Better than cure: dengue prevention and control

Rogier Kind

Dengue is a mosquito-borne viral disease that has rapidly spread in all regions of World Health Organization (WHO) in recent years. After a drop in the number of cases in 2017-18, a sharp increase in cases is being observed in 2019. In the Western Pacific region, increase in cases have been observed in Australia, Cambodia, China, Lao PDR, Malaysia, Philippines, Singapore and Vietnam. Operating in these regions, Atlas Professionals would like to share some tips on how to recognize, prevent and control dengue in line with its Zero Harm safety culture framework.

How do you recognize (severe) dengue?

Dengue causes flu-like illness and should be suspected when a high fever (40°C/104°F) is accompanied by 2 of the following symptoms: severe headache, pain behind the eyes, muscle and joint pains, nausea, vomiting, swollen glands or rash. Symptoms usually last for 2–7 days, after an incubation period of 4–10 days after the bite from an infected mosquito.

Dengue occasionally develops into severe dengue, a potentially deadly complication due to plasma leaking, fluid accumulation, respiratory distress, severe bleeding, or organ impairment. Warning signs occur 3–7 days after the first symptoms in conjunction with a decrease in temperature (below 38°C/100°F) and include: severe abdominal pain, persistent vomiting, rapid breathing, bleeding gums, fatigue, restlessness and blood in vomit. The next 24–48 hours of the critical stage can be lethal; proper medical care is needed to avoid complications and risk of death.

Treatment, prevention and control

There is no specific treatment for dengue fever, but early detection and access to proper medical care lowers fatality rates below 1%. For severe dengue, medical care by physicians and nurses experienced with the effects and progression of the disease can save lives – decreasing mortality rates from more than 20% to less than 1%. Maintenance of the patient’s body fluid volume is critical to severe dengue care.

Dengue prevention and control depends on effective mosquito control measures. At present, the main method to control or prevent the transmission of dengue virus is to combat vector mosquitoes through:

preventing mosquitoes from accessing egg-laying habitats by environmental management and modification;
disposing of solid waste properly and removing artificial man-made habitats;
covering, emptying and cleaning of domestic water storage containers on a weekly basis;
applying appropriate insecticides to water storage outdoor containers;
using of personal household protection measures, such as window screens, long-sleeved clothes, repellents, insecticide treated materials, coils and vaporizers (These measures have to be observed during the day both at home and place of work since the mosquito bites during the day);
improving community participation and mobilization for sustained vector control;
applying insecticides as space spraying during outbreaks as one of the emergency vector-control measures;
active monitoring and surveillance of vectors should be carried out to determine effectiveness of control interventions.

Atlas Professionals’ large geographic footprint means we work in many different climates and regions each day. We believe that by providing our professionals with the understanding that preventing dengue is better than curing it, they will, in turn, be empowered to deliver safety leadership throughout the business.

Should you recognize dengue symptoms, please contact your onboard medic or your local GP.