Nagbabala ang Department of Health sa posibleng community transmission ng mpox sa Metro Manila. Sa ngayon, lima na ang naitalang bagong kaso sa bansa.
Bukod dito, nakapagtala rin ang DOH ng pagtaas ng kaso ng leptospirosis at dengue lalo na ngayong maulan ang panahon.
Nagpatupad na ng increased surveillance ang DOH para bantayan ang pagkalat ng mpox, pinaiigting na rin ng kagawaran ang kampanya kontra-dengue at leptospirosis.
Ang mga kasalukuyang health emergency sa bansa at iba pang isyung may kinalaman sa kalusugan, sasagutin ni DOH Secretary Ted Herbosa sa #TheMangahasInterviews.
Bukod dito, nakapagtala rin ang DOH ng pagtaas ng kaso ng leptospirosis at dengue lalo na ngayong maulan ang panahon.
Nagpatupad na ng increased surveillance ang DOH para bantayan ang pagkalat ng mpox, pinaiigting na rin ng kagawaran ang kampanya kontra-dengue at leptospirosis.
Ang mga kasalukuyang health emergency sa bansa at iba pang isyung may kinalaman sa kalusugan, sasagutin ni DOH Secretary Ted Herbosa sa #TheMangahasInterviews.
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NewsTranscript
00:00The spread of monkeypox, leptospirosis, and dengue, and the return of PhilHealth's money to the Treasury, let's talk about it with Health Secretary Teodoro Ted Herbosa.
00:18You can watch the entire interview on the YouTube and Facebook channels of GMA News Online. Good day, Dr. Ted.
00:25Good day to all of you. Good day to all of your viewers. I hope we can share knowledge about the various diseases that are spreading in our country.
00:37Dr. Ted is a graduate of biology at the University of the Philippines.
00:42He has a postdoctoral degree in training in Tel Aviv and in Geneva in epidemiology.
00:50He also became the Executive Vice President of UP Diliman.
00:55Thank you for inviting me, Dr. Ted.
00:57Let's start with the first concern of the public, monkeypox or mpox.
01:04What is the situation now? How many cases and what are your findings? How is this disease spreading?
01:11First, let's explain mpox. Monkeypox is the first name.
01:17Last August of 2022, the WHO declared a public health emergency of international concern.
01:25We were able to get, until December of 2023, one year later, nine cases of monkeypox here in the Philippines.
01:36All of them recovered. All of them have a history of travel. That means they were able to get it from other countries.
01:44Two weeks ago, the World Health Organization declared monkeypox again.
01:51Actually, the monkeypox declaration was lifted.
01:54At this time, they declared again because there was an outbreak in the Democratic Republic of Congo.
02:00They detected almost 2,000, 1,800.
02:04But they think there are more because this is the only thing that was detected in the laboratory test.
02:09There were children who died. This time, there were children who died and many women.
02:15Because the women were mostly sexually transmitted.
02:19So now the data is coming out, that's why there's an outbreak in the Democratic Republic of Congo or Africa,
02:27is that there's a new clade or variant. The clade is like a variant.
02:33There's a clade 1B, which is apparently more deadly.
02:38The mortality rate is higher.
02:40Because of this, the WHO was afraid and declared that there's an ongoing outbreak in Congo and the nearby countries, about eight countries.
02:49They said this is a public health emergency of international concern.
02:53When we got that, the doctors also started testing.
02:57When they saw mpox-looking diseases in their clinics, the RITM received test samples.
03:05The first five test samples, one of us tested positive.
03:09He tested positive but he was sent home from the hospital.
03:15His symptoms are mild and this is the clade 2, which is the original.
03:21This is not the new 1B.
03:23So let me stay clear, the 1B has not yet arrived in the Philippines.
03:29Yesterday, we declared another two.
03:32There were about 30 tests.
03:35Many tested negative.
03:37The other tests that looked like mpox did not turn positive.
03:42There are two more that were added.
03:44Both of them are male.
03:49Two of the three are persons living with HIV.
03:54But all of them are clade 2.
03:59This is the mild malu.
04:01This is not the more deadly variant.
04:05This is not the more deadly.
04:06The nearest more deadly is Bangkok.
04:10Thailand reported two days ago that a clade 1B was added to their positive test.
04:19This is from Congo or Africa.
04:22So it's important.
04:23So it's not yet.
04:24Now for us, the three cases, the significance of malu is that we have community transmission of the original virus.
04:35The mpox clade 2.
04:37So that means we have continued transmission.
04:40So what we should do is to be careful because it's spreading.
04:45This is where I discovered that there are spas that are very popular,
04:50that have parapians in them.
04:52This is where we got our first case.
04:55When this was detected, we told the local chief executive.
04:59It looks like he got it from a spa.
05:02The spa was closed because there was no business permit.
05:05Dr. Ted, to be more clear, it looks like a clade, but there are other symptoms.
05:10What should they watch out for?
05:12If they have initial symptoms, what should they do?
05:16The first symptom, like this one where we first detected mpox, we did contact tracing.
05:23So we informed the people in the area that they have mpox because there are two of them with sexual contact.
05:34So they were informed and they are being watched.
05:37The good news is that this clade 2, the nine that we first saw, none of them infected their family members or any other people.
05:46They did not transmit, they recovered and isolated.
05:50So I think it's easy for us to control this.
05:52As long as people know that this is a disease, you will also get infected.
05:57After you get infected, you will have itching, and then the clade will come out.
06:01First, it will be rash, then it will be like water, like chicken pox.
