Dengue Does Not Discriminate - An Awareness Workshop by Sanofi Pasteur

I realise that this is not a usual topic that I would choose to write about, as it is neither related to food or holidays, but it is a topic that is close to my heart.  With four kids in tow, some of whom are rather active outdoors, one always worries as a  parent, that that dreaded white striped aedes mosquito would impart that dreaded dengue fever.  And personally as well, I enjoy jogging and walking in parks in the evening.  The trick to that usually is to never stay stationary, because when you do, you become a mosquito magnet.

So when I was invited to attend a seminar and awareness workshop held by Sanofi Pasteur, I thought it would be a good opportunity to learn more about this dreaded fever that has afflicted quite a number of my friends already in recent times.

According to the press release provided, "dengue has become the most rapidly expanding mosquito-borne infectious disease on the planet, surpassing malaria  (actually one hardly hears of anyone contracting malaria) and infecting at least 390 million people per year. As of 17 May, there were 43,126 cases of dengue reported in Malaysia, a 34% increase compared against the same reporting period in 2014 according to the Department of Health, Malaysia."

By this time I was feeling rather gloomy.  Even more startling were the fatalities caused by dengue, which is almost 50% higher in quarter 1, with 136 deaths reported. That is more than a death a day!!

Sanofi Pasteur in conjunction with ASEAN Dengue Day hosted a media workshop sharing new and revealing local attitudes and insights into the dengue epidemic gripping the country recognising dengue to be a national health threat.

In his welcome address to workshop participants, Mr Baptiste De Clarens, Managing Director of Vaccines for Sanofi Pasteur (Malaysia, Singapore and Brunei) said:
“With the current uptrend on dengue infections in Malaysia, building awareness is a priority. In 2014, Malaysia saw a big increase in dengue, in fact a three-fold increase from the 2013 numbers. More worrying is the general public apathy that surrounds the topic of dengue.

A luminary panel comprising the following people conducted the workshop and subsequently hosted a Q&A session:

Mr Baptiste De Clarens, Managing Director of Vaccines for Sanofi Pasteur (Malaysia, Singapore and Brunei)
Katharine Davis, Managing Director, Ipsos
Associate Professor Dr Zetti Zainol Rashid, Senior Lecturer & Clinical Microbiologist in the Department of Medical Microbiology & Immunology, Faculty of Medicine – University Kebangsaan Malaysia Medical Centre (UKMMC)
Professor Datin Dr. Chia Yook Chin from the Department of Primary Care Medicine, Faculty of Medicine University Malaya Medical Centre, Kuala Lumpur (UMMC)
Dr. Shahnun Ahmad, Associate Medical Director for Sanofi Pasteur Malaysia.

Some myths vs truths about dengue that were highlighted:

Misconception #1: Only the very young and the old are at risk of dengue infection.
TRUTH: Everyone, including young adults are at risk.

Misconception #2: Malaysians feel that they are Knowledgeable about Dengue
TRUTH: While Awareness on Dengue is at a high, only 11% foresee being at high risk

Misconception #3: Dengue is Not Life Threatening
TRUTH: There is No Known Cure for Dengue, Early Detection Saves Lives

Carried mainly by the Aedes aegypti mosquito, dengue is widespread throughout the tropics, with local variations in risk influenced by rainfall, temperature and unplanned rapid urbanisation – all of which are key factors making Malaysia a high-risk country. In fact, dengue is highly endemic in Malaysia where all four dengue virus serotypes are found.

The four Serotypes are DENV1, DENV2, DENV3, DENV4, and recovery from one serotype, whilst giving you immunity to that particular strain, does NOT immunize from subsequent infections by other strains.

I thought this concept of having a graphic artist to sketch the contents of the presentation was rather novel.

Malaysia by the way, is amongst the Top 10 highest dengue endemic countries, with Brazil heading the list with 447,000 average number of cases from 2004-2010.  Malaysia is ranked 9th, with 42,569, but actually as a percentage of the population, I suspect we could be ranked even higher per capita.

RANDOM FACT: Dengue is not seasonal, and is reported throughout the year.  It is also most common in adolescents and young adults (Age 15-29 years) mainly because they lead more active outdoor lives and are less sedentary.

Another gloomy statistic is Malaysia dengue fever deaths have more than tripled in 2014, as reported in BBC news on 23 Sept 2014.

The people at greatest risk of more severe illness are
- Young Children
- Elderly
- Obese (yikes)
- Diabetics
- People With Leukemia and who are on cancer drugs

SYMPTOMS

- Non specific
- Fever, usually very high
- Severe muscle and joint aches
- Headaches
- Running nose and sore throat
- Nausea and Vomitting
- Rash -: Generalised "white in a sea of red"

SIGNS  OF DENGUE
- General Appearance
- Temperature
- Blood Pressure, pulse
- Blood Flow, warm, cold and clammy
- Hydration (or dehydration)
- Bleeding gums, period
- Rash: dengue rash or bleeding spot rash

We have all heard stories of the traumatising waits for blood test results etc.
There is a test called the NS1 test, which apparently is rapid detection on 1st day of fever, before antibodies appear (which happens day5 or later).  However, according to Prof Chia, the test is relatively expensive.
The usual blood test is done after Day 5 or later to determine platelet, cmematocrit and white count.

TREATMENT FOR DENGUE

- Sadly, there's no specific medication
- No antibiotics needed
- Treatment is supportive
- Hydration (apparently, don't just drink water alone, drink caloried drinks, such as milk and fruit juices, isotonic electrolyte sol, barley/rice water....water alone may cause electrolyte imbalance)
- Try to lower the fever by sponging
- If very ill, admission

AVOID
- Acetylsalicyclic acid (Aspirin), mefenamic acid (ponstan), ibuprofen or other non steroidal anti inflammatory agents (NSAIDS) or steroids

PREVENTION
- Clean environment
- Do not allow mosquitoes to breed
- Avoid mosquito bites
- Vaccination...

Which leads us to the issue of vaccination.
As a layman attending this workshop, I felt slight surge of hope, because the message I got was that there is a vaccine in the pipeline, which will cover all the four serotypes,  I hope that this will see the light of day very soon.

[disclaimer: this post is not meant to be use as a medical reference, all information is provided by the organisers of the event]