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Dengue hemorrhagic fever in Malaysia: the 1973 epidemic
Abstract:
The first major Malaysian epidemic of dengue hemorrhagic fever with severe manifestations occurred in 1973, with 969 reported cases and 54 deaths. In a detailed study of 138 clinically diagnosed and laboratory confirmed cases at the General Hospital in Kuala Lumpur, hemorrhagic manifestations were observed in 68.7% and shock in 18.1% of the patients. The cases occurred mainly from May to September, largely in urban and suburban areas of the majority of the states in the country. A main focus of infection was Jinjang, a heavily populated outlying district of Kuala Lumpur, where unusually high incidences of morbidity, severe disease and mortality were seen. Severe disease was seen mostly in children under the age of 15 years, although a significant number of adults suffered milder illnesses. The Chinese population was chiefly affected, due to their living in crowded, low-income housing where the vector, Aedes aegypti, occurred in the greatest numbers. All four dengue types were recovered during the epidemic period, although dengue 3 (DEN-3) was incriminated as the major epidemic type. Entomological data revealed high indices of A. aegypti throughout the country and left little doubt that this epidemic was aegypti transmitted. Spraying and fogging operations were carried out in attempts to control vector populations.
Insights
Malaysia experienced its first major dengue hemorrhagic fever epidemic in 1973, primarily affecting children and the Chinese population in urban areas. Dengue type 3 (DEN-3) was the main culprit, transmitted by Aedes aegypti mosquitoes.
Area of Science:
- Epidemiology
- Medical Entomology
- Public Health
Background:
- The 1973 Malaysian dengue hemorrhagic fever epidemic marked a significant public health event with severe manifestations.
- Previous outbreaks were less severe, highlighting the unusual nature of this epidemic.
Purpose of the Study:
- To detail the clinical, epidemiological, and entomological characteristics of the 1973 dengue hemorrhagic fever epidemic in Malaysia.
- To identify risk factors and contributing elements to the epidemic's severity and spread.
Main Methods:
- Clinical case analysis of 138 laboratory-confirmed dengue hemorrhagic fever patients.
- Epidemiological investigation focusing on geographical distribution, seasonality, and demographic impact.
- Entomological surveillance to assess Aedes aegypti vector indices and transmission dynamics.
Main Results:
- The epidemic reported 969 cases and 54 deaths, with 68.7% experiencing hemorrhagic manifestations and 18.1% shock.
- Severe disease predominantly affected children under 15; the Chinese population in crowded housing showed higher incidence.
- Dengue type 3 (DEN-3) was identified as the primary epidemic strain, with high Aedes aegypti indices confirming vector transmission.
Conclusions:
- The 1973 epidemic was characterized by severe dengue hemorrhagic fever, linked to specific demographic and environmental factors.
- Effective vector control strategies targeting Aedes aegypti are crucial for preventing future severe dengue outbreaks in Malaysia.