An outbreak of dengue fever in the Philippines has been declared a national epidemic after causing hundreds of deaths this year in the wake of a government ban on the vaccine.
The country has recorded 146,062 cases of dengue from January through to 20 July this year, 98% more than the same period in 2018, the department of health said. The outbreak has already claimed the lives of 622 people. The group worst affected have been children below the age of 10.
Dengue, a mosquito-borne viral infection found in tropical countries worldwide, can lead to haemorrhaging and organ failure in severe cases and there is no specific treatment for the illness.
The outbreak follows a nationwide ban on the sale and distribution of the Dengvaxia vaccine, a dengue vaccine made by French pharmaceutical firm Sanofi Pateur, in February. The company had been at the heart of a scandal in the Philippines in late 2017 and 2018, when dozens of children given the vaccine as part of a nationwide immunisation programme died. The firm conceded that the product could put some children at higher risk.
Dengvaxia is currently the only dengue vaccination available on the market, but the World Health Organisation recommends that it should only be given to those in high risk areas who have already been exposed to the virus. It is rarely used in mass immunisation projects.
The government suspended all dengue vaccination programmes last year and set up an investigation into Dengvaxia. Sanofi Pateur was found by the Food and Drug Administration (FDA) to have shown “complete disregard of government rules and regulations” and in February the government decided to ban the vaccine.
However, the nationwide panic and widespread mistrust of vaccinations caused by the Dengvaxia scandal led immunisation rates for both dengue and measles to plummet in the Philippines, resulting in an ongoing measles epidemic across the country and now a dengue epidemic. There have already been more than 35,000 recorded cases of measles and almost 500 deaths, a 600 per cent increase on last year.
To fight the dengue outbreak, the department of health said that it was conducting a campaign to focus on finding and destroying mosquito breeding sites, while also issuing guidelines for people to wear insect repellant and wear clothes that cover the skin.
Health minister Francisco Duque said the government was studying an appeal to allow Dengvaxia back in the Philippine market, but ruled out using the drug to combat the ongoing epidemic which has hit small children the hardest.
“This vaccine does not squarely address the most vulnerable group which is the 5-9 years of age,” Duque said. The vaccine, now licensed in 20 countries according to the World Health Organization, is approved for use for those aged nine and older.
Duque said the United Nations agency also advised Manila that the vaccine was “not recommended” as a response to an outbreak, adding that it was “not cost-effective” with one dose costing a thousand pesos ($20).
Other south-east Asian countries have also reported an surge in dengue cases this year, according to the UN’s World Health Organisation.
The organisation said Malaysia had registered 62,421 cases through to 29 June, including 93 deaths, compared with 32,425 cases with 53 deaths for the same period last year. Vietnam over the same period had 81,132 cases with four deaths reported, compared with 26,201 cases including six deaths in 2018.
In south Asia, Bangladesh has been facing its worst-ever dengue fever outbreak, putting a severe strain on the country’s already overwhelmed medical system.