Philippine Malaria / Mosquito Map / Dengue Fever Map

[KeithD]

This will help people decide whether they need malaria drugs before travelling to the Philippines. Please be aware that many of these drugs do have side effect, but are not worse than actual malaria.

http://www.fitfortravel.nhs.uk/images/malariamaps/philippines/philippines.gif



DENGUE FEVER MAP

http://www.win2win.co.uk/file/Dengue-Fever.jpg

[subseastu]

Good to see Olongapo is marked as a low risk area for mosquitoes, I wish someone would have told the one that bit me and gave dengue fever!!!

[Walaytawo]

Where's Samal Island gone to :Erm:

[timbo]

Blimey !! A lot of red - Off to Naga for the yearly family visit in September - But maybey I will put some super stregnth mozzy spray in this time!!

[Arthur Little]

USEFUL information ... :68711_thanx:

[sars_notd_virus]

hmm Batangas is in low to now risk, I kept telling my husband not to take malaria tablets on his first visit in the PH ,it spoilt our moments for one week:doh

[fred]

In 30 years of travelling throughout the R.P Ive never once met any foreigner or Filipino that has suffered with Malaria!! Ever!!
IMO that map is a crock of .... and not something I would be concerned with..:icon_lol:

[Tawi2]

Wandered about from the top of Pinas to the very bottom over the years,never taken anti-malarials,your more at risk from Dengue IMHO:Erm:

[fred]

Wandered about from the top of Pinas to the very bottom over the years,never taken anti-malarials,your more at risk from Dengue IMHO:Erm:

Agreed!

[subseastu]

Dengue is not very nice to have, though it did help me loose one and a half stone in a week and a half!!

[Doc Alan]

The thread is "sticky" so here is up to date information on malaria, to the best of my knowledge. At first sight the map appears alarming, and a balanced view is needed.
The Philippines is way down (75th) in world incidence, with less than 25,000 cases ( and 25 deaths ) / year - exact figures can't be obtained. 12 million are at risk, mostly the indigenous population, farmers, forest workers, and migrant agricultural workers, in rural and mountainous areas ( below 600m). There are problems with drug resistance, self-medication, and not seeking help for financial reasons, or using herbal remedies. This means 80 million are not at risk. Travellers and ex-pats living in the country may well never encounter - or acquire - malaria, and it's low in overall risk assessment.
Around 22 provinces out of 80 are malaria-free according to Department of Health ( Aklan, Albay, Benguet, Biliran, Bohol,
Camiguin, Capiz, Catanduanes, Cavite, Cebu, Eastern Samar,
Guimaras, Iloilo, Leyte, Marinduque, Masbate, Northern Samar, Siquijor, Sorsogon, Southern Leyte, Surigao del Norte, and Western Samar).
Cases of malaria in the Philippines are decreasing, unlike dengue fever (around 100,000 last year, with over 700 deaths).
* A = Awareness ( is it present in the areas you're visiting ?)
* B = Bite prevention or avoidance ( clothing, repellents containing DEET, nets, aircon / fans)
* C = compliance with the right antimalarials ( chloroquine + proguanil, or mefloquine / doxocycline / Malarone ) - still does not give full protection.
* D = Diagnosis ( flu-like symptoms, mostly within a month ... but report ANY illness to your doctor within 3 months and up to a year after return from Philippines or other tropical country).

[KeithD]

I heard on the news the other day that more people are coming back to the UK with malaria than ever before. As with any media stats though they need to be taken in context.

For instance a rise in something of say 100%, may mean that it was previously 1 in 10,000 of the popualtion and is now 2. The first one the media use because it is alarming, the second stats are the same but give the real picture.

[Englishman2010]

Thanks for making us aware Keith and Alan.

At the end of the day we are all grown ups and have to take responsibility for our own actions. I've been to India 5 times and always taken anti malarials, I didn't on my first 4 visits to the Pina's, but I have on my last 2 visits, and will probably continue to take them on future visits.

I appreciate the risk is very low in cities, but as I'm a nature lover and like to get out in the wilds I've decided that I don't want to take the chance. People talk about the side effects and exaggerate them, but have they actually taken the tablets? The worst I've ever suffered from are fairly vivid dreams when I'm day dreaming or half asleep. I can live with that if it means protecting myself against malaria.

However, I also agree that Dengue is a bigger threat than Malaria. Is there any preventative medication for Dengue?

[Doc Alan]

Is there any preventative medication for Dengue?
There is no vaccine or drug of proven effectiveness. Treatment is "supportive" ( bed rest, fluids, paracetamol / acetaminophen), if necessary in hospital - most people do get better. There is a global pandemic of this RNA flavivirus infection spread by mosquitoes.

[Doc Alan]

I heard on the news the other day that more people are coming back to the UK with malaria than ever before.
It was once endemic in Europe. The UK had 1761 imported cases of falciparum malaria in 2010, according to the Health Protection Agency. These were mostly from West Africa or South Asia ( not from the Philippines). In 2008 there were 1,370 reported cases, an increase of nearly 30%. The fatality rate is low, less than 1%.
However, stated as an increase from 1/48,000 to 1/37,000 out of an estimated 66 million visits abroad by UK residents it doesn't sound quite so dramatic!

[subseastu]

There is no vaccine or drug of proven effectiveness. Treatment is "supportive" ( bed rest, fluids, paracetamol / acetaminophen), if necessary in hospital - most people do get better. There is a global pandemic of this RNA flavivirus infection spread by mosquitoes.

Good info alan tanks. Once my fever broke with dengue I went to hospital where all they could for 3 nights was monitor my blood pressure every 4 hours I think it was to make sure I wasn't bleeding internally due to my very, very low platelet count. I think it was supposed to be 750ppm and was down to 7ppm. I could be wrong on the first number though.

[Ako Si Jamie]

I'm sure I saw that map at the Nurse's when I went to get my jabs.:Erm:

[KeithD]

I'm sure I saw that map at the Nurse's when I went to get my jabs.:Erm:

I'm a scouser.... guess how I got it ;)

[Ako Si Jamie]

Don't tell the Doc :icon_lol:

[madmitch537]

generally i believe unless you intend to treck into the jungles etc in philippines the risk is pretty low as the map seems to suggest but the little blighters still seem to prefer white skin to the locals mozzies can also carry dengi fever a good block applied to the skin esp around dusk and daybreak is very usefull remember its only the females that bite to take blood for there eggs/young and they always reside close to there victims even in cans pots or bottles that hold water

[scott&ligaya]

if we off piste as it were , even 40km from Puerto to the nagtabong beach area it is possible to get dengue and it is only 10km off the highway. one of our dutch friends 9 yr old boys got a nasty bout. just need to be aware and have plenty of OFF and some coils in the early evening for the beach hut/kubo. and light weight trousers, I use my old gym trousers made of a sort of sarong type material.

