Dengue epidemic hits Fiji

Health

The new year got off to a bad start in Fiji where in the first two weeks six people died of the curable disease known as dengue fever.

Dengue fever is nothing new to Fiji and for that matter the rest of the Pacific but the fact that people are dying from it because they are not tak ing proper care, is a matter which is of most concern.

In an effort to stop this from getting any worse, the Fiji’s Ministry of Health approached Australia for assistance.

Four specialists from the former South Pacific Commission and now Pacific Community’s Regional Vector Borne DiseasesJ'roject, arrived in the country last month to assist the government of Fiji in its combat against the outbreak of dengue fever.

This five year $F9.4 million project will provide technical assistance and support for supplies and equipment for the control of diseases such as dengue, malaria and filariasis in the Pacific Island countries. It is being funded by the Australian govern ment through its aid agency AusAID.

The outbreak was announced at the end of last year when three people died and many others were being admitted to hospi tal. Linked to the dengue outbreak was the increase in influenza cases. At the start of the outbreak there was an average of 80 cases going through the general outpa tients. This increased to 200 in just two weeks. In hospitals around the country, the patient numbers went up drastically and octors were called back from leave to help.

Added to this was the shortage of beds.

The hospitals’ blood bank units were work ing extra hard to provide the required blood platelets for transfusion.

In a bid to bring this problem under control, the Ministry of Health together with the various municipal councils launched a major spraying campaign. The spraying campaign was carried out all over the country and was repeated 10 days later to eliminate the second generation of

mosquito population.

From the time the outbreak was recog nised, health authorities made various calls to members of the public to get rid of all

possible mosquito breeding places. In

October last year, a Suva doctor presented a paper warning an impending dengue out break in Fiji at a meeting of general practi tioners.

She gave two sets of figures from the Ministry of Health’s own research that should have warned authorities of an out break. The first set was for the months of January and February last year and the other set was for May.

There is a formula called the Bruteau Index that is used to find out if there is a risk of an outbreak. If the index exceeds 20 per cent then the risk is there. The Vector Control Unit of the Ministry of Health has a system in place to monitor the Bruteau Index of the three types of mosquitoes that spread the disease. It conducts surveys of premises in the urban and rural parts of the major centres and the airports as well. If it finds mosquito larvae in more than 10 per cent of the premises, this will also indicate a high risk of an outbreak. In January and February the Bruteau Index for one these types in urban parts of Suva, the capital, was 22 per cent. For the rural it was 50 per cent. In June, after a survey in Suva, the permanent secretary for health sent a letter to the Suva Town Clerk warning that two types if mosquito larvae had been found on 15 per cent of the premises surveyed.

The Bruteau Index for one type of mosquito was 18 per cent and 30 per cent for the second type. This mosquito was the most efficient carrier of the virus that caus es dengue fever. There are two types of dengue fever - Classical Dengue Fever and Dengue Haemorrhagic Fever.

Dengue Haemorrhagic Fever usually affects the very young and very old and if victims don’t take care, it can kill them.

The director of primary and preventative services. Dr Asinate Boladuadua said they had been alerting the public since last September about dengue fever.

She said the ministry had played its part and now it was up to the members of the public. She told The Fiji Times that they had warned people and it was their duty to clean up around their homes. An outbreak at the end of 1989 and early 1990 killed 30 people. The last epidemic was in 1991. There were eight fatal cases then and numbers so far, during the peak of the epi demic is not too far behind. ■