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Regional Coalition Calls on Governments in Asia to Support Collaborative Efforts to Combat Growing Dengue Threat

2016-01-12 11:56
-- Nearly 75% of the global population at risk of dengue[1]
-- Globally, Asia has highest dengue burden with estimated 67 million sufferers each year
-- Philippines is first in Asia to approve game changing dengue vaccine

SINGAPORE, Jan. 12, 2016 /PRNewswire/ -- On the heels of Asia's first dengue vaccine approval in the Philippines, the inaugural Asian Dengue Summit opening in Bangkok on January 13 is making a rallying call to governments and health authorities in Asia to collaborate and integrate regional efforts to wage war on dengue and to 'open a new chapter' in dengue prevention and control[2].

Making this collective call is the Asian Dengue Vaccination Advocacy (ADVA), a scientific working group that is staging the two-day Summit in partnership with the Dengue Vaccine Initiative (DVI), the Southeast Asian Ministers of Education Organisation Tropical Medicine and Public Health Network (SEAMEO TROPMED) and the Fondation Merieux (FMx).

The ADVA coalition will leverage its knowledge and expertise to help governments in the region curb the growing dengue burden. Leading regional clinicians, researchers, public health leaders, government officials and policymakers will attend the Summit to share and exchange their scientific findings and dengue prevention and treatment experiences from their countries. Among those to speak at the Summit and supporting the call for regional governments in Asia to integrate their anti-dengue efforts to curb the spread of the disease, is Professor Duane Gubler, Professor at the Duke-National University Singapore Graduate Medical School Singapore, a world renowned expert in dengue.

Rising number of dengue cases worldwide

In the last 50 years, dengue has become endemic in 128 countries, where about 4 billion people live[3], [4]. This marks a 30-fold increase in dengue incidence[3], [4]. Not surprisingly, dengue is feared as one of the most severe mosquito-borne viral diseases in the world.

Over 740 people are infected by dengue per minute, globally[5].

Asia has the highest dengue burden globally with an estimated 67 million people contracting the disease each year.

Endemic countries in Asia have spent nearly US $6.5 billion annually in both direct medical and indirect costs due to dengue[6].

Economic burden cost

The economic burden of dengue in Singapore alone from 2000 to 2009 is estimated each year to range between US$0.85 billion and US$1.15 billion, of which 41 per cent to 58 per cent is direct medical, direct non-medical and indirect costs, such as loss in work productivity and reduction of household services. The remainder is the cost of vector control efforts[7].

First of its kind dengue vaccine

With the availability of the world's first dengue vaccine, countries in Asia will soon have an effective tool to combat the virus. So far, three countries in the world, Mexico, Philippines and Brazil, have approved the dengue vaccine for individuals aged 9 to 45 years.

Professor Usa Thisyakorn, Professor of Pediatrics at Chulalongkorn University and Chairman of ADVA, described the staging of the Summit in Bangkok as both 'timely and urgent', and said that the availability of the first dengue vaccine in Asia,  newly approved by the Philippines regulators, is a historic milestone in the war on dengue.

The Summit will explore how to harmonise regional integrated efforts and enable coordinated action as many countries in the region are facing spikes in dengue outbreaks; just this month, Singapore reported a surge in dengue reported cases. The National Environment Agency reported a total of 455 dengue cases in the week ending January 2 2016, an increase of 86 more cases than the week before. This is the highest number of cases recorded in a week in 2015[8]

Integrated regional approach needed

"The Summit will look at holistic and integrated regional approaches to fight dengue. As more countries approve the use of the vaccine, information sharing and capacity building will play a critical role in the development of their vaccine implementation strategies. While much work lies ahead, we are closer to writing a new chapter in dengue prevention and control," said Prof Thisyakorn.

"For the successful implementation of the dengue vaccination programme, we need regional concerted efforts to ensure that collaborative policies around the region are set in place. By bringing together key stakeholders, ADVA hopes to jointly formulate a strategy to enable better control and management of dengue across the region," Prof Thisyakorn added.