[Doc Alan]

... just need to be aware and have plenty of OFF ...
"OFF!" is an insect repellent available in the Philippines ( www.off.com/en-US/Pages/Home.aspx). It contains DEET ( diethyltoluamide) which is the active chemical to look for in insect repellents. DEET 20-50% in lotions, sprays or roll-on formulations is usually safe for skin of adults, pregnancy (last 6 months), breast-feeding, and for children over 6 months. Avoid contact with sore, sensitive or broken skin. If asthmatic consult doctor before use. In the UK Boots sell "Repel" (www.boots.com) which contains 50% DEET.

[scott&ligaya]

thanks Doc, in the UK i used to buy a product called Jungle formula.. it even worked on the dreaded west coast highland midge LOL Not sure if it is still around

[Englishman2010]

thanks Doc, in the UK i used to buy a product called Jungle formula.. it even worked on the dreaded west coast highland midge LOL Not sure if it is still around

You can still get JUngle Formula in Boots and good chemists. Boots have a range of repellents with varying amounts of Deet depending on where you are going. I got some with 50% Deet, although I forgot to put it on myself, it was good for spraying around the door and window frames at night:icon_lol:

[KeithD]

Anyone know if this is any good, says it doesn't really smell http://www.amazon.co.uk/Autan-Insect-Repellent-Protection-Fragrance/dp/B001EJOHXW

[fred]

We used to use OFF lotion,but we were visited by friends last year that left a bottle of Mosi-guard here.
I use it sparingly to try and make it last as it works like a dream..
I sit in the garden most evenings and with that stuff on my arms,legs and feet I have not been bitten once..(Without it,I cant sit out for more than 5 mins)
Deet free and highly recommended by Fred!!


http://www.mosi-guard.com/

Reviews..
http://www.amazon.co.uk/product-reviews/B000UO5IB2/ref=cm_cr_dp_all_helpful?ie=UTF8&showViewpoints=1&sortBy=bySubmissionDateDescending

[branno]

i found that jungle formula was very very effective.. put plenty on ur feet too as its the thinest skin on ur body and easily broken..

[KeithD]

Dressing correctly also helps :xxgrinning--00xx3:

http://www.spycatcheronline.co.uk/images/PDLNBCSUIT.jpg

[KeithD]

Mozi-Guard insect repellent is an excellent product, although it is rather smelly with a pungent citronella(lemon) smell. :yikes: .... I bet Fred smells very sexy though :D .... I'll try the one I mentioned earlier.

[Doc Alan]

Personal protection against insect bites is important, not just for prevention of malaria transmission. Insect repellents are part of that protection, together with protective clothing, nets, fans and air conditioning where possible. There are four groups of repellents :-
1. Containing DEET. Examples :- "OFF!", "Repel", and "Jungle Formula". The most used ingredient in insect repellents for over 5 decades, recommended by British National Formulary (bnf.org), of proven effectiveness, safe ( see my post 22 above ). Does have oily feel, causes irritation to eyes, lips and other sensitive areas, is absorbed by skin, can cause skin reactions, damages some plastics and fabrics, strong smell.
2. Containing picaridine. Example :- "Autan". Recommended by World Health Organisation. Doesn't cause skin irritation, doesn't dissolve plastics and fabrics, safe for young children, non oily and almost no smell. May need re-application sooner than 1.
3. Containing citriodiol ( oil of lemon eucalyptus). Example :- "Mosi-Guard". A natural repellent, non-sticky, non-toxic, safer on sensitive skins and for children, harmless to most plastics / fabrics. But more expensive, may need more frequent re-application.
4. Containing permethrin ( from chrysanthemums, or similar manufactured chemicals). Example :- "PreVent Spray". Safe for spraying on fabrics. Doesn't stain and almost never irritates skin.
Associated products such as mosquito coils and citronella candles may help.
Insect bites and stings cause local pain and swelling for which antihistamines or corticosteroid cream bought "over-the-counter" should help ; occasionally there may be an anaphylactic reaction, which is an emergency requiring intramuscular adrenaline - seek medical advice.
While "anything posted in this section is the poster's own opinion ... please seek professional advice", what I have stated here is accurate to the best of my knowledge.

[fred]

3. Containing citriodiol ( oil of lemon eucalyptus). Example :- "Mosi-Guard". A natural repellent, non-sticky, non-toxic, safer on sensitive skins and for children, harmless to most plastics / fabrics. But more expensive, may need more frequent re-application.

In regards application,it seems to last far longer than the OFF lotion ..Might be because its oiler which keeps it active..6-8 hours sounds about right..


Insect repellents are part of that protection, together with protective clothing, nets, fans and air conditioning where possible.

Fans are a great mozzi deterrent but air conditioning on its own is practically useless in my experience.. Lets not forget that they thrive and bite in Siberia!



Mozi-Guard insect repellent is an excellent product, although it is rather smelly with a pungent citronella(lemon) smell. .... I bet Fred smells very sexy though

I actually like the citronella smell.. :xxgrinning--00xx3:
As long as the Mozzies dont find me sexy I`ll call it a result!!

[fred]

This is next on my shopping list..Cant get them here yet but something I would say is a really good balikbayan box item from the UK if planning to live here or anywhere else mozzies or midges thrive...Like Scotland!



http://www.mosquitotraps.biz/images/mosquito-magnet.jpg

[Doc Alan]

Biting insects, including the 2,500 different species of mosquitoes, are not usually active (although they may survive) at temperatures below 10 degrees. Even in the north of Siberia, Verkhoyansk - one of the coldest places in the world - has temperatures above 10 degrees in summer, often above 20 degrees. Similarly midges breed in Scotland from April to October, and "Autan" is a good repellent. How long repellents last depends, among other factors, on the concentration bought (DEET varies from 20% to 95%). Temperature is important, but malaria is endemic in tropical or subtropical regions - and not elsewhere - for other reasons. There are a million deaths every year from malaria, 90% in Sub-Saharan Africa, shameful considering there is effective prevention and treatment at a cost, if only there were the resources available.

[KeithD]

I've now attached a Dengue Fever Map to the first post. You may also like to read this on Dengue Fever in the Philippines. http://www.ifrc.org/docs/appeals/rpts10/PHep29071001.pdf

[KeithD]

One other point, which is very important, is that when purchasing anti-malaria tablets, DO NOT buy those with chloroquine in, as the mosquitos in the Philippines have resistance to it, usually Nivaquine or Avloclor. Because of this resistance it means the type of infection is Plasmodium Falciparum malaria which is the most serious form of the disease, which covers about 70% of cases. The remaining 30% is Plasmodium vivax. Falciparum malaria, if not treated straight away, can lead to severe malaria, such as cerebral malaria. However Plasmodium vivax malaria does not lead to cerebral malaria but it can cause relapse if treatment was not completed.

