Concerns Over Dengue Fever Endemic in Malaysia

The World Health Organization (2019), provides the advice and evidence needed for people to lead a healthy life. Good health requires commitment in a society. Therefore, we need to take steps to promote and protect health. These include being more active, eating healthy foods and avoiding tobacco and using alcohol. In addition, according to WHO (1986), explained that health is 'The source of daily life not the goal of life. Health is a positive concept that emphasizes social, personal and physical resources’. This means that health is a resource to support the functioning of individuals in the wider community. A healthy lifestyle gives us a good impact on our daily life.

Besides that, causes of the health and disease environment are pervasive and do not separate into the assessment, diagnosis, intervention, planning and components of nursing practice evaluation. However, environmental factors affecting health are often ignored by society. When environmental health problems are not taken care of disease is preventable and public health is poor. According to Rebecca (2007), from Florence Nightingale and Lillian Wald, recognize that the environment affects the health of the community.

Nurses play a role in controlling environmental hygiene factors (air and water quality, food, sanitation, hygiene, chemicals, pesticides, waste products). Everyone knows trained nurses don't just serve hospitals in the ward. Even this category of nurses also serves the community sector. This includes keeping the environment in a community. Nurses, who work in the community, work to help and improve the health of the whole population instead of caring for one patient at a time, including in the community. So, in International Council of Nurses (2003) opinion worldwide recognition of nursing professionals is an important role in the global health of the natural environment and is created by the medical remnants of recognizing real threats.

Nowadays, many infectious diseases are spreading worldwide. This is due to the many factors that cause this condition. Everyone knows that this infectious disease can be repeated and can be alleviated if the community can cooperate with each other. Often as the infectious disease epidemic arrives, we will hear news reports using specific terms such as endemic, epidemic, or pandemic to describe the outbreak rate of the outbreak. Among the most popular infectious diseases such as ebola, influenza, HFMD (hand foot mouth disease) in children and adults as well as many other infectious diseases. In the near future, dengue fever symptoms are becoming more common among Malaysian society. There are many cases of dengue in every state in Malaysia. This dengue fever attacks everyone including children.

All over the world in recent decades, the incidence of dengue has increased dramatically. Therefore, the actual cases of dengue have not been reported and many cases have been misclassified and in most cases not asymptomatic. Although the global burden of disease is too much to bear the full global burden, this explains the increase in the number of cases reported in recent years that initiated activities to record all cases of dengue fever. Other features include various serotypes of dengue virus in many countries including epidemiological diseases and hygiene and on human health, the global and national economies are impacted. From one place to another by tourists infected with the dengue virus. According to statistics on Update on the dengue situation in the Western Pacific Region (2019), which is in 2019 in the 26th week, 2 806 dengue cases were reported in Malaysia that included a death and 29 June 2019 brought the cumulative count to 62 421 cases including 93 deaths. In addition, 32 425 cases with 53 deaths were reported higher last year during the same period.

As Malaysians, every year we have been warned of dengue outbreaks. Dengue fever is a contagious disease of Aedes mosquitoes, usually breeding in stagnant water areas. It is important for everyone to eradicate Aedes mosquito breeding grounds because of the deadly dengue fever. In Malaysia, dengue fever is a contagious disease that continues to occur each year. Usually, dengue fever is an issue when we face the rainy season because Aedes mosquitoes have a place to breed. The prevalence of dengue fever is termed endemic, provided that the number of dengue fever cases does not increase and occurs at a rate similar to those of previous years. When the outbreak of an outbreak for a particular disease exceeds the expected number, the situation is no longer considered endemic. So, certain outbreaks start to infect a large number of individuals at a time, this situation is called epidemic. Then an outbreak has spread beyond the borders, the content situation is referred to as a pandemic. When an outbreak begins to reach a pandemic status, it is a very serious incident. WHO (2009) ascertained that in terms of global morbidity and mortality it is the most common human vector borne disease.

Dengue fever is a type of viral infection that spreads through infected Aedes aegypti mosquito bites. Viruses that can cause dengue fever have 4 types which is DEN 1, DEN 2, DEN 3 and DEN 4. Infection by one type of virus will give immunity to that type of virus only, if individuals live in dengue infections, they can be infected more than once in their lifetime. According to CPRC (2016), the main vector for dengue is the Aedes aegypti mosquito. Through bites of infected female mosquitoes, the virus is transmitted to humans. Once infected mosquitoes can spread the virus for a lifetime of 4-10 days after virus incubation. Then, Severson et al (2004) notes that, the main carrier is a symptomatic or asymptomatic person and even the infected mosquito acts as a source of virus. Dengue virus can transmit infections to infected patients a maximum of 12 for 4-5 days after their first symptoms appear through Aedes mosquitoes.

Mostly, Aedes mosquitoes breed in man-made containers and live in urban habitats. Daytime feeders such as aedes mosquito bites at peak times are early morning and before dusk, in the evening. Thus, Dye C (1986) revealed that at every meal, ae female aegypti bites humans. Then, in the breeding habit of aedes eggs can remain dry for a year and when in contact with water they hatch. According to Kyle and Harris (2008) discovered that in Asia, the secondary dengue vector has spread to North America and more than 25 countries in the European Region, aedes albopictus, the cause of the spread of tires used (breeding habitat) due to international trade and the spread through other goods like lucky bamboo. Also, ae. albopictus can survive in colder regions of Europe and adapt to cold conditions. Due to the tolerance to temperatures below freezing, hibernation and the ability to shelter in microbes are the means of propagation.

