This weeks feature : Médecins Sans Frontières Australia

June 2007

Cambodia: Dengue Outbreak overwhelms Takeo Provincial Hospital

Médecins Sans Frontières (MSF) is working closely with Takeo Provincial Hospital to fight a dengue epidemic. The Cambodian province of Takeo is among the most severely hit by this mosquito-borne disease, which is endemic in the country.

“This year the dengue epidemic started much earlier because of intermittent rains and the heat which created a perfect environment for breeding mosquitoes,” says MSF’s head of mission in Cambodia, Philippe Berneau. “The central health authorities were caught off-guard and are now struggling to implement preventive measures that can help contain further expansion of the epidemics into the nine most affected provinces."

MSF began providing additional staff and offering materials last week when it became clear the hospital could not cope with the increasing flow of admissions.

“The shortage of staff in the provincial hospital was our most pressing concern. Only two nurses were working in the hospital doing twenty-hour supervision per day,” Philippe Berneau recalls. “With twenty children admitted daily, the staff was overwhelmed and got totally exhausted.”

The MSF team has brought in medical supplies such as needles, infusions and rehydration kits. In addition, the team has sprayed the paediatric ward with insecticide. And to help with the lack of space in the hospital MSF transferred some of the patients to other wards and prepares to supply an additional 40 beds.

In May, a total of 270 cases were recorded in Takeo. They included 80 cases of dengue fever, 175 people with dengue haemorrhagic fever and 15 children developed dengue shock syndrome, the most severe form of the disease. According to estimates of the World Health Organisation, up to one in five people infected will die if no proper and timely treatment is available.
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“ In rural areas such as Takeo, people tend to wait too long before they bring their children and the lack of transport and absence of a good referral system are serious challenges in case of complications,” explains Philippe Berneau. “The evolution of the epidemic will partly depend on the health authorities’ capacity to address these issues.”

MSF continues to assist in the treatment of patients in Takeo Provincial Hospital and urges health authorities to boost their prevention activities.

Dengue is an infectious disease transmitted by the bite of a mosquito and caused by four different types of viruses. Symptoms include muscle pains, high fever, nausea and intense joint pains.

Dengue Haemorrhagic fever is a more severe form. Bleeding and shock can occur and are potentially lethal if not treated, particularly in children.

There is no specific medicine for the disease but early diagnostic and treatment can prevent complications and death. The World Health Organization estimates there may be around 50 million cases of infections worldwide each year.

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