Recommended anti-malaria drugs for the Philippines:
Mefloquine one 250mg tablet weekly or
Doxycycline one 100mg capsule daily or
Malarone one tablet daily

I'd go with Mefloquine (Lariam) weekly myself. :) So for a 3 week trip you would require 10 tablets, as you need to start taking them 3 weeks prior to leaving, and continue for a month after you return.

Side-effects of all these meds are listed here: http://www.doctorfox.co.uk/news/malaria-tablets-side-effects/

[Doc Alan]

It's vital that the information given on this thread is accurate, and to my knowledge what Keith says in this post (35) is correct. Note that drugs for malaria prophylaxis (prevention) are not prescribable on the NHS. Treatment is of course on the NHS ; prophylaxis is not absolute and if the patient has already taken prophylaxis, different drugs will be used.
Obviously we can't give precise recommendations for every member. Take into account : risk, extent of drug resistance, side effects, and patient-related factors ( age, pregnancy, general health such as kidney / liver disease ). Falciparum malaria is particularly dangerous in pregnancy, especially in the last trimester.
The British National Formulary (www.bnf.org) gives advice for UK residents travelling to endemic areas, agreed by malaria specialists, and I have always confirmed with it before posting.
For those requiring long term prophylaxis, Mefloquine is licensed for up to a year ( but has been used for up to 3 years without undue problems) ; Doxocycline can be used for up to 2 years ; Malarone is licensed for up to 28 days, but can be used for up to a year ( possibly longer ) with caution - take specialist advice.

[fred]

Keith... Thanks for the Dengue map.. Do you have a virtual magnifying glass to go with it?:Erm:

[Englishman2010]

Keith... Thanks for the Dengue map.. Do you have a virtual magnifying glass to go with it?:Erm:

I was going to ask the same question:icon_lol: Any chance you can post a larger version Keith?

[KeithD]

I've fixed the map :)

[Englishman2010]

I've fixed the map :)

Much better now, thanks:xxgrinning--00xx3:

[KeithD]

Blind :furious3: :xxparty-smiley-004: :icon_lol:

[Maria B]

In 30 years of travelling throughout the R.P Ive never once met any foreigner or Filipino that has suffered with Malaria!! Ever!!
IMO that map is a crock of .... and not something I would be concerned with..:icon_lol:

:xxgrinning--00xx3:I agree with you Fred. I'm from Cebu and I only heard once, a malaria victim who was an achorman (covering some news in the forest) who travels northern part in the forest in the upper Luzon. That was quite a long time ago after college that I cannot remember the name of the place. My husband first visited me in 2006 & told him that he doesn't need a malaria jab.

[worthingmale]

had Mosquitos in Palawan, and in Davao but had the air con on cold so they didnt like the room :icon_lol::D

[Maria B]

had Mosquitos in Palawan, and in Davao but had the air con on cold so they didnt like the room :icon_lol::D

:) for as long as it's not a malaria or dengue mosquito...:Hellooo:
If it's rainy season in the Phils....always close the window & doors before 6pm as the mosquito starts wandering around :)

[KeithD]

The only mosquito I saw in Cavite was a dead one!!! I didn't both with the pills or repellents, but then I wasn't wandering around much, especially after dark.

[Doc Alan]

:xxgrinning--00xx3:I agree with you Fred. I'm from Cebu ... My husband first visited me in 2006 & told him that he doesn't need a malaria jab.
If you read my posts you will know that Cebu and Bohol ( where Fred lives ) are two of an increasing number of provinces which are malaria - free, so it's unsurprising you have not seen a case. That does not mean all provinces are yet malaria - free, however. There is also no such thing as a " malaria jab " - no vaccination is currently available. In another thread in the Health Section ( " Malaria in Cavite ... " ) my post gives up to date information, with a useful link ( http://www.actmalaria.net/downloads/pdf/info/2010/Philippines.pdf ) *
It's very important that members get the correct advice about malaria, so they can make an informed judgement as to whether or not they take the correct malaria tablets, which are doxocycline or mefloquine for the Philippines. Travel insurance may NOT cover claims for treatment of malaria ( or any other tropical disease ) where the recommended medication ( or vaccination ) has not been given.
* In that link the map shows : Category A ( red ) = 1000 + cases / year ; Category B ( blue ) = 100 - 999 cases / year ; Category C ( yellow ) = less than 100 cases + significant reduction in last 5 years ; Category D ( green ) = malaria- free provinces.

[scott&ligaya]

I have stayed on and off in Palawan north of the main city in a reasonably rural site since 2006.. My wife and little ones (3 1/2yrsand 1 1/2yrs) were there for 13 months. As long as you take sensible preacautuions in the late afternoon and evening, long loose light weight clothings, occasional smoke coil on verandas, electronic device in bedrooom and close all the screens around 4pm then no problem. We also use repellant when it has been raining. Have heard of one Dutch/Filipino 9 yr old who got Dengue after spending a day with his family at a more remote beach/cove, but as long as you know to recocgnise symptoms quickly it is lke a bad flue.. although in the provinces ignorance can lead to death. Basically Palawan is NOT malaria free in the areas away from the main towns like Roxas, Aborlan, PPS San Vincente, Port Barton and Coron

[Terpe]

I recently read an interesting article claiming that a daily intake of 300mg Thiamin (Vitamin B1) works wonders for the prevention of mosquito bites.
(It said it takes a full 3 days before maximum effectiveness is reached.)

I did some research and it seems Thiamin (Vitamin B1) is pretty useful stuff
Also it seems that there’s no known toxicity from taking 300 mg Thiamin (Vitamin B1) supplements a day.

Thiamin (Vitamin B1) is water-soluble, so you do in fact need some every day anyway.

From my research I understood that Thiamin’s importance is related to the conversion of carbohydrates in food into energy the body can use.
It is apparently also needed to keep the brain and nervous system charged up.

Anyway, maybe it's worth trying to prevent mosquito bites.

Anyone got experience of this??

[andy222]

Mozzie Guard? Where do i get that from guys?

[Englishman2010]

. Basically Palawan is NOT malaria free in the areas away from the main towns like Roxas, Aborlan, PPS San Vincente, Port Barton and Coron

Thanks Scott, I was thinking about this again earlier. I never take Malaria tablets anywhere else in the Phil's but I did take them when I went to PPS Palawan in January, and was thinking about it again when I go back to El Nido and Busuanga/Coron in a few months time. I'll probably take them again, better to be safe than sorry:xxgrinning--00xx3:

[Doc Alan]

I'll probably take ( malaria tablets ) again, better to be safe than sorry:xxgrinning--00xx3:
Very wise Ian, and I'm sure you've read my #46 above, which is the most up to date information I can find :xxgrinning--00xx3:.

