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Dengue Haemorrhagic Fever
International Conference on
Dengue/Dengue Haemorrhagic Fever: A Global Challenge for the New Millennium,
Chiang Mai, November 2000
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WHO is greatly
concerned at the DF/DHF situation in this part of the world.
The disease
continues to show increased incidence and geographical spread with more
frequent out-breaks throughout the two Regions.
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Today, Dengue/Dengue Haemorrhagic Fever is
considered the most important resurgent tropical infectious disease. Epidemic
dengue haemorrhagic fever (DHF) emerged in South-East
Asia in the 1950s. In the past 20 years, rapid epidemio-logical
changes have manifested as a result of continued population growth,
uncontrolled and unplanned urbanization, increased intercountry travel and
other societal changes. All of these have created conditions ideal for
increased transmission of multiple, dengue virus serotypes in most tropical
countries of the world.
This is the first international conference
on DF/DHF to be held in Thailand.
It would serve as a forum for exchanging the latest global and regional
information on the prevention and control of dengue/dengue haemorrhagic
fever. This could lead to policy formulation and action at the global,
regional and country levels. It would also help to define major areas of
research needed to contain the spread of dengue virus and its vectors, reduce
morbidity and mortality in endemic countries; and advocate better
understanding of the disease burden and bring about public consensus and
commitment towards elimination of the disease as one of the major threats to
public health.
The World Health Assembly passed a
resolution in 1993 which urged Member States to strengthen their national and
local programmes for the control of DF/DHF. In response to this resolution,
WHO’s South-East Asia Regional Office (SEARO) developed a regional strategy
for the control of DF/DHF in 1995. A technical meeting on management of
dengue epidemic was held in India
in November 1996 and guidelines developed to deal with the outbreak. In
1997, a biregional meeting between SEARO and WPRO was held in Manila to strengthen
country collaboration between the two Regions.
WHO is greatly concerned at the DF/DHF
situation in this part of the world. In 1998, India,
Maldives, Myanmar and Thailand
from South-East Asia (SEA), and Cambodia,
Laos, Malaysia, Singapore
and Vietnam
from the Western Pacific (WP) Region experienced epidemics of DHF. The
disease continues to show increased incidence and geographical spread with
more frequent outbreaks throughout the two Regions. DF/DHF was reported for
the first time in Bangladesh
in 1999, with more than 4 172 cases and 78 deaths reported in early
2000. Outbreaks were also reported from Maldives
and, most recently, from Sri Lanka.
Here in Thailand, there is an annual,
national celebration to mark the King’s birthday. But every twelfth year, it
is a particularly auspicious occasion as in 1999, during the celebrations to
mark the King’s 72nd birthday. On that occasion, he asked the
nation to bring the scourge of dengue under control and a major
intensification of activities ensued. The convening of this conference is
closely linked with those efforts. Over the next few days you will be hearing
more about some of them.
Also in 1999, an indepth external review on
DF/DHF prevention and control was conducted in Thailand covering the national
dengue/dengue haemorrhagic fever prevention and control programme (NDPCP) and
to provide technical advice to make the programme more effective. The Review
Mission visited organizations, agencies, institutions and groups concerned
with DF/DHF prevention and control in Thailand. It critically reviewed
approaches, methods, procedures, epidemiological and economic data and
outcomes, and had intensive discussions on the approaches that may have the
greatest chance of success in Thailand.
It was agreed that the primary emphasis of the NDPCP should be on the large
urban centres of the country, using an integrated, community-based approach
to Aedes aegypti control by larval source reduction. In 2000, a
similar review of DF/DHF prevention and control was also conducted in Indonesia.
The recommendations made by the Review Mission are being implemented by the
programme.
The expected outcomes of this Conference
include refining/ redefining the pathogenesis and pathophysiological concepts
of the disease for better diagnosis, treatment and control; recommending
concerned authorities on control and prevention of DF/DHF; strengthening of
national capacity for research and training in related disciplines;
catalyzing further interest in arboviral diseases and mosquito-borne viral
diseases, as well as the development of a practical and feasible framework
for further collaborative research in DF/DHF.
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