Furthemore, severe and deadly diseases are characteristic of dengue fever. For example, flu-like illness affects infants and children and rarely causes death for adults. It seems to Health Online Unit (2019), when high fever is at a temperature of 40 ° C / 104 ° F it is characteristic of dengue. Some of the symptoms of dengue fever include back pain, muscle aches and headaches. In addition, other symptoms of dengue such as joint pain, nausea, vomiting, swollen glands and rash are visible on the entire skin surface. After an incubation period of 4-10 days after the bite of the infected mosquito, the symptoms will last for 2-7 days. As a result of plasma leakage, fluid accumulation, respiratory cancer, severe bleeding, or organ disorders are potentially life-threatening complications of severe dengue (Barniol et al, 2011).

The first symptom associated with a temperature drop below 38 ° C / 100 ° F is a warning sign that occurs after 3–7 days. These include severe abdominal pain, persistent vomiting, rapid breathing, bleeding gums, fatigue, anxiety and bloody vomiting. Subsequent critical stages can kill in 24-48 hours. So, in order to avoid complications and risk of death there must be proper medical care. On top of that, for this dengue fever, there is no specific or specific treatment. Experienced doctors and nurses can affect patients suffering from severe dengue fever with medical treatment. This results in a decrease in mortality rates from 20% to less than 1%, which means that patients' lives can be saved. In addition, the care of patients with severe dengue requires adequate amounts of body fluids (WHO, 2012).

In fact, the use of vaccines in patients with dengue has not yet been used in Malaysia. However, from WHO (2017) described, Sanofi Pasteur licensed in December 2015 introduced and developed the first high-dose vaccine, Dengvaxia® (CYD-TDV). Then, authorities have approved regulation in endemic areas of people between 9-45 years old in which 20 countries can use this vaccine. Besides that, the WHO (April, 2016) mentioned the use of vaccines for areas where dengue is highly endemic as defined by seroprevalence of 70% or higher required for vaccination. Accordingly, retrospective serostatus at the time of vaccination was determined from additional analysis in November 2017. Later, seronegative at the time of the first vaccine analyzed showed a subset of trial participants had a higher risk of dengue and non-allocated participants compared to hospitalization than dengue (WHO, 2018).

Currently, to control or prevent transmission of dengue virus is a key method for combating vector mosquitoes in a variety of ways. For people suffering from dengue fever, they should take antipyretic medications according to a doctor's prescribed prescription. According from Malaysia Kini (2016), also for those with a fever, it is advisable to drink plain water to maintain body hydration. On top of that, melalui sumber mStar (2016), encourage the community to take precautions using abate powder to kill the larvae in the catchment according to syringe. An example is a 1 pack of 20 grams of abate powder and requires only 2 grams for 18 liters of water and can last 3 to 4 weeks. There are many steps we can take to address this, such as environmental management and modification to prevent mosquitoes from accessing egg habitats including cleaning domestic water storage containers weekly and clearing containers.

In addition, preventing vector mosquitoes by eliminating or reducing the breeding site of mosquitoes such as containers such as barrels, jars, empty pots, buckets, bottles, cans, tires, water coolers and many more can cause dengue fever. Additionally, for outdoor containers it is recommended that the public also apply for insecticides. Then, windows are installed and used in every home for the protection of personal households from mosquito vector carrying. In addition, the community is encouraged to install mosquito repellent while sleeping in the house (Mike, 2018). Next, wear long-sleeved clothing such as long sleeves and shirts for cover arms and legs when leaving the house, especially in the early morning or evening (CDC, 2018).

The most important thing is to get cooperation from all the people by doing gotong-royong activities as a catalyst to prevent dengue from spreading. Furthemore, as one of the emergency vector control measures, applied insecticides as spraying space during this dengue outbreak. To determine the effectiveness of this control intervention, vector monitoring and active monitoring should be performed. So, in order to prevent the symptoms of dengue occurring continuously before the transmission season (during and after the rainy season) and the time of the outbreak should increase efforts. Also can reduce the incidence of severe dengue deaths when the public has the awareness to combat the symptoms of dengue. The government or non-governmental organizations must also enforce the law for these dengue problems, such as imposing fines or penalties for those who commit crimes that cause dengue. An example of a common mistake people make is not to waste water in an open reservoir outside their home. In addition, certain parties, especially the community, can campaign against the dangers of dengue. This is because, as a whole, people will be more aware of the importance of preventing dengue symptoms from worsening.

In the end, i think there are many ways in which the main goal is to improve the health of the population by preventing illness and injury. So, the most important person is an Environmental Health Nurse who serves the community to focus on identifying environmental issues that could affect their health and well-being in the area. Take for example the symptoms of dengue as we discussed. The community also plays an important role in reducing this dengue problem. Therefore, the community should work with their environmental health nurses and other health personnel to address the problem. Cooperation is very important to each other so that the goal and objective is to achieve together to eradicate this dengue virus from the masses.

In conclusion, people need to be concerned about dengue. In fact, dengue may be endemic for a long time and major public health in Malaysia is still worried about dengue. I also hope that the surveillance system in Malaysia has made continuous and significant improvements and that there will be changes in the future. Therefore, when this happens it monitors the effects of dengue disease control in the future and understands the true burden of dengue. I urge all Malaysians not to take it easy on dengue. The effects of dengue can be fatal. In addition, I hope that all of us can adopt a healthy lifestyle so that we can live a quality and happy life.