[Englishman2010]

Very wise Ian, and I'm sure you've read my #46 above, which is the most up to date information I can find :xxgrinning--00xx3:.

I certainly have Doc, and thanks for your ongoing good advice on medical matters :xxgrinning--00xx3: ...and I always listen to a Doctors advice, except when they tell me to stop smoking:doh

[Doc Alan]

Elsewhere there has been further discussion about avoiding mosquito bites (http://filipinaroses.com/showthread.php/36452-Is-Insect-Repellent-cheaper-and-Better-In-Philippines-than-in-UK?highlight=malaria ). Some are more susceptible than others.
Even if you are bitten, the risk of malaria is from low to non-existent, depending on which part of the Philippines you’re visiting, or live in ( see above ). Should you decide on prevention, the recommended drugs ( this thread ) haven’t changed. Although the Department of Health reported 36,000 cases ( 42/100,000 ) in 2005, there were only 162 deaths ( compared to 26,000 from TB ) in the following year. The commonest, and most serious, type is due to Plasmodium falciparum ( there are three others ).
Worldwide, the bad news is that malaria deaths may be 1.24 million, almost twice previous estimates, according to a reliable Seattle team funded by the Bill and Melinda Gates Foundation ( http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60034-8/fulltext ).
However, as in the Philippines, the best estimates are that malaria deaths have steadily decreased – by a third - between 2004 and 2010. Most are still in Africa, and in children ( where ¼ children die from malaria ). We always used to think that children exposed to malaria either died, or acquired immunity, so rarely dying from malaria as adults. What has now been shown is that in Africa a third of all deaths, and two fifths elsewhere, are actually in adults. In part this is explained by drug treatment of mothers, decreasing children’s immunity. We still don't fully understand acquired immunity. Of course visitors to malarial areas such as European tourists have NO immunity, which is why prevention should be taken seriously.
We don’t – and can’t – have completely reliable figures for malaria numbers around the world .
However, in the past decade about 230 million cases have been treated, and the same number of bed nets distributed to those at risk. Although eradication is not yet possible, there’s hope the number of deaths will keep falling – to less than 100,000 by 2020 :).

[Steve.r]

Interesting Alan, thanks

I think it impossible to believe it can ever be eradicated though.

[Doc Alan]

This summarises dengue ( thanks to Maria ) :-
http://i1265.photobucket.com/albums/jj517/DocAlan/dengue-1.gif
More detail here :- http://www.nhs.uk/Conditions/dengue/Pages/Introduction.aspx
Even more here :-
http://whqlibdoc.who.int/publications/2009/9789241547871_eng.pdf ).
As we all know, dengue fever is a mosquito-borne disease caused by dengue viruses ( DV ). We also know severe forms of dengue infection can be fatal and are a leading cause of hospital admission in many parts of the world, not just Philippines. There has been a 30-fold increase in the number of dengue cases in the past 50 years.There are an estimated 50—100 million infections each year. It’s especially common in southeast Asia ( over 120,000 cases, but under 200 deaths, in Philippines in 2010 ), but dengue has spread throughout Latin America and more than half of the world's population now lives in dengue-endemic countries. Increasing numbers of travellers return from endemic regions with dengue, and there are now a few cases of locally acquired dengue in the USA and Europe. You should always tell your doctor of recent travels, if you do have fever or other symptoms after coming back to UK.
What’s new ?
The first Association of Southeast Asian Nations (ASEAN) Dengue Day was held last June, to focus attention on dengue and the need to develop more effective prevention and control strategies. ASEAN member states represent more than 600 million individuals who bear the major part of the global burden of dengue. The ASEAN Dengue Day was an example of the shift from reactive programmes to forward planning.
A World Dengue Day has been proposed, to underscore the effects of dengue and encourage a global response. Greater awareness of the disease, together with new diagnostics, drugs, and vaccines, should help to make dengue a preventable disease.
As there is no cross-protection between the 4 DV serotypes, only a "tetravalent " vaccine – working against all 4 types - is acceptable. Despite many years of work, progress in DV vaccine development has been slow. DV grows poorly in cell culture and there is no reliable animal “ model “ for dengue ( DV only infects humans ). Tetravalent DV vaccines have so far been disappointing ( compared to " monovalent " vaccines, acting on only one type ).
However, one such vaccine, developed by France’s Sanofi Pasteur, is undergoing a 4 year “Phase III” clinical trial, the final hurdle before it becomes available to the public. I understand this is being carried out in San Pablo, Laguna and Cebu province.
It could be cut short especially if no dangerous side effects are found or if the authorities and regulatory bodies including the World Health Organization and the United States Food and Drug Administration “ fast track “ approval.
Reasons to be cheerful :xxgrinning--00xx3: !

[Doc Alan]

Unlike other infections, dengue is usually more severe the second time round, as a member ( Chiechie ) has described in another thread ( http://filipinaroses.com/showthread.php/36876-Small-But-Terrible-Dengue-Mosquito ).
• There is still no specific treatment or vaccine. It’s complicated because there are four different types of virus causing dengue ( serotypes – DEN-1, DEN-2, DEN-3, and DEN-4 ). Recovery from one gives lifelong immunity, but infection by other serotypes increases the risk of severe dengue. It does this by “ confusing “ the immune response ( antibodies and “ T cells “ ). Recent work in several centres round the world has confirmed this. It has slowed development of a vaccine, although there is hope at least one ( being tested in Philippines and Thailand ) will be available by 2015.
• Despite the increase in dengue – endemic in over 100 countries, including Philippines – it is not usually fatal. Good medical care means less than 1% deaths ( although possibly 5% of the estimated 50 – 100 million worldwide cases do prove fatal ).
• It’s a mosquito-borne infection and the only methods to control dengue are by targeting the mosquitoes.
• Last year the Philippines Department of Health ( DOH ) unveiled a campaign “ AKSYON BARANGAY KONTRA DENGUE “ ( ABaKaDa ) to encourage community action. This includes Search and destroy mosquito sites (covering water containers ), Self-protection ( long-sleeved shirts, mosquito repellents ), and Seeking early advice/ consultation at the nearest health center.
• So far this year the DOH has reported around 19,000 cases ( 25% lower than last year ), with 107 deaths ( less than 1% ) – although there were more cases in three regions ( Zamboanga, Davao and Bicol ).

