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Wednesday, November 27, 2024

Rising Dengue Cases in the Philippines Call for Stronger Prevention and Innovative Solutions

As dengue cases continue to rise in the Philippines, public health experts emphasize the need for sustained preventive efforts and innovative solutions to combat the mosquito-borne disease. Dr. Nina Gloriani, Head of the Department of Science and Technology’s (DOST) Vaccine Expert Panel, highlighted the cyclical nature of dengue and the increasing morbidity rates.

“We’ve seen an increase in severe dengue cases,” Dr. Gloriani said. “Dengue is not usually fatal, but it can seriously affect certain segments of the population, especially children.”

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While school-age children, particularly those up to 9 years old and between 9 to 16 years old1,2, remain the most vulnerable, dengue’s broader impact on the healthcare system and the economy cannot be ignored. The Philippines is among the top five ASEAN countries affected by dengue, and the cyclical outbreaks demand a more proactive response3.

“Complacency is a problem we’re seeing not just in communities but perhaps among authorities as well,” Dr. Gloriani noted. “While we tend to view dengue as a seasonal disease, its broader impact must be addressed.”

Preventive measures and the role of the government

The country’s dengue prevention efforts are anchored on the 4S strategy—search and destroy mosquito-breeding sites, secure self-protection, seek early consultation, support fogging, spraying in hotspot areas. However, Dr. Gloriani pointed out that this approach, while essential, has not been consistently implemented across the nation.

“Proactive efforts are underway in some provinces, with monitoring of breeding sites and information campaigns beginning as early as June. But these efforts are not always consistent nationwide,” she said. Dr. Gloriani stressed the importance of basic prevention methods, like keeping surroundings clean and adhering to the 4 o’clock habit when mosquitoes are most active.

Next-generation Vaccines: a potential game-changer

“There are at least two new dengue vaccines currently in development,” Dr. Gloriani explained. “The goal is to prevent severe cases and offer broader protection.” The introduction of second-generation dengue vaccines offers hope for more effective prevention vs the firstgeneration.

First-generation vaccines can be given to people who already had previous dengue infection. This means that anyone who wants to get the vaccine must first undergo screening. Because of testing requirement, this set of vaccines pose challenges in access and convenience.

Meanwhile, the second-generation vaccines use the dengue virus 2 as its backbone, imitating as closely as possible the dengue infection and engaging the body’s natural defenses. Furthermore, they focus on targeting dengue’s four serotypes and include components that address the non-structural protein 1 which is associated with severe dengue. They may be given to groups of the population with or without a history of dengue infection, allowing for wider use and providing expanded coverage against dengue.

The World Health Organization has recommended the use of second-generation vaccine among children aged 6 to 16 years olds in areas with high dengue burden and high transmission intensity. While other Southeast Asian countries like Indonesia, Thailand, Malaysia and Vietnam are already introducing these next-generation vaccines, the Philippines is taking a more cautious approach, ensuring sufficient public education on vaccination.

Fighting dengue through immunization: the Brazil experience

In 2024, more than 6 million cases of dengue have been recorded in Brazil, peaking during the summer between the months of January and March. Dr. Gloriani highlighted the country’s experience of combating the dengue epidemic with public immunization efforts. Brazil has integrated the use of dengue vaccination as one of the innovative interventions to address the situation.

“Brazil has faced significant outbreaks and tried mass immunization with the vaccine. However, vaccinating a large portion of the population requires more resources, which is not always feasible,” she said. The goal, she added, is to vaccinate a large enough segment of the population to achieve herd immunity.

The increase in global dengue burden is further exacerbated by climate change and other factors. While dengue remains endemic in the Philippines, experts like Dr. Gloriani emphasize that it can be managed with the integrated approach to dengue prevention and control, including vaccination and public education. She concluded, “Dengue will never completely disappear, but we can prevent it”.

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