DENGGI DAN CHIKUNGUNYA KENAPA MENGGANAS

Laporan di atas tertera di Akhbar The New York Times keluaran Julai 1981, lebih kurang 28 tahun yang lalu. Ia menceritakan perihal demam denggi berdarah yang menimpa pendatang kaum Haiti ke Amerika waktu itu. Pendatang luar terpaaksa dikuarantina selama sepuluh hari sebelum boleh dihantar ke kawasan penetapan.

Seorang Dr Craven, epidemiologist perubatan Pusat Kawalan Penyakit( Centers for Disease Control) menyebut bahawa nyamuk yang menjadi pembawa demam dengue juga sebagai pembawa demam kuning dan boleh didapati di pesisiran pantai Atlantik Selatan dari Carolina Utara ke Florida serta sepanjang Pantai Telok dari Florida ke Texas.

Di negara kita, penyakit demam denggi mula dilaporkan pada tahun 1924 di Pulau Pinang. Sejak itu penyakit ini telah meragut nyawa ramai kanak-kanak dan orang dewasa.


Ketua Pengarah Kementerian Kesihatan Malaysia, Tan Sri Dr Ismail Marican menyebut dari 4hb ke 17hb Januari 2009, terdapat 3211 kes demam denggi dengan 8 kematian berbanding dengan 1514 kes dan 4 kematian dalam tempoh yang sama pada tahun 2008. Ini bermakna wujud peningkatan sebanyak 212 % menurut beliau lagi.

Menurut beliau lagi demam denggi kini menyerlah dalam bentuk baru yang luar biasa seperti penyakit radang otak (encefalitis) yang menyerang otak dan menyebabkan mangsa di bawa ke hospital setelah diserang sawan, juga simptom jaundis (kuning pada bahagian kulit), sakit perut, hepatitis dan kegagalan fungsi hati atau ginjal. Biasanya pesakit demam denggi datang dengan pendarahan di kulit serta jumlah platlet rendah.

Isunya sekarang ialah apa yang boleh kita sama-sama lakukan. Kita semua kaya dengan pengalaman mencegah penyakit demam denggi serta pihak kakitangan perubatan dan kesihatan mahir dalam pengurusan penjagaan kes denggi di hospital meskipun tiada rawatan "definitif" yang memuaskan buat masa ini.

Bagi penyakit Chikungunya pula, kajian dan penyelidikan perlu dijalankan secara intensif, Sebagai contoh, bagaimana dalam tiga minggu pertama tahun ini, tiada kes chikungunya dilaporkan bagi negeri-negeri Sarawak, Sabah, Melaka, W.P Labuan dan Terengganu. Apakah keistimewaan negeri-negeri di atas, adakah disebabkan kurangnya tenaga buruh asing di negeri tersebut.


PUTRAJAYA: The number of dengue cases and deaths has doubled and the Health Ministry is urging Malaysians to wage war against the disease immediately.

Its director-general Tan Sri Dr Ismail Merican said that from Jan 4-17 this year, there were 3,211 cases with eight deaths, compared with 1,514 cases and four deaths during the same period in 2008.

“That’s a 212% increase,” he said at a press conference here on Monday.

The states with the most cases were Selangor and Kuala Lumpur, followed by Penang, Johor, Sarawak and Kedah, he said.

According to the statistics provided by the Ministry, there were four deaths in Selangor, one in the Federal Territories (Kuala Lumpur/Putrajaya), one in Perak and two in Johor.

Dr Ismail said the Ministry was discovering atypical or unusual symptoms with the more severe cases.

“Patients used to suffer from bleeding and low platelet count, but now you can get dengue encephilitis that affects the brain and people can come in with epileptic attacks, jaundice with pain in the abdomen, hepatitis and kidney or liver failure,” he said.

As the result of the atypical presentation, some of the diagnoses were made late, he added.

“We have informed all our doctors to add dengue testing if a patient has fever and weird symptoms in high dengue cases states,” he said.

