Published Date: 2007-07-09 23:50:00
Subject: PRO/MBDS> Dengue - Myanmar (04): RFI
Archive Number: 20070709.2177
DENGUE - MYANMAR (04): REQUEST FOR INFORMATION
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Sun 8 Jul 2007
Source: ChinaView, Xinhua News Agency report [edited]
Local media reported Sunday [8 Jul 2007], that 30 people out of 3000
infected with dengue fever [DF] died in Myanmar in the first half of
this year , a number higher than that during the same period of 2006.
The health authorities have warned the public to take precaution
against DF especially during the current monsoon season which started
last month [June 2007], said the Myanmar Times in its next weekly
issue [9-15 July 2007] pre-published on Sunday [8 Jul 2007].
The highest number of DF cases occurred in southern Mon state,
followed by Yangon and Ayeyawaddy divisions during the half-year
period, the report said.
According to statistics, in 2006, 11 049 people were infected with DF
in the country resulting in 130 deaths.
Dengue fever cases dropped in Yangon city in 2006, thanks to
preventive measures taken against the disease. The dengue fever cases
in Yangon declined to 1531 with 18 deaths in 2006, from 5621 cases
with 40 deaths in 2005.
The dengue fever cases were attributed to heavy population and poor
stream-water flow in some areas in the 680 sq km (262.6 sq mi)
Yangon, which has a population of 6 million.
The health authorities have occasionally advised people to take
necessary measures to prevent and control the disease, including
hygienic use of drinking water, combating larvae, weekend sanitation
activities, and education talks on dengue fever, which is spread by a
species of mosquito active during the day.
According to official statistics, nearly 13 000 dengue fever cases
occurred in Myanmar in 2005, a sharp increase from the previous
year's 6000. The figures represented the 2nd largest outbreak of the
mosquito-borne viral disease since 2001, when 15 695 cases were
reported. Of the 6000 dengue fever cases reported during 2004, nearly
half were also in Yangon, especially in the Southeastern area of
Thaketa, according to the health department.
The authorities warned that the _Aedes_ mosquito carrying the virus
put residents in heavily populated areas at increased risk of
contracting the disease, adding that there is no specific treatment
or vaccine for dengue fever.
Dengue fever usually breaks out during and after the rainy season and
children aged under 12 are particularly vulnerable to the disease.
[With intermittent outbreaks] in Myanmar, dengue fever was 1st
detected in Yangon in 1969, and a major outbreak of the disease
followed in 1970, which was confined in Yangon until 1973. The 1st
case in northern Mandalay division was detected in 1974, and major
outbreaks have occurred in the division about every 4 years, most
recently in 2001 and 2005.
[In a 1975, Thaung U et al published a study on the epidemiology of
dengue and chikungunya in Myanmar (see: Thaung U, Ming CK, Swe T,
Thein S: Epidemiological features of dengue and chikungunya
infections in Burma. Southeast Asian J Trop Med Public Health 1975
Jun ;6(2):276-83.). The abstract follows:
"A serological survey for antibody to dengue and chikungunya was
carried out in all 14 divisions and states and 2 border towns in
Burma [Myanmar] during 1973-74.
Dengue HI antibody prevalence rate of less than 10 percent was
observed in Arakan and Shan States, 10 to 30 percent in the
Irrawaddy, Pegu, Mandalay Divisions, and Kachin, Mon, and Karen
States, 31 to 60 percent in Sagaing Division, and over 60 percent in
Rangoon [Yangon], Magwe, and Tenasserim Divisions. Similarly,
chikungunya HI antibody prevalence rate of less than 10 percent was
observed in Arakan State, 10 to 30 percent in the Irrawaddy, Pegu,
Mandalay and Sagaing Divisions and Kachin State, 31 to 60 percent in
Rangoon Division and Mon State.
Both dengue and chikungunya antibodies were detected where _Aedes
aegypti_ mosquitoes were prevalent, but the antibody prevalent rates
were not directly proportional to the premises index. No HI antibody
to dengue nor chikungunya was detected in _Aedes aegypti_-free hilly
areas, Chin and Kayah States, but was detected in the Shan State,
Dengue and chikungunya infections were observed both in rural and
Dengue and chikungunya infections affected all socioeconomic classes
in Rangoon [Yangon] equally, but in Mandalay high socioeconomic class
was nearly 3 times less affected than lower socioeconomic class. The
infrequencies of dengue and chikungunya infections were observed to
be 2 to 3 times higher in residents of Rangoon City than those of other towns.
In Rangoon the antibody prevalence rates to dengue increased
progressively with age while in other towns no appreciable increase
in rates with age was observed. Both sexes were equally affected.
This study provides strong circumstantial evidence that dengue and
chikungunya viruses are highly and widely distributed throughout
Burma [Myanmar], and that new outbreaks of haemorrhagic fever could
occur in previously free areas following introduction of dengue
viruses into populations previously exposed to one type of dengue."
Information on annual reported cases and deaths attributable to
dengue and dengue hemorrhagic fever in Myanmar are available at the
Global Infectious Disease and Epidemiology Network (GIDEON) website
at <http://www.gideononline.com> and are presented below:
Annual reported cases: 1654 in 1970; 691 in 1971; 1013 in 1972; 349
in 1973; 2477 in 1974; 6750 in 1975; 3158 in 1976; 5364 in 1977; 2029
in 1978; 4685 in 1979; 2026 in 1980; 1524 in 1981; 1706 in 1982; 2856
in 1983; 2323 in 1984; 2666 in 1985; 2192 in 1986; 7424 in 1987; 1181
in 1988; 1196 in 1989; 6318 in 1990; 8055 in 1991; 1678 in 1992; 2297
in 1993; 11647 in 1994; 2477 in 1995; 1655 in 1996; 3993 in 1997;
8978 in 1998; 5828 in 1999; 1884 in 2000; 15 695 in 2001; 16 047 in
2002; 7907 in 2003; 7369 in 2004; 16 986 in 2005
Annual reported deaths: 81 in 1970; 34 in 1971; 32 in 1972; 15 in
1973; 159 in 1974; 365 in 1975; 98 in 1976; 236 in 1977; 82 in 1978;
158 in 1979; 79 in 1980; 90 in 1981; 49 in 1982; 83 in 1983; 39 in
1984; 134 in 1985; 111 in 1986; 233 in 1987; 65 in 1988; 52 in 1989;
182 in 1990; 305 in 1991; 37 in 1992; 67 in 1993; 444 in 1994; 48 in
1995; 18 in 1996; 76 in 1997; 142 in 1998; 88 in 1999; 14 in 2000;
204 in 2001; 170 in 2002; 78 in 2003; 79 in 2004; 158 in 2005
Note that the historical numbers of reported cases presented in the
newswire above differ from those available on the GIDEON website -- a
clarification would obviously be appreciated.
It is noteworthy that while historically epidemic years have been in
approximately 4-year cycles, it does appear as though this year
(2007) is an epidemic year, with total numbers of reported cases in
the 1st 6 months already almost twice those seen in 2004 and close to
80 percent of the number of reported cases in 2005.
Information on the serotype(s) of dengue virus implicated in this
year's (2007) activity in Myanmar would be greatly appreciated as well.
For a map of Myanmar with administrative divisions, see