Professor Leo Yee Sin, executive director of Singapore's National Centre for Infectious Diseases (NCID), stated on Wednesday that more attention must be devoted to seniors with dengue since they are at a greater risk of severe illness and death (June 15).
She spoke at the fifth Asia Dengue Summit, which was held at the Orchard Hotel from June 13 to 15 and organized by the Asia Dengue Voice and Action organization.
More than two hundred doctors, academics, government public health officials, and politicians from around Asia gathered to explore dengue control methods for the region.
Citing research from Singapore's Environmental Health Institute at the National Environment Agency, Prof. Leo stated that at least 30 percent of persons aged 60 and older in Singapore have never experienced a dengue infection.
Recovering from an infection with one serotype of the dengue virus confers permanent immunity against that virus serotype.
Prof. Leo stated, "As you can see, there is a substantial population in Singapore that is highly vulnerable to dengue."
Additionally, it is more difficult to detect dengue in the elderly, she noted. Prof. Leo said, with reference to a Taiwanese research, that elderly dengue patients exhibit less symptoms, including fever, aches and pains, and rashes.
In spite of this, the elderly have a greater likelihood of requiring admission to the Intensive Care Unit for dengue, as well as a higher prevalence of co-morbidities, such as hypertension and renal failure.
Prof. Leo said that elderly dengue patients have a greater mortality rate and are less likely to be able to bear the disease's toll due to their advanced age.
"We need to look very closely at ways to better manage elderly (dengue) patients," she added.
Another speaker at the summit, Dr. Shirin Kalimuddin, a senior consultant at the Department of Infectious Diseases at Singapore General Hospital, warned of the possible long-term implications of a dengue infection.
Noting that there have been few research on post-dengue chronic sequelae - the persistence of symptoms more than three months after infection - Dr. Kalimuddin, an assistant professor at Duke-NUS Medical School, stated that the disease's burden may be underestimated.
Dr. Kalimuddin and other researchers studied over 200 patients, a quarter of whom had dengue illness, in a study that is currently under evaluation.
18% of patients continued to experience symptoms such as tiredness, headaches, and decreased memory and focus around three months later.
In addition, they experienced functional impairment and a decrease in health-related quality of life.
Dr. Kalimuddin acknowledged that her research was conducted with a limited sample size and other constraints, but stated that it did raise some relevant concerns, such as whether vaccinations and treatments may be customized to treat not just acute but also chronic dengue symptoms.
A third speaker at the summit, Associate Professor Somia Iqtadar from King Edward Medical University in Pakistan, cautioned that dengue infection during pregnancy is connected with greater rates of maternal and perinatal death.
"There is a constellation of issues that might arise if a pregnant woman has dengue," said Prof. Somia, listing the likelihood of preterm labor, fetal discomfort, and miscarriages as examples.
"We require admittance and prompt illness care (for) infected pregnant women, since this is of the highest significance to preserve the lives of the mother and the fetus," she added, calling for a rigorous program created exclusively for the management of pregnant dengue patients.
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