The number of local dengue fever cases has rapidly increased since the first case was reported on June 13, jumping to more than 300 cases in a month. Experts are warning that the infection risk and severity might keep growing if prevention measures are not implemented quickly and effectively.
The Centers for Disease Control’s (CDC) disease surveillance data on Wednesday confirmed 322 local dengue cases — the highest number for the same period since 2017. Local cases have continued to be reported in the past few days.
While most local cases reported so far were in southern Taiwan — mostly in Tainan, which accounts for more than 80 percent of all cases — cluster infections have also been reported in central Taiwan’s Yunlin County and sporadic cases in Taichung, indicating that the infection risk might be expanding across the country.
The cases in Tainan and Yunlin had dengue virus serotype 1 (DENV-1), while the Kaohsiung Department of Health on Wednesday and Thursday reported two local cases of DENV-2, which studies suggest is more often associated with severe illness than other serotypes.
The reports have prompted experts to warn about secondary dengue (infection with another serotype after a previous infection), which is linked to greater risk of developing more severe symptoms, including dengue shock syndrome and dengue hemorrhagic fever.
In 2015, Taiwan experienced the largest dengue outbreak of the decade: 43,784 local infections, including 647 severe cases and 228 deaths, with a case fatality rate of about 0.5 percent. More than half of the cases were in Tainan and involved DENV-2.
A 2015 study by the CDC and National Taiwan University on dengue hemorrhagic fever cases between 2003 and 2013 found that people aged 60 or older with DENV-2 were most at risk for developing dengue hemorrhagic fever after infection, and that fatality risk grows 10-fold in those aged 60 or older with diabetes and who have dengue hemorrhagic fever.
The CDC expressed concern that as of Tuesday, 44 percent of the local dengue cases this year have been people aged 60 or older, which is higher than the average of 26 percent between 2014 and last year, and that elderly people, particularly those with underlying health conditions, are at greater risk of developing severe dengue fever.
Dengue case numbers in many southeast Asian countries are exceeding those of the same period in the past three years. Experts are also concerned that with Taiwan’s international travel boom this year, particularly in the summer, more undetected infections and new variants might be brought in from other countries.
Local governments in central and southern Taiwan have stepped up mosquito control efforts in recent weeks, including Tainan setting up an epidemic command center for dengue fever to incorporate the efforts and resources of different departments, district offices, public health centers and local military forces.
Government efforts include inspecting the environment for mosquito breeding sites and removing them, contact tracing, targeted outdoor and indoor insecticide fogging in hotspots, and notifying local healthcare practitioners.
No specific method exists to treat dengue fever and averting mosquito bites is the best way to prevent it. Experts say that people, especially those living in dengue hotspots, must cooperate with fogging policies and expanded testing, and keep the environment clean for dengue control to be effective.
The CDC and experts have suggested wearing loose-fitting and long-sleeve clothing; screening windows and doors; using mosquito repellents and removing standing water from flowerpots and scrubbing them clean weekly; addressing any symptoms and telling one’s doctor about recent travel and possible exposure.
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