In recent years, countries in South and Southeast Asia, including India, Bangladesh, Thailand, Malaysia, Indonesia, Vietnam, Singapore, and the Philippines, have witnessed worse dengue outbreaks than usual ahead of the traditional peak season. There is also a high probability of an increasing number of cases in non-endemic countries in coming years, as climate change shifts epidemiological trends.
According to World Economic Forum, changes in weather patterns have resulted in the emergence and re-emergence of climate-sensitive diseases such as dengue, and the number of cases of dengue has increased 30-fold worldwide over the past 50 years. Dengue not only affects public health but also imposes an economic burden of up to $8.9 billion worldwide.
A comprehensive strategy with targeted measures to manage dengue is therefore needed to achieve a zero-mortality rate by 2030. This includes existing surveillance and vector control measures, as well as the potential introduction of a safe and efficacious vaccine. Importantly, stakeholder efforts from both public and private sectors are crucial in preventing, managing, and controlling this health threat.
Dengue is a viral infection transmitted by the Aedes aegypti mosquito, and its infection can range from subclinical disease to severe flu-like symptoms. Some patients develop severe dengue associated with severe bleeding, organ impairment, and plasma leakage – the main causes of hospital admissions and death from dengue among both adults and children. Additionally, as infection demographics have shifted towards the older age group, higher rates of co-morbidities in these individuals contribute to more severe disease and mortality.
Dengue’s prevalence has risen sharply, and first outbreaks have been reported in countries that were previously not endemic. Nearly half of the world’s population is at risk of dengue if no effective solutions are implemented. This highlights the urgency for an integrated management strategy.
The World Mosquito Program has introduced a method that breeds mosquitoes to carry the naturally occurring bacterium Wolbachia and releases them into the environment. The bacterium makes it difficult for viruses such as dengue to replicate in mosquitoes and reduces the risk of viral spread in humans. While existing methods play a role in managing dengue, they are only partially effective.
As we intensify the utilization of vector control strategies, a concurrent decrease in population immunity poses a significant challenge in efforts to further control the disease. This situation resembles the Singapore Paradox, where diminishing immunity levels against dengue lead to increasingly frequent outbreaks.
The Asia Dengue Summit held this year emphasized the need for an integrated approach, where vaccination, along with surveillance, a robust healthcare system, and sustainable community awareness, is anticipated to help eradicate the increasing global burden of dengue.