Dengue fever is rampant in Indonesia: hospitals are full and the number of deaths has tripled

The dengue fever epidemic is so severe that patients in some cities are on IV drips in the corridors of hospitals because they cannot cope with the influx. The Minister of Health calls on fellow countrymen to better protect themselves against mosquito bites and to no longer resist a new control method. Specially infected mosquitoes are released into residential areas.

In the first four months of this year, Indonesia recorded 62 thousand cases of dengue fever, also known as dengue. 475 patients did not survive the infection. That is a significant increase compared to last year (22,500 infections, 170 deaths).

The government points to the weather phenomenon El Niño as an explanation. As a result, the rainy season lasts longer and it is warmer. Much to the delight of the common mosquito species Aedes Aegypti and Aedes Albopictus, which can transmit viral diseases such as dengue fever, yellow fever, Zika and Chikungunya. The mosquitoes grow faster, live longer and reproduce the viruses faster in their bodies.

The outbreak in Indonesia fits into a global trend. According to the World Health Organization (WHO), the number of dengue infections has increased tenfold since 2000. In 2023, 6.5 million people were infected in 80 countries, of which 7,300 died.

Because most infections have a mild course, similar to flu, only a fraction of infections are recognized and reported. The WHO estimates that 100 to 400 million people in the world become infected every year.

Dengue fever is also becoming increasingly common in Europe

The virus is also on the rise in Europe. This happens from the south, which, according to researchers, also has to do with global warming. The WHO warns that there is no treatment for dengue fever and emphasizes prevention: cover the skin, use anti-mosquito spray or other products, install screens and remove any standing water from around the house.

The Indonesian government has now warned travelers to Bali about dengue fever. This happened after an Australian newspaper reported about tourists on IV drips in Ubud, a popular destination on the island.

The Indonesians themselves regard the dengue fever epidemic as a severe flu. Most of them spend a week sweating in bed with fever and red spots on their skin. A popular piece of advice (without further explanation): drink lots of guava juice. In the hospital, patients with serious complaints are given paracetamol and saline solution (intravenously) to prevent dehydration.

Young children are at greater risk of death

In rare cases, the patient’s nose and gums begin to bleed; a sign that blood vessels are leaking, eventually causing organ failure. Young children are most likely to die from dengue.

Wealthy Indonesians and tourists have recently been able to protect themselves by purchasing the new Qdenga vaccine from Japan for approximately 100 euros in a private hospital. This vaccine promises five years of protection against the four types of Dengue viruses that circulate globally (two injections three months apart).

Mosquito as a pesticide

The renowned Australian Monash University (Melbourne) has been experimenting with a specially bred mosquito as a pesticide since 2011. By injecting the eggs of the Aedes Aegypti in the laboratory with the Wolbachia bacteria, a common bacterium among insects, a mosquito is created in which the dengue virus cannot develop or has difficulty developing.

Another important property of Wolbachia: it gives itself a great advantage in reproduction. After just a few generations, research shows, almost all mosquitoes in a population have Wolbachia in their bodies.

The first Wolbachia mosquitoes were released in 2011 in the Australian city of Cairns. They can now be found in fourteen countries, including Indonesia, Vietnam, Brazil, and Colombia. As a result, 11 million people benefit from protection, says the World Mosquito Program, a non-profit partnership between Monash University, NGOs and philanthropic institutions such as the Bill & Melinda Gates Foundation.

Decrease of 77 percent dengue reports

The first scientific results came from the Indonesian city of Yogyakarta, where researchers found a 77 percent decrease in dengue reports and 86 percent fewer hospital admissions five years after its introduction (2014-2019).

However, it is not easy to get the mosquitoes to the right place. Although Monash produces tens of millions of injected eggs per week, volunteers all over the world then have to go into their countries to release groups of mosquitoes here and there, or one every 50 meters. mozzie box (a carton of eggs in a layer of water).

The World Mosquito Program has also recently started experimenting with drones that release cooled (sedated) mosquitoes in hard-to-reach areas. The flight altitude is very important; the mosquitoes have to wake up before they hit the ground.

What is also not easy: convincing residents that releasing tens of thousands of extra mosquitoes around their house, infected with a mysterious bacteria, is a good idea. According to the initiators, this requires two years of information and consultation before work can begin.

That preparation went wrong in the Balinese capital Denpasar, where the project was halted at the end of 2023 due to unrest among residents. The acting governor of Bali province ordered additional scientific research into the dangers of the Walbachia mosquito.

Unnecessary, said Indonesian Health Minister Budi Gunadi Sadikin last week. According to him, concerns about possible dangers of the Walbachia mosquito are based on a misconception. The number of dengue cases is rising in Bali and elsewhere in Indonesia, the minister underlined, while the virus is under control in Yogyakarta.