In the last ten years, the Philippines experienced the 7th highest number of dengue cases in the world. And in 2015, it rose to epidemic levels with an average of 220 reported cases per day according to the World Health Organization (WHO). But this year, a new prevention tool in the fight against this high disease burden in the country has been introduced–the Dengue Vaccine.
Sanofi Pasteur, the world leader in human vaccines, brings light to the emerging perception about the Dengue Vaccine (commercially known as Dengvaxia®) via a press conference on Friday, October 21, in Dusit Thani Manila.
“Approval of the first dengue vaccine in Asia, which bears 70% of global disease burden, is a major milestone in dengue prevention and public health,” notes Olivier Charmeil, President and CEO of Sanofi Pasteur. “Approval of Dengvaxia® in the Philippines, following closely the first approval in Mexico, is further evidence of Sanofi Pasteur’s long-standing commitment to introduce this innovative new vaccine first in countries where dengue is a major public health threat.”
Dengue is a high-profile and ongoing public health concern in the Philippines. The first known epidemic of severe dengue or dengue hemorrhagic fever anywhere in the world was recorded in Manila in 1953. By the mid-1970s, severe dengue had become a leading cause of hospitalization and death among children in the region. Between 2004 and 2010, the Philippines experienced the seventh highest number of dengue cases in the world according to the World Health Organization (WHO).
2016 data suggests an increasing trend in reported dengue cases
In 2013, DOH reported 204,906 cases of dengue, the highest number recorded since the establishment of the National Dengue Prevention and Control Program in 1993. More than 200,000 dengue cases were reported in the Philippines in 2015, 80,000 more than were reported in 2014. In both September and October 2015, the number of reported cases rose above the epidemic threshold.
Although the number of reported dengue cases slightly decreased in 2014, the 2015 data suggest an increasing trend in cases in the coming years. Recent data gathered by the Department of Health from January to 24 September this year shows an increase of 11.5 percent year on year across the country, with total dengue infections at 142,247 compared to 127,525 last year and 604 recorded fatalities
Based on Philippine surveillance data collected between 2011 and 2015, an average of 220 dengue cases were reported in the country every day. In 2015, almost 50% of reported cases came from three most urbanized regions: Region 3 (17.6%), Region 4 (17.3%), and the National Capital Region (12.6%). Cases stemming from all four serotypes of dengue were reported in 2015.
Disease burden: US$345 million per year
The economic burden of dengue in the Philippines is substantial. A study published in 2015 estimated that between 2008 and 2012, clinically diagnosed dengue cases in the Philippines were associated with a direct medical cost (in 2012 US dollars) of $345 million annually. The study calculated the average cost of treatment per case to be $409, representing 16% of the Philippines’ 2012 per capita GDP. Sixty-five percent of cases were treated in inpatient hospitals, representing 90% of direct costs.
In addition to dengue’s burden on a household, the illness can adversely impact a country’s economy through a loss of productivity caused by the illness and pre-mature death, increased healthcare costs and a possible reduction in tourism.
Seasonality and global climate change
Dengue has become a year-round threat in the Philippines. However, data suggests that the number of dengue cases increases one to two months after the onset of the rainy season, resulting in a peak of dengue cases between July and November each year.
The Philippines is severely affected by extreme weather events and is vulnerable to the effects of climate change. Vector-borne diseases like dengue may be particularly sensitive to both periodic fluctuations and sustained changes in global and local climates. Additionally, a study examining data from eight Asian countries including the Philippines over 18 years revealed a strong correlation between regional dengue epidemics and elevated temperatures associated with El Niño.
DoH implements a step-wise public vaccination program in 2016
The Department of Health announced on January 4, 2016 that one million (1M) nine-year-old Filipinos enrolled in government schools in Region 3, Region 4-A and the National Capital Region will be the first beneficiaries of the government-procured dengue vaccine.
In a recent dengue vaccine cost-effectiveness study performed by Professor Hilton Lam of the UP-National Institutes of Health, a nationwide annual routine vaccination of nine-year olds starting in 2016 would lead to an estimated 24.2% reduction in dengue cases in the country over a five-year period. This would translate to 775,053 avoided cases of dengue, 502,000 avoided hospitalizations, 22,010 avoided deaths and almost Php 21 billion in avoided cost to society.