KUALA LUMPUR, Jan 1 — A dengue fever epidemic will hit Malaysia this year and cases are expected to peak next year and in 2025, experts reportedly warn.
The phenomenon is due to a “cyclical transmission of dengue fever” that occurs every three to five years, public health expert and epidemiologist professor Datuk Dr Lokman Hakim Sulaiman told the New Sunday Times.
“Based on observations over the past three decades, severe dengue outbreaks occur every four to five years.
“Last year was the beginning of the next major outbreak, which I predict will peak between this year and 2025,” he was quoted as saying.
The cycle is caused by the prevalent dengue serotype, Universiti Malaya’s epidemiologist and health informatician professor Datuk Dr Awang Bulgiba Awang Mahmud reportedly explained.
There are four serotypes of the virus that causes dengue fever (DENV-1, DENV-2, DENV-3 and DENV-4). All four are found in Malaysia.
Immunity to a serotype is gained through infection, but a person is still vulnerable to other serotypes.
“Cases will decrease as immunity builds up to one serotype.
“However, this downtrend is not permanent, and an uptrend is likely with a new serotype,” Dr Awang Bulgiba was quoted as saying.
He also reportedly spoke on the newly developed Qdenga vaccine by Tokyo-based pharmaceutical company Takeda, saying that it should be trialled before any decisions are made on its use to vaccinate the population.
Qdenga, according to Takeda’s website, was approved for use in Indonesia as of August last year.
“We should also consider a proper cost-benefit analysis of vaccination as, generally, dengue rarely results in death or long-term disability,” Dr Awang Bulgiba was quoted as saying.
He reportedly referred to issues of rollout with another dengue vaccine Dengvaxia in the Philippines.
“Whether antibody-dependent enhancement (ADE) will occur with the Qdenga vaccine remains to be seen and Malaysia needs to be cautious of this possibility.
“Even though Indonesia intends to use Qdenga, the same concerns about ADE have been raised,” he was quoted as saying.
On the other hand, public health expert and epidemiologist Datuk Dr Lokman Hakim Sulaiman reportedly suggested a pilot programme for the Qdenga vaccine in a small area as well as post-market surveillance.
“The cost of managing dengue runs into the billions in severe outbreak. One point for the Health Ministry to think about is what is the entry point for the vaccination if they decide to use it?
“The peak age group is between 20 and 30. It may be worth considering secondary school children, taking into account that human papillomavirus (HPV) vaccination is already required for 13-year-olds,” he was quoted as saying.
He reportedly added that running a mass dengue vaccination programme is not cost effective and should therefore be prioritised in high-risk urban areas.