[Iani]

Last thing I want to do is trivialise dengue or malaria, but a bit of common sense and understanding of the mossies will go a long way.

Generally, dengue is a different mossie, is active during the day, and at low levels (walking around by the pool = maybe putting yourself at risk. Also sitting at the bar?

It's not what people want to do, but wearing long pants, socks (grief) may help, as it's the lower areas most at risk of being nibbled.

Malarial ones, well they are more active at night, especially in the rainy season, and it frankly doesn't matter if you're high or low.

Fans are said to confuse them.

Oh and allegedly, the lemon body butter from body shop helps repel mossies - smells absolutely brilliant too. I used it a lot and can't tell if my bites were before or after smearing the stuff on at night, so..........well.

What I did notice in Thailand, was that they left me alone after eating the local food for a few days. Maybe it's the lemongrass

[Doc Alan]

Last thing I want to do is trivialise dengue or malaria, but a bit of common sense and understanding of the mossies will go a long way.


Thanks for your input. This thread is " sticky " ( unclosed ) because it does include common sense and understanding from many members, with regular updates from myself. 1.5 million deaths in the world, and countless more illnesses, due to mosquito transmission - every year - is no trivial matter.
It should not be long before we have a vaccine and specific treatment for dengue. Meanwhile it may help to explain - clearly and to the best of my knowledge - why they are taking so long to produce. I have done the same to explain the situation with malaria. Many members view this thread. Some have suffered malaria and dengue. All wish to avoid them. Information here should be accurate, and evidence - based.

[grahamw48]

Maybe it's the Thiamine in the beer. :D

[Doc Alan]

• Unlike the situation with dengue, there are specific drugs for malaria.
• The decision as to whether drugs should be taken rests with the individual and where exactly they intend to travel . Most travellers to the Philippines don’t take antimalarials.
• As the drugs need to be paid for, it’s important to choose the right ones for where you are going. Expect to pay 40 GBP for a course.
• Price should not be the only factor – up to a third of antimalarials on sale around the world - including South East Asia - are fake . The NHS will treat – for free - those unfortunate enough to be diagnosed with malaria on return to the UK.
• Drug resistance to front-line treatments for malaria is increasing. The parasite to worry about is Plasmodium falciparum, carried by mosquitoes.
• For the Philippines, these are the drugs to take : Mefloquine ( Larium ) 250 mg starting 1 - 3 weeks before travel, every week in the malarious area ; OR doxycycline ( Vibramycin ) 100 mg daily, starting 2 days before. Continue tablets for 4 weeks after leaving. Proguanil 100 mg and atovaquone 250 mg ( Malarone ) is a third choice – start 2 days before and continue for 1 week after leaving. They are over 90% effective. Possible side effects are too numerous to list here – consult your healthcare professional first, and read the instructions.
• Do NOT take chloroquine ( Avloclor, Nivaquine, or Malarivon ) alone or with proguanil ( Paludrine / Avloclor ), quinine, artemether with lumefantrine ( Riamet ), primaquine, pyrimethamine ( Daraprim ) or pyrimethamine with sulfadoxine. This is because of resistance or ineffectiveness or use in treatment of known malaria.
• For travel to other malarious areas, risk - and the recommended drugs - vary.

[Ako Si Jamie]

Several more provinces are close to becoming malaria free like Cam Sur and Cam Norte which will mean the whole of Bicol will be (Albay, Masbate, Sorsogon & Catanduanes already are).

Antique province is at the same stage and when that gets elimination status, the whole of Panay will be free as will the vast majority of The Visayas. The exception being Negros Island.

Dinagat Islands no longer has malaria neither does Misamis Occidental in Mindanao.

Others close to eradication are Pangasinan, Lanao del Norte, La Union and Laguna.

The highest amount of malaria cases occur in the three largest provinces Isabela & Cagayan in North-East Luzon and Palawan, and also Tawi-Tawi and Sulu.

[Doc Alan]

It has proved hard to produce a vaccine against malaria. Now the British pharmaceutical firm, GlaxoSmithKline ( GSK ) has announced a vaccine ( “ RTS,S “ ) which provokes antibodies and “ killer cells “ which attack the parasites before they leave the liver ( where they go after a mosquito’s bite injects them into the bloodstream ).


This was a “ Phase 3 “ trial, in Africa. In children it reduced cases by about half, and infants by a quarter, 18 months after vaccination. But its effects decline after a year. For further ( Phase 4 ) trials there needs to be approval from the European Medicines Agency and World Health Organization ( WHO ). More widespread use depends on approval by donors from all sectors of society. Financing of malaria programmes in 2011 was thought to be only half of the US$ 5 billion required globally.



Malaria occurs in 99 countries and over 3 billion people are at risk of acquiring it.



About 80% of cases and 90% of deaths occur in Africa – especially children. However, since the turn of this century cases have declined by around a fifth and deaths by a quarter. 50 of the 99 countries are on track to reduce cases by 75% by 2015. Elimination of malaria in the European Region appears possible by 2015.


Malaria is linked to poverty – poorer populations living in rural areas ; in housing with less protection ; less access to insecticide treated mosquito nets ( ITNs ) ; longlasting insecticidal nets ( LLINs ) ; indoor residual spraying ( IRS ) ; and they don’t / can’t use health facilities which allow diagnosis and best treatment. Poorer countries do get a higher share of international funding from international sources.



The Philippines is a country described by WHO as in “ Control Phase for malaria “. It has achieved over 75% decrease in cases since the turn of this century. Most financing is “ external “ ( Global Fund to fight AIDS, Tuberculosis, and Malaria ). Coverage is good for ITN / IRS. Annual confirmed cases are less than 10,000 and deaths far below 100. The country is either malaria-free ( at least 27 provinces ), has less than 1 case / 1000 population ( 73 % ), with 1 or more / 1000 in only 7%. It’s mostly a “ rural disease affecting far-flung barangays “.


See http://www.who.int/malaria/publications/country-profiles/profile_phl_en.pdf





Most visitors to the Philippines rightly choose not to buy anti-malarial tablets ( they are not free in the UK ). If you do decide to buy them, advice is inconsistent. Having carefully reviewed this, I see no reason to change the drugs already recommended here.
EITHER


• Doxocycline ( “Vibramycin” ) 10 mg daily 1-2 days before you go, every day in the malarious area, and for 28 days after you leave.

OR


• Mefloquine ( “ Lariam “ ) 250 mg tablet weekly, starting 1-3 weeks before you go, every week in the malarious area, and for 28 days when you leave the area.


If you are unfortunate enough to acquire malaria, wherever you have been, our NHS WILL treat you for free. Remember that immunity ( whether natural / acquired or from a future vaccine ) is not long-lasting, so it is still possible to get malaria from an infected mosquito.

