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‘Dengue is escalating - and it’s not being taken seriously enough’ (Politics Home)

16 December 2016

This article was originally published on Politics home.

This month, experts and Members of Parliament discussed how best to tackle the growing threat of dengue fever.

“Looking at dengue makes the fight against malaria seem easy.”

These were the words of Philip McCall, Professor of Medical Entomology at the Liverpool School of Tropical Medicine, during a roundtable to discuss this mosquito borne virus, which over the past 50 years has spread from nine to over a hundred countries – making it one of the fastest growing infectious diseases in the world.

In a bid to raise global awareness of the disease, global health NGO, Malaria Consortium, launched a report, Dengue: Falling between the cracks, and held a parliamentary roundtable with Shadow International Development Minister Imran Hussain and SNP International Development Spokesperson Patrick Grady.

Despite the alarming spread of dengue, it remains relatively low on the global health agenda. So, why, when Zika and malaria lead global news agendas, does dengue fall through the cracks?

Professor of Emerging Infectious Disease at London School of Hygiene & Tropical Medicine, Martin Hibbard, said one reason is the notion of dengue as a minor disease, often dismissed as "just a fever". He added: "Zika wasn’t perceived with real importance until it became clear what the consequences are for pregnant women."

The World Health Organisation’s Dr Raman Velayudhan echoed this point, saying the "fear factor" is lacking for dengue as "the number of deaths are relatively low”, as opposed to Zika which “naturally drives the fear” because of the effect it has on pregnant women.

Dr Velayudhan agreed that dengue was taken seriously enough which that is worrying because "it’s coming and it’s expanding".

Professor McCall warned that in the near future, there could be an outbreak in the northern hemisphere if there was a hot summer or as a result of climate change. He added that there has to be proper disease and vector surveillance, to help us better understand dengue and plan appropriate interventions.

Department for International Development’s Dr Chris Lewis said one of the main problems in preventing an outbreak and fighting the fever is the "shocking" lack of evidence. "We don’t know what works…we desperately need to address this."

He called for the "silos to be broken down" in order to create an environment where entomologists, public health experts, and others can work together.

Dr Charlotte Watts, Chief Scientific Adviser at DFID, added that we need new and innovative tools for dealing with the dengue mosquito, which also transmits Zika, chikungunya and yellow fever. What worked for malaria won’t necessarily work for these diseases.

Dr Philip Price, Science Advisor at the Wellcome Trust shared this concern, fearing for the lack of investment in new vector control methods, despite having been identified as a priority. “The elephant in the room is vector control... It’s a case that everyone wanted to make an omelette, but nobody bought any eggs.”

The panellists agreed that community-led solutions for vector control are important, such as removing breeding sites and covering water sources.

Dr Giuseppina Ortu, Malaria Consortium Senior Public Health Specialist, was concerned about the lack of good data. “There is no quality data on dengue as there is no clear understanding of how to diagnose and correctly define a dengue case. We don’t really have a definition of what an outbreak is. Predicted maps aren’t very useful as they are based on poor quality data.”

She added: "Only if we start implementing active surveillance will we be able to understand whether a town is at risk of a dengue outbreak. Dengue is very hard to predict even with the best will in the world and the best investment."

Dr Christopher Nelson, from Sanofi Pasteur, said the first licensed dengue vaccine is an exciting development, but warned it was not a "silver bullet". A vaccine needs to be used along with other preventive measures. His point was echoed by other panelists who agreed dengue prevention is better than cure, especially as there is no specific treatment for dengue fever. Sanofi Pasteur, said the first licensed dengue vaccine is an exciting development, but warned it was not a "silver bullet". A vaccine needs to be used along with other preventive measures. His point was echoed by other panelists who agreed dengue prevention is better than cure, especially as there is no specific treatment for dengue fever.

Mr Hussain said the discussion highlighted the serious complexities of dengue and agreed there needs to be more "joined up working". He said he did not know whether this problem had been borne out of lack of funding, but he said global conversations needed to take place.

Mr Grady, the SNP’s international development spokesperson, suggested he would table some written questions, oral questions, or table an Early Day Motion to make sure this important topic becomes part of the Government agenda.

The MPs agreed they were encouraged by the motivation of those around the table and the consensus on what the challenges are. They pledged to build on the momentum of the event and take the issue of dengue on in Parliament.

Country: Cambodia

Keywords: Advocacy and policy

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