A renewed commitment to surveillance, prevention and control
On 18 May 2002, the WHO World Health Assembly adopted a resolution urging Member States to strengthen surveillance, prevention and control and management of dengue and dengue haemorrhagic fever (see resolution).
The WHO Secretariat prepared a background report for this World Health Assembly, Dengue prevention and control. It describes the resurgence of epidemic dengue fever and the emergence of dengue haemorrhagic fever (DHF) as major public health problems and outlines the implementation of the global strategy for preventing and controlling dengue fever/DHF:
- strengthening epidemiological surveillance
- accelerated training and the adoption of WHO standard clinical management guidelines for DHF
- promoting behavioural change at individual, household and community levels
- accelerating the research programme.
In 2000, there was an international conference on dengue and dengue haemorrhagic fever in Chiang Mai, Thailand at which more than 700 public health specialists from 41 countries recommended that all countries at risk of dengue viral transmission should develop and implement sustainable prevention and control programmes. For more details, see Chiang Mai Declaration on Dengue/Dengue Haemorrhagic Fever.
In 1999, an informal consultation reviewed the 5 major componments of the strategy for the prevention and control of dnegue and DHF: selective integrated vector control, with community and intersectoral participation; active disease surveillance based on a strong health information system; emergency preparedness, capacity building and training; and vector control research.
It highlighted the need to strengthen and standardize disease reporting systems, using standard case definitions for dengue fever and dengue haemorrhagic fever. Under "reducing the disease burden", it was concluded that there is sufficient evidence on the reduction of dengue haemorrhagic fever case fatality rates through application of standardized clinical management practices to warrant an acceleration of capacity building and training in this field. The application of vector control methods, including source reduction, use of chemical larvicides and adulticides and of biological control agents is hindered by weak programme capacity, the absence of well-defined indicators and programme targets, and poor understanding of efficacy and cost-effectiveness of control measures particularly in terms of reducing transmission. The need to adapt and develop current and successful behaviour change interventions was urged as was the need for ministries of public health and communities to develop strong links with other key partners for a sustainable reduction in the risk of infection and burden of disease.
WHO Collaborating Centre Network
Many of the internationally important outbreaks involve the diverse group of arboviral diseases and viral haemorrhagic fevers. The WHO Collaborating Centres global network of centres for these diseases has collaborating centres in every WHO region and about one third of the centres in developing countries. These centres work in close partnership with WHO and Member States to investigate, confirm and control outbreaks. Through the WHO Collaborating Centre searchable database, information about those centres and laboratories dealing with specifically with dengue and dengue haemorrhagic fever is available.