IN the 1973-74 dengue epidemic, I was a consultant paediatrician with Dr Sham Kassim in the management of children who were admitted to the paediatric wards of the Kuala Lumpur General Hospital. I continued to be involved in the management of dengue patients when I joined University Malaya Medical Centre.

It is important that the public be reminded of the true nature of this disease.

As recently reported by Professor Sazaly Abu Bakar, the number of reported cases of dengue rose from 518 cases in 1973 to 45,856 last year.

In Selangor last year, 15,871 cases were reported with 32 deaths.

This has occurred despite the state carrying out fogging.

Darus Ahmed, director general of the Malaysian Remote Sensing Agency, says in his report about the dengue risk map (”War on dengue: Are we getting it wrong?” — NST, April 20) that the number of dengue cases are less in areas with bungalow houses than in areas with terrace houses and that abandoned high-rise buildings have become the major breeding ground for mosquitoes.

Recently, Sungai Siput member of parliament Dr Xavier Jayakumar called for an end to ignorance about dengue, while Sazaly has called for more research.

Here are a few suggestions of mine.

- The dengue virus has four strains and all have been identified in Malaysia.

If a person is infected by one strain, he is only immune to that viral strain.

He can be infected by the other three strains. This has caused difficulties in the manufacture of a polyvalent vaccine.

- Research should be a co-ordinated effort by universities and centres and there should be publicity for such research.

Research projects have been going on in individual centres without co-ordination and publicity.

- Fogging only kills adult mosquitoes and also useful garden insects.

Larvae are not killed. Fogging is a waste of time and money.

- School health programmes should be revamped.

Children should be encouraged to look for larvae in their homes and neighbourhood. School toilets have been known to harbour larvae.

Chemical agents that destroy larvae should be brought to the attention of the public and made available.

- Teach our medical students.

Many pursue their studies in Russia where dengue may not exist at all.

Students in new medical schools do a twinning programme with universities in countries where dengue does not occur.

Nurses from foreign countries may not have been involved in dengue-teaching programmes and they as well as young doctors should be taught to recognise the disease and trained in all its aspects.

There is no specific drug against dengue, only correct fluid therapy.

- The cutting down of hillslopes and natural vegetation should be stopped or controlled.

Abandoned high-rise buildings should be destroyed.

There can be optimism. Thailand, where the mortality rate from dengue is only 0.5 per cent, is on top of the problem.

There is no reason why Malaysia cannot get there.

DATIN DR REBECCA GEORGE, Kuala Lumpur

Source: NST – April 28, 2008