Dengue fever cases still on the rise despite seasonal change in some regions

Gemma Holliani Cahya

The COVID-19 epidemic has not slowed the onset of the seasonal dengue fever across the country, the Health Ministry has said, with 70,418 cases and 458 disease-related deaths recorded as of Thursday.

The official tally increased from 34,451 cases and 212 deaths in March.

However, the ministry also said that the number of dengue cases recorded between Jan. 1 and July 1 this year was lower than that in the same period in 2019, when 105,222 cases and 727 deaths were logged.

Still, this year’s figure is higher than that of 2018 in the same period, which saw 21,861 cases and 158 deaths by dengue.

Cases of dengue fever, which is primarily spread through mosquito bites, usually increases during the rainy season.

The country has been battling dengue fever since early this year, at a time when state resources have been spent on curbing the COVID-19 outbreak. The similarities between dengue fever and COVID-19 symptoms have also complicated efforts to mitigate the annual spike in cases.

In a recent press statement, the Meteorology, Climatology and Geophysics Agency (BMKG) said that while 51.2 percent of the country had entered the dry season, the rest of the archipelago was expected to experience prolonged rain for the next two to four months.

The agency said cities and other areas experiencing a drawn out rainy season “must take extra caution over the risk of dengue fever disease”, even though the intensity of rain is expected to decrease over time.

Most of the cases were found in West Java, which recorded 10,485 cases, followed by Bali (8,930) and East Java (5,781). However, the Health Ministry said no region had yet to declare a dengue emergency.

Contacted on Thursday, West Java Health Agency head Berli Hamdani said there were at least 95 people in West Java who had died from dengue fever this year.

And although they have sufficient health facilities to anticipate more patients, Berli said it was a challenge to spray insecticide with fogging machines in a number of areas and communities, especially in the midst of the epidemic. Fogging is one effective method of exterminating the Aedes aegypti mosquito, the carrier of the dengue virus.

“Many people are staying in their houses during quarantine so it’s challenging to conduct ‘focus fogging’ to eliminate mosquito breeding grounds in some areas. […] We can’t do any fogging where there are people because of the dangers of insecticide,” Berli told The Jakarta Post.

Another possible hurdle the agency found was that people were still worried about seeking out medical assistance at hospitals over fears they might be exposed to COVID-19. “It causes delayed efforts to seek medical attention,” he said.

The ministry’s director for vector-borne and zoonotic diseases, Siti Nadia Tarmizi, said prevention was still the best way to fight dengue.

She encouraged communities to stay alert on the dangers of dengue fever, employ larvicides where necessary and use the state-sponsored triple action method of draining, covering and burying any containers that can hold water. Mosquitoes lay eggs near water.

“If you catch a fever and it doesn’t get better after three days or you experience some kind of bleeding – red spots on the skin, bleeding gums or nose bleed – don’t hesitate to get checked out at the nearest health facility,” Siti told the Post on Thursday.

She stressed that people should not be afraid to visit health facilities, which were safer now than most other places because they usually had screening systems to separate non-COVID-19 and COVID-19 patients.

“It’s better to check whether you have dengue fever as soon as possible, because it might get worse if you’re too late,” she insists.

Mulya Rahma Karyanti, an expert on infections and tropical pediatrics at Cipto Mangunkusumo Hospital in Jakarta, reiterated in a press conference with the National Disaster and Mitigation Agency on June 22 that Aedes aegypti mosquitoes were daytime feeders, with peak feeding occurring in the morning and in the evening before dusk.

“They like to bite between 10 a.m. and 12 p.m. when our children are studying. […] and [before] maghrib [dusk] prayer between 4 p.m. and 5 p.m.,” Mulya said.