WORLD HEALTH ORGANIZATION
ORGANISATION MONDIALE DE LA SANT~
REGIONAL OFFICE FOR
THE WESTERN PACIFIC
BUREAU REGIONAL DU PACIFIQUE OCCIDENTAL
REGIONAL COMMITTEE Twenty-sixth session Manila 1-6 September 1975 Provisional agenda item 13
WPR/RC26/7 16 June 1975 ORIGINAL: ENGLISH
DENGUE HAEMORRHAGIC FEVER: PROVISION FOR ASSISTANCE IN EMERGENCIES Report by the Regional Director The Regional Director invites the attention of the Regional Committee to the outbreaks of dengue fever/dengue haemorrhagic fever that have occurred ovel' :.he past two or three years ~n many countries md territories of the v 'stern Pacific Region. In 1 73, 969 cases were reported from Peninsular Malaysia, 1255 cases from Singapore, and more than 14 000 cases, with abo1lt 1000 deaths, from South Viet-Nam. In 1974. 1482 cases were reported from Peninsular Malaysia. In the South PacifiC, between 1972 and 1974, outbreaks occurred in Fiji, French Polynesia, Gilbert and Ellice Islands, Nauru. New Caledonia, New Hebrides. Niue, Papua New Guinea, Tonga, Trust Territory of the Pacific Islands and Western Samoa. Between January and April 1975 there was an epidemic of dengue type I in Fiji, with an estimated 30 000 cases occurring in Suva. During the same period. about 5000 cases occurred in Nuku'alofa, Tonga. National health authorities have been gravely concerned and some governments have accepted assistance offered by WHO. The first meeting of the WHO Technical Advisory Committee on Dengue Haemorrhagic Fever for the South East Asia and Western Pacific Regions was held in Manila in March 1974. Technical guides for the control of dengue haemorrhagic fever were drawn up and distributed to the Government of Malaysia, to representatives of Member States attending the twentyfifth session of the WHO Regional Committee for the Western Pacific, and directly to the health authorities of interested countries and territories in the Region. In February 1975, at the second meeting of the Technical Advisory Committee, held in Bangkok, Thailand. the technical guides were revised. The revised versions will be distributed as soon as they are finalized.
WPR/Rc26/7 page 2 To arrest an outbreak, the measure which must immediately be put into force is control of the vector mosquitoes. In some instances experts sent by WHO, to assist countries where outbreaks of dengue were in progress, found that the equipment and insecticides necessary for mosquito control were not locally available for immediate use. In others there was difficulty in obtaining quickly the funds necessary for purchasing equipment and chemicals. Thus, there may often be considerable delay before mosquito control can be put into effect. With a view to solving this problem, it is proposed that the Regional Office should establish a stock of supplies and equipment to be made available immediately in the event of emergencies. Since there is no provision in the approved regional Programme Budget for the necessary funds to make these purchases, the Regional Director requests approval to place an amount of U8$10 000 in the 1976 List of Additional Projects to enable the Regional Office to buy the equipment and insecticides mentioned below. These will be available for immediate despatch to Governments in the Region upon request for the control of outbreaks of dengue or dengue haemorrhagic fever. It is envisaged that the cost of transporting the machines and insecticides by air freight to a country where an outbreak is in progress will be borne by the government making the request. Equipment Although the LECO H-D is good for quick application over a large "rea within a short period, it would not be economical, because of its i,,,,avy weight, to ship it from one place to another by air freight. It is, 1.L,erefore, proposed to purchase a few portable ULV application machines. rc the different types available at present, the Fontan is considered l.he best choice despite its heaviness and noisiness. The cost of a Fontan is approximately U8$350. It is recommended that six Fontans be ordered, for storage in Manila, at a total cost of apprOXimately U8$25OO. Insecticides For mosquito adult control ULV grade malathion (96%) or fenitrothion (95%) is recommended, based on the tests made by the WHO Aedes Control Research Unit. The prices are as follows: 96% malathion 95% fenitrothion ••••••••••••• US$2.30 per litre. 5.60 per kg.
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These insecticides can be easily ordered from commercial firms in the Region. It is suggested that U8$50OO be earmarked for purchases in emergencies.
WPR~C26/7
page 3 For mosquito larval control Abate has proved to be effective and safe for application in potable water. The price for Abate 1% sand granules is approximately U8$1.00 per kg. It is suggested that U8$1000 be earmarked for purchases in emergencies. The approximate total cost of the above-mentioned proposals is as follows: 1. 2. ULV ground machines •.•.....•••.•••.••••••• ULV insecticides .......................... Abate.. .. . .. .. .. . . . .. .. .. .. . . . .. . .. .. . . . .. . . .. .. .. .. .. . .. .. .. .. ..
U8$2500
5 000 1 000 1 SOO ====::=:=~::::
.3.
4.
Freight charges ......................................................
GRAND T<YI'AL •••••• U8$10 000 The Committee is requested to approve the provision of U8$10 000 to meet emergency requests of governments in the event of a dengue haemorrhagic fever outbreak.