Amidst Covid-19, watch out for the danger of dengue


The rising dengue cases this year sheds light on the importance of awareness of symptoms, personal risk, disease management and prevention.

DENGUE cases in Malaysia have been decreasing over the past couple of years after hitting an all-time high in 2019.

Last year, Malaysia recorded the lowest number of cases within the decade with 26,365 dengue cases recorded – a drop of 70.8% from 90,304 cases in 2020.

According to University Malaya Medical Centre Infectious Disease Physician and Head of Infectious Disease Unit, Associate Professor Dr Sharifah Faridah Syed Omar, the reason for the decrease in cases is yet to be determined but the measures in place to curb the transmission of Covid-19 might have been a factor.

“With it (the decrease in cases) coinciding with Covid-19, the postulation is whether the movement control order contributed to the reduced cases.

“Theoretically, with people moving less, there was less interaction with the vector (mosquito).

“However, based on previous data, an outbreak is expected every four to five years and therefore the next outbreak might be in the next few years.

“At the beginning of this year, we saw more cases reported – about an 11% increase from the start of the year till mid-February compared to the same period in 2021.

“As we move about more, we may see a rise in cases,” she says.

Dr Sharifah says cases of Covid-19 and dengue co-infection may not be as common in Malaysia but warrants some caution.Dr Sharifah says cases of Covid-19 and dengue co-infection may not be as common in Malaysia but warrants some caution.

While we still grapple with Covid-19 as we transition to the endemic phase, dengue is already an endemic disease in Malaysia – which begs the question: Could a person be infected with Covid-19 and dengue at the same time?

“Covid-19 has only been around for some two years but with dengue, we are always on the lookout for multiple infections that can happen together.

“It is uncommon but it can happen (being infected with Covid-19 and dengue at the same time). When you get both together, then the risk of severe morbidity and death increases,” she says.

With the rising dengue cases and the continuous evolution of the Covid-19 virus and increased spreadability, it sheds light on the importance of awareness of symptoms, personal risk, disease management and prevention.

Dr Sharifah opines that there are similarities between Covid-19 and dengue – both are caused by a virus as well as early symptoms like a sudden onset of fever, body and muscle ache but with some key differences.

“Covid-19 patients predominantly would have respiratory symptoms, cough, sore throat and loss of smell and taste (with some variants).

“Patients with dengue, on the other hand, often complain of a rash, gum or nose bleeding and patients lose a lot of fluid as well, with fluid accumulating in the lungs and abdomen,” she says.

Meanwhile, Dr Sharifah expressed there is no specific treatment for asymptomatic or mild Covid-19 disease, those at high risk of developing severe Covid-19 can be given antivirals if available.

As for dengue there is no good antiviral, she adds, so at the beginning of the illness, it is more of a supportive treatment.

“Rest well and keep yourself hydrated. Drink six to eight glasses of water a day. Isotonic drinks and soups are considered a source of fluid to keep you hydrated too.

“If the fever persists after four to five days, or you feel extreme lethargy, drowsiness, severe abdominal pain or find it difficult to breathe or look very sick, you should seek medical advice instead of waiting it out.

“We hope there will be a similar vaccine (like that for Covid-19) for dengue as even though the majority of cases are mild, there is still an impact on quality of life,” she says.

Since dengue is transmitted by mosquitoes, she adds, another way to reduce transmission of dengue is by vector control.

“We need to put in measures to not only destroy the mosquitoes but also avoid getting bitten by it by using insect repellent or insecticide. Wear long sleeve tops and pants during dawn and dusk.

“These mosquitoes do not travel far, so those infected might have been bitten around their housing areas or workplace so it is always good to look around for breeding sites when there are cases,” she says.

But of late people have been so busy with Covid-19, she adds, that prevention plans for dengue have been lacking.

When talking about risk factors of developing severe dengue and Covid 19, she says, people with comorbidities are at the highest risk, with dengue, people of extreme age – either very young or old are also at risk of severe dengue.

“Dengue reinfection may also be more severe than the first episode. There are four types of dengue serotype, and theoretically, you can contract dengue four times.

“While you are protected from reinfection with one serotype you do not have protection against the other three. Usually, younger people would get asymptomatic dengue the first round and therefore are unaware that they have been affected,” she says.

While both Covid-19 and dengue infection can vary from asymptomatic, symptomatic to severe disease, she opines that the nation has been very preoccupied with Covid-19 and rightfully so, she hopes that more focus could be given to dengue in terms of education and awareness before an “explosion of dengue” cases occur.

Note: The information provided is not intended to substitute for professional medical advice, diagnosis or treatment. Please consult a healthcare professional for further advice.

This community service message is supported by Takeda Malaysia.

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