Many areas in the country are prone to flooding especially during rainy and storm season due to poor drainage system and blocked water sewerage passages. Aside from the dreaded dengue carrying mosquitoes thriving in wet and flooded surfaces, there are also victims of leptospirosis caused by drenching in flood waters infected from rat urine body wastes.
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Leptospirosis is a bacterial disease that affects both humans and animals. It is caused by bacteria called Leptospira. In humans, it can cause a wide range of symptoms, some of which may be mistaken for other diseases. Some infected persons, however, may not show any symptoms at all.
Like dengue, the symptoms includes rashes, high fever and other similar signs. Fatality rates are also high like dengue. People who are exposed to leptospirosis are given prophylaxis, an anti-bacterial agent. Leptospirosis targets the kidneys and if not prevented, it can damage the kidneys and eventually cause death.
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To control the spread of leptospirosis, everyone must observe cleanliness in the surroundings.
According to health secretary Francisco Duque, the DOH can only advice the government to ensure proper and efficient collection of garbage, flood waters has to be drained. The issue has to be addressed environmentally.
Avoid drenching yourself to floodwater especially if you have open wounds, even a small cut. People without any cuts are also not considered safe from the infection.
Should you already immersed yourself in the flood, you need to immediately go to the nearest hospital or health center for consultation. Infected individuals are given Doxycycline or Prophylaxis, an anti-bacterial medication to prevent infection.
The best way to stop the disease is to control rodent population by maintaining a clean environment.
Dengue carrying mosquitoes are everywhere and every home must be protected from it. The first line of defense against the dreaded disease is prevention and we can all do it by doing these simple steps at home.
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The Department of Health (DOH) recently declared a “national dengue epidemic” since dengue cases have been significantly increasing. This is 98% higher than the numbers in 2018, six hundred and twenty two people already lost their lives this year alone.
While the local government units are addressing the situation of the epidemic, the first step to prevent it starts from our homes.
Here are some home hacks that you can do to prevent mosquitoes from breeding to get rid of dengue.
The DOH recommends The Enhanced 4-S implantation which calls for everyone to be active in controlling the spread of mosquito population and avoiding any possible dengue deaths within the community.
1. Search
Find out where mosquitoes thrive and destroy their breeding sites. Mosquitoes lay their eggs in stagnant water, so throw all the containers where stagnant water can accumulate especially during rainy season. These include old tires, blocked drainage, flooded diggings, and even cracked concrete.
2. Secure self-protection
Wear mosquito-repellant, long pants, and long-sleeved shirts. Aedes egypti are daytime biting mosquitoes but they can also bite during the night so it's best to wear an insect repellant most of the time especially when it is near dark time.
3. Seek early consultation
If the person shows most common symptom of dengue like fever, headache, eye pain, muscle and joint pain, rashes, nausea, vomiting, and unusual bleeding (nose or gum bleeding) do not hesitate to go to a nearby hospital or clinic for consultation. The first 24 to 48 hours of dengue infection are crucial and early treatment is important.
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4. Support fogging or spraying in hot spot areas DOH also encourages fogging and spraying in mosquito-breeding hotspots to be done by authorized and trained sprayers to achieve immediate knockdown of mosquitoes.
Installing creens on windows, doors, and vents, using insect sprays and mosquito repellant both inside and outside the house can also help a lot.
Pet's drinking bowl should be checked and changed on a regular basis. Drain rainwater tanks and water storage bins and nearby plants trimmed and under control. Light-colored clothing has to be worn because mosquitoes are reportedly more attracted to dark colors.
These simple steps could help a lot to keep mosquitoes away. The war against dengue can be fought one home at a time.
The rainy season is said to be the peak season for getting sick due to the many water-borne diseases that are brought about by the climate. Flooding is also a problem in many areas during rainy days. Cases of diarrhea and dengue rise during this season. Because of flooding, many become victims of leptospirosis as well.
The National Kidney Transplant Institute said that 99 people have already died due to this disease since January.
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Leptospirosis is an infection caused by a corkscrew-shaped bacteria called Leptospira. Symptoms can range from none to mild such as headaches, muscle pains, and fevers; to severe with bleeding from the lungs or meningitis. Studies show that exposure to flood or swimming in a pool contaminated with rat urine is the known major cause of leptospirosis. Exposure to soil with rat urine can also infect humans. The Department of Health (DOH) has recorded a total of 99 deaths out of the reported 1,030 cases of leptospirosis in different government hospitals in the Philippines from Jan. 1 to June 9, Health Secretary Francisco Duque III said as cases of the flood-borne disease rise nationwide.
Nine patients taken to the National Kidney and Transplant Institute (NKTI) in Quezon City, including those admitted on June 22-27 are among the fatalities, according to Duque.
As the cases of leptospirosis continue to grow, they have transformed the hospital gym into an improvised ward and formed a special lane to accommodate the patients, according to NKTI director Rose Marie Liquete.
Duque urged the public to seek immediate treatment when they have a fever or any other symptoms of leptospirosis after wading in flood water.
The DOH is conducting close monitoring, particularly on the regions with rising cases of leptospirosis to determine if there is a need to declare an outbreak of the deadly infection
Duque identified Western Visayas, Caraga, Zamboanga peninsula, National Capital Region and Davao as the five regions with high leptospirosis cases.
To prevent your family from contracting leptospirosis, these tips have to be followed:
1. Avoid exposure to flooded areas especially if you have any open cuts or wounds. Use boots or any protective gears if you need to.
