During the National Research and Development Conference 2019 convened by the Department of Science and Technology at the Philippine International Convention Center, a team of researchers reported that they are already doing the Phase 1 clinical trials on a herbal medicine that can hopefully cure dengue.
Dr. Rita Grace Alvero, a pharmacologist-epidemiologist from the De La Salle Medical and Health Sciences Institute who led the study and presented the findings, pointed out that “they were determined to pursue the full drug-development process to make the breakthrough drug to help cure and stop deaths from dengue,” the Philippine Star reported.
The potential dengue drug, which was formulated from a cocktail of three endemic plants, will be available by the end of 2020. “We’ve done the pre-formulation tests, we’ve done animal studies, we’ve tested for efficacy,” The Star’s Rainier Allan Ronda quoted Alvero as saying. “We’ve done the capsule, we’ve documented the efficacy results.”
The result is very encouraging. “It was given to patients with very, very low platelet counts who are bleeding already,” Alvero reported. “It reversed [the progression of the disease], and improved the well-being [of the patient].”
But instead of being enthusiastic, Davao-based Dr. Richard T. Mata seemed to be reluctant with the findings. “Plasma leakage is the problem in dengue that causes severe internal dehydration,” pointed out Dr. Mata, a dengue consultant with the World Health Organization (WHO) Philippines.
He acknowledged the team for doing such extensive study but suggested, however, that what “they need to do” is “to replicate plasma leakage in animals and then try to cure it.”
According to Dr. Mata, Thailand and Sri Lanka have zero casualties when it comes to dengue (compared to 1,000 deaths annually in the Philippines). “These countries never said they got a drug from an herb; they said it’s about correct fluid management,” he said.
Research in the aforementioned countries is focused more on fluid management. In comparison, most Filipino researchers are “focused on herbs, which are actually or are already being used by many, but still the deaths are high,” Dr. Mata lamented.
Once taken for granted, dengue is indeed lethal. Six-year-old Lenny was struck with fever one night after two days of rain in the town of Bansalan. But there was something different; she appeared flushed. She was irritable and had poor appetite, although she never complained about food. Sarah, the mother, observed that her daughter’s flushed skin had some white areas, but she just ignored it.
Sarah thought the fever was just ordinary, so she didn’t bring her daughter to the doctor and instead gave her paracetamol, which she believed would help subside the fever. The fever indeed vanished one day only to return the following day. On the seventh day of on and off fever, Lenny experienced what most doctors called as “shock.”
“Lenny was breathing rapidly,” Sarah recalled. “She was restless, and her pulse was beating fast. Her skin was cold and clammy, and she felt drowsy all the time. She was vomiting, and blood was oozing from her mouth. Before long, she completely lost consciousness.”
Sarah brought her daughter to the nearest hospital, some 30 minutes away from home. One of the doctors tried to pull Lenny out of shock by replacing the fluids and blood she lost, but it was all in vain. The doctor failed to save her.
Lenny died of dengue, one of the most widespread mosquito-viral diseases in the world. “After a dengue patient has gone into shock,” explained the doctor who tried to save Lenny, “it is just a matter of time before multi-organ failure occurs and death becomes inevitable.”
Bansalan is in Davao del Sur, one of the provinces in Davao region to be included as a “hot spot” in the Dengue Surveillance Report of the Department of Health. Davao del Norte, Davao Oriental and Compostela Valley also made it to the list.
Other dengue hot-spot provinces listed in Mindanao were Zamboanga del Sur, Bukidnon, Lanao del Norte, Lanao del Sur, Misamis Oriental, South Cotabato, Agusan del Norte and Surigao del Norte.
Also included among the dengue hot-spot provinces were Aurora, Bulacan, Isabela, Batangas, Cavite, Laguna, Nueva Ecija, Rizal, Occidental Mindoro, Oriental Mindoro and Romblon in Luzon and Negros Occidental, Negros Oriental, Cebu, Bohol and Samar in the Visayas.
Within three months (from January 1 to March 30 of this year), the health department reported 55,976 dengue cases. The figure was higher compared to dengue cases recorded in the same period last year: 31,247.
The number of deaths was also higher: 227 this year compared to 168 last year. Most of those deaths were recorded in Central Visayas (37), followed by Western Visayas (27), then Cagayan Valley (22) and finally Calabarzon (20).
The higher figure of dengue cases and deaths is inevitable. As Health Undersecretary Eric Domingo told reporters in Manila: “It really seems were seeing a lot of cases this year. It’s the natural cycle. Two years with low cases, one year with high cases. It looks like this is that year.”
The dengue virus is transmitted to human beings through the bites of infected female mosquitoes. “After virus incubation for four to 10 days, an infected mosquito is capable of transmitting the virus for the rest of her life,” the WHO states in its web site.
However, it is the infected humans who are the main carriers and multipliers of the virus. This is the reason if there is someone in your neighborhood who has dengue, it is most likely that more people will become infected. “Patients who are already infected with the dengue virus can transmit the infection [for four to five days; maximum 12] via Aedes mosquitoes after their first symptoms appear,” the WHO says.
According to the UN health agency, dengue should be suspected when a high fever is accompanied by two of the following symptoms: severe headache, pain behind the eyes, muscle and joint paints, nausea, vomiting, swollen glands or rash.
“Symptoms usually last for two to seven days, after an incubation period of four to 10 days after the bite from an infected mosquito,” the WHO states.
Dengue fever “seldom causes death,” WHO points out, but it becomes deadly when it develops into severe dengue, “a potentially deadly complication due to plasma leaking, fluid accumulation, respiratory distress, and severe bleeding or organ impairment.
“Warning signs occur three to seven days after the first symptoms in conjunction with a decrease in temperature and include: severe abdominal pain, persistent vomiting, rapid breathing, bleeding gums, fatigue, restlessness and blood in vomit,” the WHO says.
Once those symptoms appear, the next 24 to 48 hours of the critical stage can be lethal. “Proper medical care is needed to avoid complication and risk of death,” the WHO urges, adding that “maintenance of the patient’s body fluid is critical to severe dengue care.”
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