Published Date: 2007-08-30 23:50:00
Subject: PRO/MBDS> Dengue - Cambodia (05)
Archive Number: 20070830.2850
DENGUE - CAMBODIA (05)
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A ProMED-mail post
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International Society for Infectious Diseases
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Date: Tue 28 Aug 2007
Source: Earthtimes.org [edited]
<http://www.earthtimes.org/articles/show/98913.html>
The death toll from an epidemic of dengue fever in Cambodia reached
365 with the monsoon season still in full swing, sparking fears it
could yet top 400, authorities said Tuesday [28 Aug 2007]. The vast
majority of victims are children under 15 who have yet to develop
immunity to the mosquito-borne virus, which is endemic to the region.
The government's director for dengue-fever control, Duong Socheat,
said although the crisis had eased in some provinces, 365 confirmed
deaths had already been recorded and there had been 34 542 confirmed
cases. Around 116 Cambodians died of dengue in 2006.
According to experts, an urban construction boom combined with
climatic changes that have caused heavy monsoon rains to be broken up
by unusually warm spells have created ideal breeding conditions for
the day-biting _Aedes_ mosquito, which spreads the disease.
"In coming months we will continue to increasingly focus attention on
prevention and education. We will be putting larvicide in the water
and spraying to try to reduce mosquito populations," he said.
He said the most seriously affected areas continued to be the
northern tourist town of Siem Reap, the capital Phnom Penh, Kandal
province, which surrounds the capital, and the heavily populated
agricultural province of Kampong Cham in the country's east.
Dr Beat Richner, who runs the Kantha Bopha children's hospitals,
which treat thousands of Cambodian children free of charge, said the
infection rates may be even higher.
Richner, a Swiss national, has placed advertisements in local
newspapers saying that poor initial treatment by under-qualified
local doctors is driving up the death toll, as well as a reluctance
by impoverished parents to seek immediate medical care.
The seasonal monsoon, which is the traditional peak time for dengue
fever, is not scheduled to end until October [2007].
Dengue symptoms include high fever, headache, and chronic muscle and
bone pain. In severe cases, patients may develop haemorrhagic fever,
bleeding spontaneously from the nose, gums, skin, or intestinal tract
as their white blood cell counts plummet.
Dengue shock syndrome is another potentially deadly complication of
the virus. Patients with dengue also have a reduced immunity, leaving
them vulnerable to other illnesses.
--
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[In the last PRO/MBDS report on dengue in Cambodia (see Dengue -
Cambodia (04): RFI 20070731.2472), there were reports of
approximately 25 000 cases and almost 300 deaths attributable to
dengue fever/dengue hemorrhagic fever (DHF). The newswire above
reports almost 10 000 more cases and more than 65 more deaths during
the course of the month of August 2007.
The newswire mentions the feeding habits of the _Aedes_ spp
mosquitoes. While _Aedes_ spp feeding times tend to be concentrated
in early morning and late afternoon (around sun up and sun down),
they have been documented to feed during the course of the day. For
an interesting article on the feeding patterns see Ponlawat A,
Harrington LC: Blood Feeding Patterns of _Aedes aegypti_ and _Aedes
albopictus_ in Thailand. J Med Entomology. September 2005. 42(5):
844-9. - Mod.MPP]