The Ministry spent RM1.7mil on campaigns to create greater awareness of dengue and issued a total of RM3.4mil in fines last year on those found with mosquito larvae in their premises.

Dr Ismail urged community leaders to organise gotong-royong (communal) clean-up efforts and to keep the public abreast of the outbreak,

Doctors should inform state health departments immediately whenever there is a suspected case so that fogging can be carried out immediately in the affected area.

“Those with symptoms such as fever, rashes, muscle aches, vomiting and bleeding must seek treatment immediately,” he said, adding that the most critical phase of the infection is between 24 and 48 hours of the onset of the infection.

In KLANG, state health director Dr Rosnah Hadis said the main reason for the high incidence of dengue in Selangor was the large number of breeding sources.

These include homes as well as abandoned housing projects, she said.

State health committee chairman Dr Xavier Jayakumar said the Selangor government was carrying out clean-up operations through the local councils and is also working closely with the state health department.

He said the high population density in urban areas has led to a high concentration of breeding grounds for the aedes mosquito.

Abandoned projects as well as unoccupied residential and commercial premises have become breeding grounds, he noted, adding that Selangor residents must also cooperate when local council workers carry out fogging.

“People usually close their doors when fogging work is going on, but there is nothing to fear as the chemical used is harmless to people,” he said.

Dr Xavier also said he hoped the Health Ministry would approve the combination of chemicals used as a fogging agent in developed countries such as Singapore.

“This is a third generation combination of chemicals which has a human-friendly aroma and is very effective in eradicating mosquitoes,” he said.

He urged the Health Ministry to expedite the licensing of the product given the current situation.

In KUALA LUMPUR, Setapak recorded the most number of dengue cases in the Federal Territory last year as well as in January.

The constituency reported 78 dengue cases in January 2009, and 1,186 cases throughout 2008 from a total of 5,001 cases that were reported to the Kuala Lumpur City Hall (DBKL).

Out of the 5,001 cases in 2008, 2,563 were positive. There were 12 deaths reported as well, of which six were positive dengue cases, said an official for DBKL.

Last year, Cheras had a total of 1,014 cases followed by Kepong (890), Old Klang Road (806), Town centre (756) and Damansara (349).

DBKL is conducting fogging at suspected zones. Among those identified was Salak South New Village where DBKL organised a search and destroy operation to identify potential aedes breeding grounds on Jan 19.

In GEORGE TOWN, Penang Health, Welfare and Caring Society Committee chairman Phee Boon Poh said that as far as dengue was concerned, the situation in the state was under control.

“The Health Ministry’s figures are only based on the first two weeks of January, as compared with the corresponding period last year,” he said.

“We admit that in Penang there was a surge of dengue cases in the first week of this year but the figure has since dropped as the state health department and the Penang Municipal Council have been very proactive with health measures and clean-up.”

He said the surge in the first week was because some general practitioners in the Balik Pulau area were not alert and treated the situation as a normal viral attack.

“There must be follow-up, even it the doctor thinks it is a normal viral infection, as it could be dengue or chikungunya instead,” he said.

In JOHOR BARU, the state Health Department said it would be enlisting the help of community groups and private clinics in its war against dengue. Two deaths have been reported in the state this year.

Its director Dr Mohd Khairi Yakub said that department personnel would go down to the ground more to spread awareness within the community.

“We will be having more awareness programmes as well as gotong-royong activities to get the message across to the public.

“We will be working closely with community groups to ensure the effectiveness of the programmes,” he said when contacted here on Monday.

The department would also urge private clinics to cooperate by informing the department more quickly of patients infected with dengue.

Dr Mohd Khairi said that last year, there were 16 deaths from more than 3,000 cases reported statewide -- 80% of these cases were in Johor Baru.

“We will also intensify fogging operations, but public awareness is more important as fogging alone cannot solve the problem permanently,” he said.

Source: Mstar online

Further Reading HERE

WHO info HERE, NYT Reports HERE