching individual communities throughout the country the importance of preventing mosquito-breeding and assisting them in developing a proper system with which to do so. Home or business owners refusing to cooperate face warnings and heavy fines. All cases must be reported so that immediate chemical fogging can take place and chains of infection broken.
Complicating the situation in southern border provinces such as Ranong are twin outbreaks of malaria and dengue with upwards of 300 people in one district infected by malaria late last month. Landslides and flash floods have now worsened the situation. Asean, in conjunction with the World Health Organisation, has tried to help tackle this public health menace, but, medically, it is no closer to a solution.
Epidemiologists have suggested a possible link between the increasing prevalence of the disease and climate change, especially in light of the 2009 outbreak in the southern US which gave Florida its first case in 55 years. Rising temperatures, longer rainy seasons and increased urbanisation are all contributing to the explosion of dengue and other debilitating vector-borne diseases, which are no longer cyclical. At one time they only targeted children but now adults are just as vulnerable. The inability of health authorities to cope must be of concern to everyone.
If the increase in vector-borne diseases is conclusively linked to climate change, and the disease continues to spread to more temperate regions, pharmaceutical companies might just show greater interest in research and development because the developed world offers more business potential than cash-poor developing nations. But the reality is that there is no cure, vaccine or effective treatment yet for any of the four strains of the disease, or the potentially fatal dengue haemorrhagic fever or dengue shock syndrome.
This concern is not limited to tropical countries. The UK's Health Protection Agency has seen the 166 cases it treated in 2009 grow to 406 a year, of which it has linked 15% to visits to Thailand. The World Health Organisation says the disease infects about 50 million people a year and threatens 40% of the world's population.
At least the problem is not being completely ignored. Genetic engineering is being employed to develop wingless female mosquitoes or to sterilise males so they are unable to reproduce.
Tests have been carried out in Brazil and the Cayman Islands. Scientists say this ploy would stop the females from spreading disease, but tampering with nature is a risky business. South Korea is even said to have developed a mobile phone ringtone that repels mosquitoes. But the only real recourse is to eliminate breeding grounds and conduct proper surveillance, education and clean-up campaigns, none of which are being effectively carried out at present.
The rapid growth of our cities is leading to overcrowding, urban decay and poor sanitation, allowing more disease-carrying mosquitoes to live closer to more people, with predictable results. It has become impossible to avoid them.
Chemical fogging is usually employed only after a case of infection has been confirmed, which is often too late. Such measures need to be used more extensively before infected mosquitoes draw blood.
Dengue is not confined to rural areas. It is becoming a nasty problem in Bangkok as well as resort areas in the South, and is not a disease to be taken lightly. Apart from the cost in human misery, damage to the economy has been put at an annual 1.6 billion baht. It is time the region came together as a whole and tackled this health menace head-on.