Health officials believe Puerto Princesa City and several towns in Palawan are currently experiencing dengue outbreaks as a result of two primary factors—the residents’ inadequate compliance with the 5S Strategy, and the insufficient proactive efforts by local government units to consistently carry out awareness campaigns aimed at preventing its spread.

Both Dr. Ricardo Panganiban, the chief of the City Health Office (CHO), and Dr. Erika Faye Labrador, the chief of the Provincial Health Office (PHO), believe that the dengue outbreaks in distant barangays of Puerto Princesa and towns in Palawan stem from residents’ complacency and reliance only on misting as a solution to eradicate the mosquito vectors.

“Complacent sila, at ang view ko pa nga, parang nag-e-expect sila lagi na pupuntahan—ang iba kasi yong misting, fogging, at pausok lang yong naiisip nila na solusyon. Yong iba nagsasabi na bakit hindi nagpa-fogging doon sa area,” emphasized Friday, July 7, by Dr. Panganiban, underscoring the importance of strictly adhering to the 5S Strategy.

“Sadly, sa ating pag-oobserba, yung feedback sa atin—hindi naman lahat—mayroon tayong iilan na hindi pa rin fully-committed into the 5S Strategy ang ating community. Ito ay napansin namin when we get yung ating environmental screening and vector mapping,” Dr. Labrador also said in a statement released by the Palawan Provincial Information Office (PIO) on the same day.

The previous strategy against dengue used to be 4S, but with the introduction of Sustain Hydration, it has been upgraded to 5S. The addition of the last S aims to highlight the role of local government units (LGUs) in setting up their own hydration stations to save lives.

5S urges the public to Search and Destroy the breeding grounds of the Aedes mosquitoes; Seek Early Consultation if an individual has been experiencing fever for two days; Secure Self Protection, which involves using mosquito repellents, bed nets, and wearing protective clothing that prevents mosquito bites; Support Fogging by spraying, misting, and using larvicides; and Sustain Hydration, or maintaining proper fluid intake to prevent dehydration, which is a common complication of dengue fever.

Dr. Panganiban stressed the critical importance of diligently practicing the strategies for the elimination of dengue and the prevention of further deaths among residents. Instead of relying solely on health offices to conduct fogging missions, he said that the proactive implementation of the 5S would be instrumental in achieving these goals.

“Dapat mahigpit ang pagsunod sa 5S Strategy para bumaba na ang kaso,” he added.

The increase in cases, he explained, may also be attributed to climate change.

According to some studies, as global temperatures rise, the geographical range of the Aedes mosquito, which carries the dengue virus, expands. Warmer temperatures also accelerate the mosquito’s breeding and maturation cycles, leading to increased populations and a higher risk of dengue transmission.

“Iniisip din natin kung ano ba talaga? Pero isa din yong weather—yong climate change malaki ang epekto niya,” added Dr. Panganiban.

Recent data presented by local health authorities shows that the number of dengue cases in the city and approximately six towns in Palawan has exceeded a significant count of over 3,270 and shows an ongoing upward trend.

Out of the total figure, Puerto Princesa accounted for 1,063 cases, with 12 fatalities reported in the first half of the year.

Benedict Basaya from the City Health Office (CHO) noted that in 2022, only 15 deaths were reported due to the viral infection. However, in 2023, with several months remaining, the death toll has already reached a dozen.

“Ngayon, ang namatay na sa atin, 12 agad. Yong 15 last year, yon na yong pinaka mataas na number ng mortalities ng dengue sa isang taon. Pero ngayon, kalahati pa lang ng taon, 12 agad. Ano na lang ang mangyayari sa kalahati ng taon pa?” Basaya asked during the launch of the “Search and Destroy” awareness campaign by the CHO at City Hall.

Prevention efforts
Dr. Panganiban acknowledged the existing outbreak in the city, but he advised against declaring a state of public health emergency. He expressed confidence in the ability of his office to handle the situation effectively, citing their sufficient funds allocated for activities aimed at reducing the number of cases to a more manageable level.

“Hindi ko na irerecommend [ang declaration ng state of public health emergency] kasi sa tingin namin enough naman yong funds na nandyan sa amin ngayon. Kahit na yong mga gamit, mga gamot, ay meron kami,” Dr. Panganiban pointed out.

Mayor Lucilo Bayron highlighted that one of the ongoing activities of the city government aimed at consistently raising awareness against dengue is the implementation of the Search and Destroy campaign. This initiative involves deploying CHO personnel to barangays with the highest dengue prevalence, with the purpose of reminding people about the crucial importance of practicing the 5S.

“One time, big time—yong mga barangay na mataas ang cases, yon muna ang haharapin natin,” he stated during his address to the barangay officials who attended the launching of the campaign.

He pointed out to the barangay officials that their support in the campaign is vital, along with their partnership with the CHO in the fight against dengue. By working together, they can make significant progress in preventing more people from succumbing to the disease.

On the other hand, Dr. Labrador has long recognized this fact, particularly in the towns of Taytay, Roxas, Brooke’s Point, Narra, Bataraza, and more recently in Araceli, where an imminent outbreak is looming.

Among these municipalities, Taytay reported the highest number of dengue cases, reaching a count of 1,079, followed by Bataraza with 425, Roxas with 413, Brooke’s Point with 322, and Narra with 202. She did not provide information regarding the number of dengue cases recorded in Araceli.

“Patuloy ang ginagawa nating mga hakbang upang masugpo at maiwasan ang sakit na dengue. As of this time, ang tinututukan natin ay ang bayan ng Araceli. Mayroon tayong augmentation na ginawa dito, nagpadala tayo ng team from the PHO, and ngayon ay nasa Araceli to have technical assistance, coordination meeting, and nakagawa na rin sila ng data validation, vector mapping, and yong ating information and education campaign sa ating mga community she said.

New variant?
Dr. Panganiban has put forward too the possibility that the surge in dengue cases may be linked to the emergence of a new variant.

This hypothesis suggests that the virus responsible for dengue fever could have undergone genetic changes, leading to a variant that exhibits altered characteristics or enhanced transmission capabilities.

“Baka ang nandyan sa atin ngayon, iba na rin ang variant,” he said.

“Kasi parehas din yan ng ibang virus—nagmu-mutate din yan. Puwedeng maging matapang yong virus,” added Dr. Panganiban.

He said they have collected samples and sent them to the DOH for studying, aiming to determine whether a new variant is present.

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has been with Palawan News since January 2019. She is its managing editor, overseeing and coordinating day-to-day editorial activities. Her writing interests are politics and governance, health, defense, investigative journalism, civic journalism, and the environment.