2. Keep your area clean and free of clutters that attract rats. Observe rodents and rats control.
3. Strengthen your immune system by having a healthy diet.
In the midst of Filipino parents with kids already vaccinated with the controversial anti-dengue shots worries, the World Health Organization releases their stand and answers questions about Dengvaxia. Over 7000,000 had been vaccinated since the nationwide vaccination commenced and the Department of Health that about 10% of them were not infected by the virus prior to the vaccination putting them at risk of having "severe diseases" as to the statement of the vaccine manufacturer Sanofi Pasteur.
What is Dengvaxia®? There continues to be a strong public health need for effective preventive interventions against dengue, a disease caused by four viruses, termed serotypes 1-4. One dengue vaccine has been licensed, Dengvaxia® (also referred to as CYD-TDV), developed by Sanofi Pasteur. Dengvaxia® is a live recombinant tetravalent dengue vaccine developed by Sanofi Pasteur, given as a 3-dose series on a 0/6/12 month schedule. Dengvaxia® is the first dengue vaccine to be licensed and has now been approved by 19 regulatory authorities for use in endemic areas in persons typically ranging from 9-45 (in some countries 9-60) years of age. It has been introduced in two subnational programs in the Philippines and Brazil targeting about one million individuals. It is otherwise available on the private market in countries where there is a marketing authorization.
What was previously known about the licensed dengue vaccine, Dengvaxia®? Dengvaxia® has been evaluated in two Phase 3 clinical trials (CYD14 trial in five countries in Asia and CYD15 trial in five countries in Latin America). Together, these trials included over 30,000 participants aged 2 to 16 years. Vaccine efficacy against confirmed dengue pooled across both trials was 59.2% in the year following the primary series, and 79.1% against severe dengue. Efficacy varied by serotype, by age at vaccination and serostatus at baseline (i.e., previous exposure to dengue prior to vaccination).
While efficacy was reported against hospitalized and severe dengue in Years 1 and 2 post-dose 1, an excess of cases of hospitalized and severe dengue cases in those receiving Dengvaxia® was seen in Year 3 in some subgroups, although it is based on relatively small numbers of cases. Whether the increased risk was due to age or serostatus at baseline, which is highly correlated with age, could not be fully clarified with the available data at the time. For subjects aged 9 and above, in the first 25 months of the phase 3 trials, there was a reduction in severe dengue by 93% and a reduction in hospitalizations by 81%. Owing to the higher efficacy among participants vaccinated at age ≥9 years, as well as an elevated risk of hospitalized dengue in the 2–5-year age group, licensure was obtained in several countries to date for those aged 9–45 or 9–60 years living in dengue-endemic settings.
What is WHO’s current position on the use of Dengvaxia®?
Following recommendations made by the Strategic Advisory Group of Experts (SAGE) on immunization, WHO’s advisory body on vaccination, a position paper was published in July 2016 based on the data available at that time. The position paper makes a conditional recommendation on the use of the vaccine for highly endemic areas. Based on considerations of superior efficacy and, possibly, safety and duration of protection in seropositive individuals, SAGE recommended seroprevalence thresholds as the best population-level strategy. Based on mathematical modeling, an optimal seroprevalence in the age group targeted for vaccination was defined in the range of ≥70%. At that time theoretical elevated risk of dengue in vaccinated seronegative subjects was noted, and research into this was considered high priority. WHO thus called on Sanofi Pasteur to provide more data on efficacy and safety in baseline seronegative vaccine recipients.
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What are the additional analyses on efficacy and safety in baseline seronegative persons who received Dengvaxia®? Because the Phase 3 trials did not collect blood samples from all participants to be able to determine serostatus at baseline, the company performed additional testing to infer serostatus at the time of vaccination. However, samples were available for all trial participants at month 13, one month after the 3rd dose was administered. These samples were tested using an assay that identifies antibodies against the dengue non-structural protein 1 (NS1) based on the fact that the Dengvaxia® non-structural proteins code for Yellow Fever vaccine proteins, rather than for dengue. This allows differentiation between previous natural exposure to dengue and vaccination. Based on this test, Sanofi Pasteur reanalyzed the trial data stratified by seronegative and seropositive subjects to estimate the safety and efficacy of the vaccine by baseline serostatus.
What are the preliminary results from the recent analysis of vaccine safety in persons seronegative to dengue prior to vaccination? While vaccinated trial participants overall had a reduced risk of virologically-confirmed severe dengue and hospitalizations due to dengue, the subset of trial participants who had not been exposed to dengue virus infection prior to vaccination had a higher risk of more severe dengue and hospitalizations due to dengue compared to unvaccinated participants, regardless of age. This increased risk was observed after an initial protective period and persisted over the observation period of up to 66 months post primary vaccination. What is WHO’s interim interpretation of the data?
WHO’s interim interpretation of data is that: —The vaccine significantly protects against hospitalized and severe dengue in subjects seropositive for dengue at time of first vaccination in all age groups studied; —The risk of hospitalized and severe dengue is significantly increased among vaccinated subjects who were seronegative for dengue at the time of first vaccination in all age groups studied;
WHO will conduct a full review of the data through the Global Advisory Committee on Vaccine Safety and SAGE, for revised guidance of the use of Dengvaxia®.
Pending the full review of the data, as a precautionary and interim measure, WHO recommends that Dengvaxia® is only administered to subjects that are known to have been infected with dengue prior to vaccination.
What do these data mean for other dengue vaccines in clinical development?
A more detailed analysis of the data is needed to answer this question. The two candidate vaccines in phase 3 clinical development differ significantly from Dengvaxia®, so that no conclusions on the safety and efficacy profile of these candidates should yet be drawn. However, it will be necessary to carefully monitor vaccine performance over time in both seronegative and seropositive subjects.
Meanwhile, the Department of Health releases an infographics of the most frequently asked questions about the vaccine. The DOH assures every Filipinos that the situation is being closely monitored.
