Nina A. Loasana, Jakarta – The Health Ministry has urged the public to stay alert yet calm amid a spike in dengue cases and deaths across the country, with the rise expected to continue in the coming weeks.
As of March 23, health authorities recorded some 43,200 dengue cases and 404 deaths nationwide since the beginning of the year. The figure is almost triple that of the same period last year, when the country saw around 17,400 cases and 144 deaths.
Regions reporting the highest cases are the Tangerang and Lebak regencies in Banten, the West Bandung and Subang regencies in West Java and Kendari in Southeast Sulawesi.
But the worst is yet to come, as the wave of dengue infections has not peaked and will likely continue to increase in the coming weeks, according to the Health Ministry's disease control and prevention director Maxi Rein Rondonuwu.
"It seems like we'll continue to see a rise in dengue cases until the transition from the rainy to dry season is over," he said in a statement on Tuesday.
The Meteorology, Climatology and Geophysics Agency (BMKG) previously forecast that the seasonal transition period would take place between March and April.
El Nino effect
A viral disease, dengue fever is transmitted through the bite of infected Aedes aegypti and Aedes albopictus mosquitoes, which are commonly found in tropical regions such as Indonesia. The disease primarily occurs during the rainy season when mosquito populations thrive and breed in stagnant water.
The Health Ministry blamed the recent outbreak on a warmer rainy season triggered by the El Nino weather phenomenon, which has brought hot and dry air to the Indonesian archipelago. The warm temperature speeds up mosquitoes' life cycles, helping them grow faster and live longer, causing the disease to spread faster.
The increase in dengue cases has overwhelmed hospitals in various cities, such as Kendari, Bandung in West Java and Kudus in Central Java. Doctors in such cities have been forced to treat patients in hallways and wheelchairs.
Most people who get dengue do not show symptoms, or show only mild ones that get better in one to two weeks. But others can develop severe dengue that can be fatal, thus, these cases need treatment in hospitals.
Maxi urged the public not to panic, while ensuring that the national bed occupancy rate was still considered at a safe level.
"We still have beds available in regular wards as well as in the intensive care unit [ICU]," the director said.
Not enough prevention
Experts blame the recent dengue spike on inadequate prevention efforts by authorities to curb the disease.
"We've seen an increase in dengue transmission in several regions since November, but we didn't put serious efforts in to control the disease," said Masdalina Pane of the Indonesian Epidemiologists Association (PAEI).
"As a result, it has spread to more regions and cases continue to increase," she said.
Masdalina also slammed the government for "not showing a sense of urgency" and its lacking efforts to curb the disease, even as the disease has killed more than 400 people.
The government failed to provide the dengue vaccine in all health care facilities across the country. The relatively new vaccine is only available in big hospitals in major cities and is relatively expensive at between Rp 1 million (US$63.04) and Rp 3 million for two doses.
Previously, the communicable disease control and prevention director Imran Pambudi pointed the finger at the public's resistance to new technology to fight dengue and the lack of adherence to the decades-old "3M" campaign as challenges in preventing the disease.
The 3M campaign stands for menguras, menutup, mendaur ulang (draining water sources, covering water sources and recycling) to get rid of items that could potentially serve as breeding grounds for mosquitos.
Health Minister Budi Gunadi Sadikin said the ministry was in the process of purchasing larvicide to curb mosquito larvae and insecticide to kill adult mosquitos to control the disease transmission.
"But the public still needs to drain reservoirs that could potentially serve as breeding grounds for the Aedes aegypti mosquitos," Budi said last week. "It's also crucial to bring people who show dengue symptoms to the nearest health facilities as soon as possible."