Dengue – Prevention & Control

Dengue is a viral disease transmitted by mosquitoes of the Aedes genus, mainly Aedes aegypti and Aedes albopictus. These mosquitoes also spread other diseases, such as chikungunya and Zika.

Dengue can cause various symptoms, from mild fever and headache to severe hemorrhagic fever and shock. Dengue is endemic in many tropical and subtropical regions of the world and poses a significant public health threat to millions.

Dengue can also cause outbreaks that overwhelm health systems and disrupt social and economic activities.

There is currently no specific treatment or vaccine for dengue, although several candidates are under development. Therefore, the primary strategy to prevent and control dengue is to reduce exposure to mosquito bites and eliminate the vector mosquitoes’ breeding sites.

This requires a coordinated and integrated approach that involves multiple sectors and stakeholders, such as health, environment, education, urban planning, community participation, and media.

Key preventive and control measures for dengue

Personal protection

Long-sleeved clothes, insect repellents, mosquito nets and avoiding outside activities during the peak biting times (dawn, dusk, and early evening) are ways to protect people from mosquito bites.

These measures are essential for travellers visiting dengue-endemic areas, pregnant women and people with chronic diseases or low immunity.

Environmental management

This involves modifying or eliminating potential mosquito breeding sites, such as containers that hold water (e.g., buckets, tires, flower pots, etc.), by emptying, covering or treating them with larvicides or biological agents (e.g., fish or bacteria).

Environmental management also includes improving water supply and sanitation, solid waste management, drainage systems and urban landscaping.

This involves applying insecticides to kill adult mosquitoes or larvae in targeted areas, such as households, schools, hospitals, or public places. Mosquito control can be done through space spraying (fogging), residual spraying (on walls or surfaces), or larviciding (in water containers.

Vector control should be based on entomological surveillance and risk assessment. It should follow the principles of integrated vector management (IVM). This rational decision-making process optimizes the use of resources and minimizes the negative impacts on human health and the environment.

Surveillance

This involves monitoring the epidemiological situation of dengue cases and outbreaks and the distribution and density of vector mosquitoes. Surveillance data can help to identify high-risk areas, guide intervention strategies, evaluate their effectiveness and detect emerging trends or threats.

Training health workers should conduct surveillance using standardized tools and methods, such as case definitions, laboratory tests, reporting systems, rapid response teams, and geographic information systems (GIS).

Clinical management

This involves providing timely and appropriate care to patients with suspected or confirmed dengue infection. Clinical management includes early diagnosis using rapid diagnostic tests (RDTs) or polymerase chain reaction (PCR), supportive treatment with fluids and analgesics, close monitoring of vital signs and warning signs of severe dengue (such as bleeding, abdominal pain, vomiting, etc.).

Clinical management should follow the WHO guidelines for diagnosing, treating, preventing, and controlling dengue.

Social mobilization 

This involves engaging and empowering communities to participate in dengue prevention and control activities. Social mobilization can be done through education campaigns, behaviour change communication (BCC), social media platforms, mass media outlets or interpersonal communication.

Social mobilization can help to raise awareness about dengue symptoms, transmission modes, risk factors, prevention methods, and health-seeking behaviours. Social mobilization can also foster cohesion and solidarity among community members to take collective action against dengue.

Research

This involves generating new knowledge and evidence to support developing and implementing effective interventions for dengue prevention and control. Research can be done in various domains, such as epidemiology, entomology, virology, immunology, vaccinology, pharmacology, clinical trials, health economics and social sciences. 

Dengue is a complex and dynamic disease that requires a comprehensive and multidisciplinary approach to prevent and control it.

Is vaccination available for dengue?

Yes, there is a vaccine for dengue, but it is not widely available or recommended for everyone. According to the World Health Organization (WHO), there are two commercially available vaccines for dengue prevention: Dengvaxia and Qdenga.

Dengvaxia is a live-attenuated vaccine developed by Sanofi Pasteur and approved by the European Union, the United States, and several other countries. However, Dengvaxia is only recommended for people with a previous dengue infection, as it may increase the risk of severe dengue in those without.

Qdenga is a tetravalent vaccine developed by Takeda and approved by the European Union, Indonesia and some other countries. Qdenga is designed for people without a previous dengue infection, as it is safe and effective in preventing symptomatic dengue in all serotypes.

Both vaccines require three doses to be administered over 12 months and are not suitable for children under six years or adults over 45 years of age.

Besides vaccination, other measures can help prevent and control dengue, such as personal protection from mosquito bites, environmental management of mosquito breeding sites, vector control with insecticides or biological agents, surveillance of dengue cases and outbreaks, clinical management of dengue patients, social mobilization of communities and research on new interventions.

Conclusion

In conclusion, dengue is a deadly and contagious illness that can result in significant complications and even death. 

However, there are many ways to prevent and control dengue, such as vaccination, personal protection, environmental management, vector control, surveillance and clinical management.

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