Personal insect repellents will always be required, but as with antimalarial drug resistance, resistant mosquitoes and individual skin types need to be kept in mind when buying them.

See also :-



http://www.who.int/malaria/publications/world_malaria_report_2012/en/

http://www.gsk.com/media/press-releases/2013/malaria-vaccine-candidate-reduces-disease-over-18-months-of-foll.html

http://www.wpro.who.int/philippines/areas/communicable_diseases/mvp/malaria_free_provinces/en/index.html

http://www.wpro.who.int/philippines/en/

[Doc Alan]

In my judgement this further update on malaria is worth posting here on a permanent thread. As always the information is accurate to the best of my knowledge and I take responsibility for it.


Global malaria death rates have fallen by about half since 2000. There were still over 200 million cases and over 600,000 deaths in 2012. Most are in sub-Saharan Africa ( in November a woman from UK died from malaria after a holiday in The Gambia ). The local population may have some natural immunity, but too many get malaria who might not have done, if they had insecticide-treated bednets and the right drugs. An estimated million lives have been saved in Africa by such measures in the past decade.



Almost ALL drugs have more than one action – either good and / or unwanted “ side effects “. Added to this with antimalarials are :- parasite resistance ; and fake drugs – so if the wrong drugs are used for a given part of the world they may be worse than useless.



Even genuine anti-malarials CAN have side effects, but they are nowhere near as common as many people think.



Five issues may be considered by individuals and their pharmacists / doctors :-


• Risk of exposure to malaria

• Extent of drug resistance

• Efficacy ( how good ? ) of recommended drugs

• Side effects

• Individual factors ( age, pregnancy, other illness such as kidney / liver disease ).



If you decide to take antimalarials, but worry about side effects then you could start a few weeks before your trip, so any problems become obvious before leaving the UK. If you DO develop side-effects while abroad, try to continue prevention by obtaining a reliable alternative from a pharmacist or doctor.



Antimalarial drugs need to be paid for in the UK. However, if malaria is diagnosed on your return ( in most cases it’s a straightforward diagnosis ), then treatment is FREE on the NHS. 30 -50 cases a week may be treated by the NHS ; it reflects well on the success of treatment that only 2 – 16 deaths have occurred in this country each year over the past two decades.


As for the Philippines, reported malaria cases have decreased by ¾ since 2000 ( now less than 10,000 ) ; deaths by almost 100% ( from about 750 to a dozen ) ; and the national goal is to eliminate it by 2020 .



It’s a matter for individual judgement ( and the five issues above ) whether to take antimalarials. The most highly endemic provinces are now Apayao and Quirino in Luzon, Sul and Tawi-Tawi in Mindanao.



If anyone DOES consider they need antimalarials for the Philippines, the recommended drugs are still EITHER doxocycline 10 mg daily ( 1 – 2 days before travelling ; daily in the malarious area ; for 28 days after leaving ) OR mefloquine ( 250 mg weekly ; starting 1 – 3 weeks before trip ; every week in malarious area ; for four weeks after leaving ).



My own choice ? I have never taken antimalarials during work in Malaysia or visits to the Philippines in the past 4 decades .


http://globalhealthsciences.ucsf.edu/sites/default/files/content/ghg/country-briefings/asia-pacific/Philippines_2013.pdf

[Doc Alan]

Half the world’s population is now at risk of contracting dengue, although it’s only severe in 1/20 and fatal in 1%. There have been more cases in Brazil this century than any other country. All of the few hundred cases reported each year in the UK are the result of travelling to endemic areas, although numbers of insect bites and stings do seem to be increasing.


• The Philippines continues to have many thousands of cases, and several hundred deaths, each year – it’s a leading cause of childhood hospitalizations.


• No wonder therefore, that a dengue vaccine study involving Filipino children from San Pablo City, Laguna and Cebu City, together with others from Indonesia, Thailand, Malaysia and Vietnam, has attracted much interest.


• This is a " Phase 3 " trial – meaning the vaccine has " passed " the first two smaller phases to test its safety.


• Two cheers for the results :doh ! It’s been shown to have an overall protective efficacy ( effectiveness ) of 56% in over 10,000 children aged 2 – 14 years. The efficacy was best for dengue types 3 and 4 ; less good for type 1 ; and low against type 2. It was better in younger age groups.


• A problem with dengue is that the immune response is not only complex, but also ( unusually ) a response to one type leads to a more severe reaction if infected at some future time with another type.



• More results are awaited. For now, this is the best of several vaccines in the pipeline. But it can’t be a single solution with less than 3/5 efficacy :NoNo:.


• The vaccine – produced by Sanofi-Pasteur, could be available by 2016. It’s unlikely to be cheap. So there is doubt as to whether national dengue vaccination programmes could be justified and cost-effective. Perhaps only high-risk groups or age groups where the vaccine is most effective should be targeted. Ideally the vaccine needs monitoring for a few years to confirm it’s safe and reasonably effective.


• Meantime, for the foreseeable future, prevention will continue to require control of the Aedes mosquitoes with insecticides, checking surroundings for stagnant and clean water, use of insect repellents, nets, protective clothing, and air conditioning. This is easier said than done. The mosquitoes causing dengue are day-time biting ( unlike malaria ), and other factors contribute to the increase in cases ( urbanisation, poor living conditions, climate change, international travel ). There is also still no specific treatment – although at least most cases are self-limiting.


• Dengue should always be considered – by anyone recently returned from the tropics with a fever, as well as their doctor. Successful treatment for most includes bed rest, plenty of oral fluids, and paracetamol ( not aspirin ).


http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61060-6/fulltext

[Doc Alan]

There have been an estimated 300,000 ( + ) deaths from malaria in Africa since the Ebola epidemic started earlier this year.


Good news from the Philippines – no ebola cases so far, and the country is on course for eliminating malaria by 2020 :xxgrinning--00xx3:.