Increasing international travel contributing to dengue migration

Prof Gubler attributes rapid migration to urban cities, climate change and increasing international travel to the alarming rise of dengue migration.

Most dengue virus infections in travelers are acquired in Asia, followed by the Americas, and only a small proportion from Africa.

Prof Gubler explained that because there are four different but closely related serotypes of the dengue virus (DEN-1, DEN-2, DEN-3 and DEN-4), recovery from one serotype infection does not provide lifelong immunity against the remaining three. In subsequent infections by other serotypes, the patient faces the increased risk of developing severe dengue (also known as Dengue Haemorrhagic Fever).

Advocating the need for regional collaboration, Prof Gubler said, "The ability of the virus to travel makes it critical that we adopt an integrated model to prevent the introduction of the dengue virus into new areas, or the introduction of new strains into already endemic settings. This means every country needs to successfully contain the spread of dengue as it can have a ripple effect across the region".

"Effective prevention and disease management will require the integration of both vaccine and mosquito control measures. Vaccination has proven to be integral in the management of vector-borne diseases, and we will see this in the case of dengue. The arrival in Asia of the first dengue vaccine will be a game changer in dengue prevention," Prof Gubler added.

Dr Raman Velayudhan, World Health Organisation (WHO) Director at the Department of Vector Ecology and Neglected Tropical Diseases, a keynote speaker at the Summit said, "A complex disease like dengue requires an inclusive approach that looks beyond just the health sector. By reorienting health services to identify early cases, implementing appropriate management of severe cases and training health personnel together with coordinated surveillance, we can be one step closer to reducing dengue mortality by 50% and morbidity by 25% by 2020 in endemic countries[9]. We have also seen that effective communication can achieve behavioural outcomes and add to prevention programmes."

The two-day Summit will cover a broad and comprehensive overview of the current endemic and its cross-border management. It will address the necessary measures and governmental policies needed to implement a dengue vaccination programme and seek solutions to the practical issues for dengue programmes.

Other than the Philippines, licensing approval for the dengue vaccine is expected in more countries across the region.

About Asian Dengue Vaccine Advocacy (ADVA):

The Asian Dengue Vaccine Advocacy (ADVA) Group is a scientific working group dedicated to dengue vaccine advocacy in Asia, with the aim of disseminating information and making recommendations on dengue vaccine introduction strategies in Asia.

ADVA was set up in 2011 to identify opportunities and make practical recommendations for improving surveillance and laboratory capacity for dengue disease confirmation. It is supported by an unrestricted educational grant from Sanofi Pasteur since inception.

Media Contact for ADVA:

Shruti Bose, +65-6825-8018
SBose@webershandwick.com

Clarinda Ng, +65-6825-8042
CNg2@webershandwick.com

Sources:

[1] 

Asian Dengue Vaccination Advocacy; http://adva.asia/about-us

[2]

Asia Dengue Summit; http://adva.asia/ads/about.html

[3]

Ibid.

[4]

World Health Organisation; Impact of Dengue; http://www.who.int/csr/disease/dengue/impact/en/

[5]

Nature. 2013 Apr 25;496(7446):504-7  

[6]

Shepard DS, Halasa YA, Undurraga EA, Stanaway J. Global economic cost of dengue illness. Poster presented at: American Society of Tropical Medicine and Hygiene Annual Meeting; Oct. 25-29, 2015, Philadelphia, PA, Poster 781 

[7]

The Straits Times, Act against dengue now with tools that exist; http://www.straitstimes.com/singapore/environment/act-against-dengue-now-with-tools-that-exist

[8]

The Straits Times, Sharp rise in dengue cases last week; http://www.straitstimes.com/singapore/health/sharp-rise-in-dengue-cases-last-week

[9]

World Health Organisation; Dengue and severe dengue; http://www.who.int/mediacentre/factsheets/fs117/en/

Source: Asian Dengue Vaccination Advocacy (ADVA)
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