Deadly bite
It’s a problem that’s been hovering since the 2017 Dengvaxia controversy led to the suspension of the Department of Health’s (DOH) vaccination campaign against this endemic scourge.
On Saturday, Quezon City declared a dengue outbreak, while the DOH has noted “a concerning rise” in the number of dengue cases in eight other local government units (LGUs) in the National Capital Region, Calabarzon, and Central Luzon.
Data from the QC Epidemiology and Surveillance Division showed that 1,769 dengue cases were reported between Jan. 1 and Feb. 14 in Metro Manila’s most populous city, with at least 10 deaths logged, eight of them minors.
Across the country, the DOH reported a total of 28,234 cases from Jan. 1 to Feb. 1—a 40-percent increase for the same period in 2024. From 2008 to 2012, the agency noted an annual average of 117,065 dengue cases, placing the country fourth in dengue burden in Southeast Asia.
The alarming figures led Barangay Addition Hills in Mandaluyong to offer a bounty for mosquitos or their larva, in an initiative called “May Piso sa Mosquito.” Villagers will be paid P1 for every five mosquitos or wriggler (“kiti-kiti”) brought to the barangay hall, where the insects will be placed in a sealed glass container and eventually killed.
Lingering misinformation
Addition Hills, according to local health data, posted 44 cases of dengue since the start of the year, most of them children.
While “well-intentioned,” the initiative has been criticized for possibly exposing bounty hunters to more mosquitos, or causing a “cobra effect,” in reference to India’s anti-cobra drive that had people breeding the reptile instead to collect the reward money.
“People might end up propagating the very vector that we are trying to destroy,” Assistant Health Secretary Albert Domingo said, adding that while incentives can be powerful when used properly, coordination with local health offices was the better approach. The DOH suggested instead that incentives be given for regular cleanup drives or for early reporting of new dengue cases.
Indeed, if funds for reward money are available, LGUs could use it to organize a house-to-house information campaign on the disease, with health care workers expounding on dengue’s symptoms and prevention and addressing lingering misinformation in the wake of the Dengvaxia controversy.
Vaccine hesitancy
In 2017, Sanofi Pasteur developed a suitable vaccine for dengue that was approved in 19 countries and used in a vaccination campaign in the Philippines involving more than 800,000 school children. But Dengvaxia quickly caused panic when Sanofi announced new clinical data showing that individuals not previously infected by the virus could suffer more severe complications from dengue after being vaccinated. Sensational media reports and rumors of deaths caused by the vaccine led to “vaccine hesitancy” or distrust of this medical intervention, and a ban on Dengvaxia’s sale and use in the country.
Such vaccine hesitancy could have led to the measles outbreak in 2019, after the country’s measles immunization coverage fell dramatically following the Dengvaxia scare. The World Health Organization noted the DOH’s official report of over 12,700 measles cases with 203 deaths from Jan. 1 to Feb. 23, 2019, as vaccination rates plummeted from 80 percent in 2008 to below 70 percent in 2017, and falling further in 2018.
Similarly, the current dengue outbreak could have been stoked by the fear of vaccines as a result of the contentious issue that personalities allied with former president Duterte used to pin down then President Aquino’s health officials.
‘5S’ strategy
While the Department of Justice has recently ordered the withdrawal of cases against former health officials charged for the alleged Dengvaxia-related deaths by the Public Attorney’s Office, there’s no guarantee that it would allay the residual anxieties caused by the media circus on the issue.
An extensive information campaign, starting with how to recognize dengue’s symptoms so people can seek immediate medical attention, could help remedy that. So would the other LGUs acknowledging the dengue outbreak in their area to forewarn residents and enable affected communities to access more funds and government support.
Prevention being infinitely better than cure, the DOH has reiterated its “5S” strategy to combat dengue: search and destroy mosquito breeding sites; self-protection measures; seek early consultation; say yes to fogging where needed; and start and sustain hydration.
Other LGUs, too, might want to follow Quezon City’s response to the outbreak, which includes longer operating hours for health clinics in the city to extend immediate treatment to dengue patients.
The DOH should also take a second look at dengue vaccines that are widely accepted in other countries, especially now that thousands of lives—mostly minors—are at stake.