There has been a drastic steady decline in cases and deaths within the past decade. The Asia-Pacific Malaria Elimination Network ( APMEN ) is talking not just of control but elimination of malaria in the Philippines. Reported cases have declined to under 8,000 last year :-


http://i1265.photobucket.com/albums/jj517/DocAlan/MalariacasesPhils_zps8d659068.jpg (http://s1265.photobucket.com/user/DocAlan/media/MalariacasesPhils_zps8d659068.jpg.html)


Deaths have gone from 150 in 2005 to 12 last year :-


http://i1265.photobucket.com/albums/jj517/DocAlan/MalariadeathsPhils_zps677e9d24.jpg (http://s1265.photobucket.com/user/DocAlan/media/MalariadeathsPhils_zps677e9d24.jpg.html)


The " stratification map " for 2013 shows this pattern :-


http://i1265.photobucket.com/albums/jj517/DocAlan/Malaria2013_zps9344a115.jpg (http://s1265.photobucket.com/user/DocAlan/media/Malaria2013_zps9344a115.jpg.html)


15 of the country’s 80 provinces contributed to almost all of the reported cases ; half in Palawan, and a third in Tawi-Tawi :-


http://i1265.photobucket.com/albums/jj517/DocAlan/HighmalariamapPhils_zps3ab7007f.jpg (http://s1265.photobucket.com/user/DocAlan/media/HighmalariamapPhils_zps3ab7007f.jpg.html)


53 provinces are " malaria-endemic " - the top 5 being Palawan, Tawi-Tawi, Sulu, Maguindanao, and Zambales. " Malaria –free " means no indigenous cases in the last 5 years :-


http://i1265.photobucket.com/albums/jj517/DocAlan/Malariaendemicprovinces_zps639d7460.jpg (http://s1265.photobucket.com/user/DocAlan/media/Malariaendemicprovinces_zps639d7460.jpg.html)


Early diagnosis and prompt treatment are vital :xxgrinning--00xx3: !

( RDT = rapid diagnostic test using a drop of blood on a test strip ; microscopy is " gold standard " = looking for parasites on a slide smeared with blood ) :-



http://i1265.photobucket.com/albums/jj517/DocAlan/Diagnosistreatmentmalaria_zps45908b0d.jpg (http://s1265.photobucket.com/user/DocAlan/media/Diagnosistreatmentmalaria_zps45908b0d.jpg.html)



Prevention, should it be considered necessary, is still with doxocycline ( Vibramycin ) or mefloquine ( Lariam ). Of course the world’s first malaria vaccine will hopefully be available in the next two years :smile:.


http://apmen.org/philippines/


http://apmen.org/storage/apmen-vi/APMEN%20VI_S1_CP%20Update_Philippines_Mario%20Baquilod.pdf

[Terpe]

Nice post Alan, very useful update :xxgrinning--00xx3:

[Doc Alan]

Nice post Alan, very useful update :xxgrinning--00xx3:

Thank you Terpe :smile:

Good news like this deserves noting - I do try to keep members informed especially when they have posted about a health topic. How it would be appreciated if they all responded :xxgrinning--00xx3:

[Doc Alan]

Today there are few cases and very few deaths from malaria in the Philippines. If it is considered necessary to take tablets for prevention, " Malarone " ( atovaquone-proguanil ) 1 tablet daily ( from 1-2 days before entering malarious area to 7 days after leaving ) ; " Vibramycin " ( doxocycline ) 1 tablet daily ( from a day before to 4 weeks after leaving ) ; OR " Lariam " ( mefloquine hydrochloride ) 1 tablet once a week ( from 1-2 weeks before to 4 weeks after leaving ) are recommended as guidelines, depending on individual circumstances. Take advice from your doctor or travel health clinic … and be prepared to pay.



The major decline in malaria appears to result from a combination of early detection / treatment ; improved vector ( mosquito ) control ; and health promotion ; external funding outweighs Government expenditure.


Malaria is of course still a very serious infection elsewhere in the world – causing over 600,000 deaths annually, over 90% of these being in Africa ( over 80% children under 5 ). The Ebola epidemic may have resulted in more untreated cases and an additional 10,000 deaths in Guinea, Sierra Leone and Liberia.


The malaria parasite has a complicated lifestyle - which is why it has proved so hard to produce an effective vaccine. Now there is good news – widely reported in the media - about a malaria vaccine which provides " modest protection " against Plasmodium falciparum ( the commonest ) malaria in children for the 12 months after vaccination.


The vaccine has been assessed by European Medicines Agency ( EMA ), although it’s not for marketing in the EU. The hope is to use it for active immunisation of African children. World Health Organization ( WHO ) will add to EMA’s work by looking at other factors such as cost ( the manufacturer claims it sees this vaccine as " humanitarian rather than as a commercial " product ) and effectiveness – then give their recommendation by November this year.


The vaccine is known as " Mosquirix " ( also " RTS,S/AS01 " ). It’s composed of a Plasmodium falciparum protein fused with hepatitis B surface antigen, and combined with hepatitis B surface antigen(s) in the form of non-infectious virus-like particles produced in yeast cells by recombinant DNA technology. So the vaccine does protect against hepatitis B – but there is already an effective hep B vaccine for use where malaria prevention is not needed. Hep B is much commoner in the Philippines than the UK.


The benefits of " Mosquirix " seem to outweigh the risks, but it doesn’t offer complete protection, and an 18 month booster dose is needed after the initial course of 3 vaccines. It would seem to be a milestone but not a magic bullet. If WHO does approve, it will then be up to countries in Africa and other malaria-prone regions to decide whether to adopt the vaccine – in addition to all the other measures needed to beat this dreadful infection.


http://www.ema.europa.eu/docs/en_GB/document_library/Press_release/2015/07/WC500190447.pdf

[Doc Alan]

About half the world’s population is now at risk of dengue - up to 4 billion people in 128 countries, with actual numbers estimated to be about a tenth of this. There were large outbreaks worldwide last year, including around 170,000 cases reported in the Philippines.


It’s mainly spread by the bites of infected female Aedes aegypti mosquitoes - which also transmit Zika infection, chikungunya and yellow fever.


Local and imported dengue outbreaks could ( again ) occur in Europe - such as affected Madeira and mainland Portugal 4 years ago, transmitted by mosquitoes which can survive lower temperatures.


Recovery from one of the 4 types of dengue gives lifelong immunity to that type - but subsequent infection by another type increases the risk of severe dengue ( " Dengue Haemorrhagic Fever " ).


Severe dengue was first recognized in the 1950s during outbreaks in the Philippines and Thailand. Although there’s still no specific treatment, death rates can be less than 1%, given the right care - especially maintaining patients’ body fluid volume.


The first dengue vaccine has been registered in the Philippines and several other countries since late last year ( " Dengvaxia " by Sanofi-Pasteur ) ; several other vaccines are being developed.


The main method of controlling or preventing transmission MUST still be to target the mosquitoes.


There is controversy about the safety of " Dengvaxia " ( possible side effects including a future rise in cases of severe dengue ), availability, and cost, for all who might benefit from it. The Philippines Department of Health should pay attention to future recommendations from SAGE ( World Health Organization Strategic Advisory Group of Experts ) !


We should be optimistic that it WILL be possible to prevent dengue in the next few years.


http://bit.ly/1W8ci83

[Michael Parnham]

Another interesting update, thank you Alan:xxgrinning--00xx3:

[SimonH]

The Philippines is the first country to launch the dengue vaccine :smile:

http://edition.cnn.com/2016/04/06/health/dengue-fever-vaccine-philippines/

http://www.channelnewsasia.com/news/asiapacific/historic-dengue-vaccine/2664344.html

[ssbib]

Advice needed: I'm in Quezon City waiting for my wedding at the end of the month. For this trip I was advised to get malaria medication (I haven't been in the past) and I am having a bad reaction to it. I'm coming out in a rash and it's getting itchy and spreading. I want to discontinue and checking out that map on the first page it looks like I'm in a low to no risk zone so why was I advised to get this. Do any of you take this medication when travelling to Manila area?

[Longweekend]

No I have never taken any medication even when I lived in Manila....

[Michael Parnham]

No none at all even when I lived in Dumaguete, never had any vaccinations for anything since 2007:Erm:

[Terpe]

Advice needed: I'm in Quezon City waiting for my wedding at the end of the month. For this trip I was advised to get malaria medication (I haven't been in the past) and I am having a bad reaction to it. I'm coming out in a rash and it's getting itchy and spreading. I want to discontinue and checking out that map on the first page it looks like I'm in a low to no risk zone so why was I advised to get this. Do any of you take this medication when travelling to Manila area?

I'm another one who has never taken malaria tabs in Philippines.
Personally i'd stop them with such a reaction
Some malaria meds can result in some nasty side effects

There a limits on just how long you can continue taking them due to the effects
I'm living here now for nearly 3 years without malaria meds
Like others I'm Just sharing my own experience.

I've lived in a few countries with malaria mozzies and at first was advisedto take the meds
But when you're living there for months on end you're advised not to take them

[Terpe]

Advice needed: I'm in Quezon City waiting for my wedding at the end of the month. For this trip I was advised to get malaria medication (I haven't been in the past) and I am having a bad reaction to it. I'm coming out in a rash and it's getting itchy and spreading. I want to discontinue and checking out that map on the first page it looks like I'm in a low to no risk zone so why was I advised to get this. Do any of you take this medication when travelling to Manila area?

I'm another one who has never taken malaria tabs in Philippines.
Personally i'd stop them with such a reaction
Some malaria meds can result in some nasty side effects

There a limits on just how long you can continue taking them due to the effects
I'm living here now for nearly 3 years without malaria meds
Like others I'm Just sharing my own experience.

I've lived in a few countries with malaria mozzies and at first was advisedto take the meds
But when you're living there for months on end you're advised not to take them

[Steve.r]

Never taken any here either

[ssbib]

Thanks for all the advice guys. I have been in touch with the tropical medicine centre at Liverpool hospital and they have told me to stop taking them and said I shouldn't have been told to get them anyway if I'm only going to be staying in Quezon City. I should be having them now with breakfast but think I will stop.

[fred]

The Philippines have been very lucky that the Covid virus seems not to be compatible with the dreaded Dengue annual death scourge!

Dengue deaths down 80++ %?? Wow. It`s a miracle.

Think the last 2 posts would do better in the conspiracy thread!:icon_lol:

[Dave_]

The Philippines have been very lucky that the Covid virus seems not to be compatible with the dreaded Dengue annual death scourge!

Dengue deaths down 80++ %?? Wow. It`s a miracle.

Think the last 2 posts would do better in the conspiracy thread!:icon_lol:

Is this the report you are referring to?

WHO - Dengue - Surveillance report 20210923 (https://www.who.int/docs/default-source/wpro---documents/emergency/surveillance/dengue/dengue-20210923.pdf?sfvrsn=fc80101d_90#:~:text=Philippines%20(no%20update)&text=This%20is%2083%25%20lower%20compared,the%20same%20period%20in%202020.)

Quite possibly the number of cases of Dengue is lower because people are shielding from Covid and staying home.

[fred]

Is this the report you are referring to?

WHO - Dengue - Surveillance report 20210923 (https://www.who.int/docs/default-source/wpro---documents/emergency/surveillance/dengue/dengue-20210923.pdf?sfvrsn=fc80101d_90#:~:text=Philippines%20(no%20update)&text=This%20is%2083%25%20lower%20compared,the%20same%20period%20in%202020.)

Quite possibly the number of cases of Dengue is lower because people are shielding from Covid and staying home.

Philippines reports dengue deaths are down dramatically.

One year after the national dengue epidemic was announced in August 2019, reported dengue cases have dropped from 430,282 to 59,675 in 2020. Dengue mortalities have also significantly dropped from 2019 with 1,612 deaths versus 231 in 2020.

https://doh.gov.ph/press-release/DOH%E2%80%99S-W.I.L.D.-INITIATIVE-LOWERS-DENGUE-DEATHS-BY-78-percent

Do you honestly think that people here just stay at home?
Stay at home and do what?
Await their Philippine Government furlough relief schemes in order to buy Rice and Fish?:Help1:

Must be the masks and plastic face shields that are protecting the people from Mosquito bites!!
Do people really read this shyte and believe it to be so?

If you check the link above you will see that the Government are attempting to take credit for the 80++% reduction in Dengue cases due to their W.I.L.D initiatives during a so called Flu + Pandemic that they claim is out of control.
Quite incredible.
In reality,the Phils GOV. probably report their success in tackling the Dengue death scourge in order to receive more back slapping and financial 3rd world Sponsorship from the renowned CORRUPT Organization, the W.H.O.
Good Job Philippines Health dept.!!

As far as Malaria goes,I have never met a single soul that has suffered with it here in the Philippines in 37 years.
Perhaps I need to get out more.. (better not though as I could get Dengue or the Flu+!!)

I must apologize if my comments mainly based on facts come across as a little "Flippant".
Not my intention.

[fred]

Through these efforts, the DOH will roll out the Nucleic Acid Amplification Test-Loop Mediated Isothermal Amplification Assay (NAAT-LAMP) which offers cheaper and simpler dengue diagnosis

Yes.
It`s called a Covid 19 molecular (PCR) test.
:icon_lol:

[Doc Alan]

One of the posts you thought "would do better in the conspiracy thread" was actually mine, with good news about malaria.

There were only 3 deaths from malaria in the Philippines last year, and a dramatic decline in reported cases since this thread was started over a decade ago.

Elsewhere in the world malaria is still a deadly disease. Over 260,000 children in sub-Saharan Africa die from malaria annually. My post reported on a long-awaited malaria vaccine ("RTS, S") which acts against P.falciparum, the most deadly malaria parasite globally.

It is far more difficult to produce an effective vaccine against a parasite than bacteria or viruses. Even a reduction of 30% in severe malaria is a significant achievement.

Conspiracy ? Not in my opinion. Thanks for your apology. I'll think twice before posting again.