06:07But it doesn't look like chicken pox.
06:09It's like herpes zoster.
06:12There are clades.
06:13But this is usually found in private parts.
06:18It can also be found on the face, palms, and body.
06:21As long as you have it and you're not sure, our suggestion is to consult a doctor.
06:27We have already identified the doctors.
06:30Usually, they go to a derma, to a skin clinic because skin is the problem.
06:35Then we taught them how to get a sample and send it to RITF.
06:40Capacities for testing are increasing.
06:43PCR test fell like the COVID PCR test.
06:47But the cartridge is different so we need to get more tests.
06:51Our capacity is limited.
06:53Our other test kits expired and we need to buy more.
06:58This is what DOH is preparing for our country.
07:02Is there an initial remedy or first aid?
07:06You said that if you go to a dermatologist, you might not be able to detect it right away.
07:11What is the dangerous point that they need an emergency?
07:17As long as the vesicles have water, they are very infectious.
07:22The moment you have those symptoms, even if you're not a dermatologist,
07:27any doctor will... because we inform all doctors about this new public health emergency of international concern.
07:35It's important to confirm and test.
07:38That's what we are recommending.
07:40As you can see, the transmission rate is not that high.
07:46We have cases of B.
07:49But what can we do to avoid community transmission?
07:56The transmission of MPAX is through close and intimate contact.
08:02Including sex.
08:04But we have seen in Africa, it can also be caused by the sharing of towels and clothes.
08:11So you can touch somebody.
08:14But the likelihood is lower.
08:16But the real spread is skin to skin.
08:19What will be the number of days before there is an outbreak?
08:23Because you said that if there is a boutique...
08:25Intubation.
08:26That's the intubation period so that people can also know.
08:29Once you're exposed, it's anywhere from 7 to 21 days.
08:34As far as 30 days, you can still get infected.
08:38So the range is long.
08:40So you really need to monitor for a longer period of time after you're exposed to a positive disease.
08:47Maybe our countrymen will know.
08:51These three, right?
08:53Maybe per person, we can identify 40 that they list as their close contacts.
09:01Our contact tracers also call them and inform them that you have a positive case.
09:08Observe.
09:09Initially, you will not be quarantined.
09:12You will be observed.
09:13And if you have a fever, headache, muscle pain, and vesicles, you will be examined.
09:19What are the medicines that can be taken to arrest a fever or develop intubation in a serious stage?
09:31So the usual, we recommend the usual medicine for a fever, paracetamol.
09:36But it has a medicine, tecoviramat, which is an antiviral.
09:40Unfortunately, it is not registered and available.
09:43So I am asking the WHO to provide this so we can have supplies.
09:50Of course, I will not fight in Africa because I'm sure this is needed.
09:55There is also a vaccine, Malu.
09:57There is a vaccine for mpox.
10:00It's coming from cowpox.
10:02But that's also what we talked about in a meeting with the WHO and other health ministers.
10:07We will distribute the vaccines to the countries that have an outbreak, which is Congo, Burundi, and the countries around them.
10:14So we can test the distribution.
10:16So we agree on that.
10:18We will wait.
10:19Although I have a queue.
10:21I think there are 2,000 vaccines.
10:242,500 doses.
10:27The ASEAN share.
10:28We call it the share of other countries in the vaccine for equity.
10:33So I have a queue there and we're doing the process so we can get it to the Philippines.
10:38Okay.
10:39Do we still need to close our borders or ban travel?
10:43No, the WHO did not require any border control.
10:49What we did, Malu, is we added questions on e-travel.
10:54So on e-travel, when you return to the Philippines, someone will ask,
10:59So you will be flagged if you put Democratic Republic of Congo.
11:06And then thermal scanning, we increased the temperature scan.
11:12And of course, if you have symptoms, we want people to be honest and go to our quarantine officers.
11:18They are wearing white uniforms at the airport.
11:20Those who are behind the thermal scan.
11:22If you are from Thailand or Congo and you think you might have MPAX,
11:28we will help you get tested so we can make sure that your symptoms are not MPAX.
11:35All right.
11:36Now, the three cases are all males.
11:39You said they are of age, middle age.
11:4330 plus, around 30-32 range, 33.
11:47Those are their ages.
11:48And it looks like it's common through intimate contact.
11:52And you said that you were surprised that there are SPAs,
11:56apologies to the preferences of our people on their leisure or lifestyle.
12:02But are there health permits for these SPAs to be clear?
12:08Because it might be unfair that they are not allowed to go to places.
12:14What we will do, even if they are at risk,
12:17those who work here, the SPA workers will be at risk also if we have a transmission.
12:23So we will educate them.
12:25We're distributing posters to warn people.
12:28We're also going to teach them, of course, the towels, bed sheets,
12:32things that you use in the SPA should be washed after the first client.
12:36And it should not be reused without soap and water.
12:40Soap and water will kill the MPAX virus.
12:43So it's very important that all linens and towels will not be shared if they are used.
12:49All right.
12:50And it's only in NCR right now, right?
12:53Yes.
12:54Two from Quezon City and one from Mandaluyong.
12:57So it's only in NCR.
12:59A chief of hospital reported a suspected case in Northern Samar.
13:05So we're awaiting the result of the test.
13:08When we heard from our fellow countrymen, health officers,
13:11let's just report those who tested positive.
13:14Because there are a lot of people getting tested.
13:16There are more negative cases than positive.
13:20So we prefer not to scare our fellow countrymen.
13:24I don't want what happened in Baguio,
13:27where there was a meningococcemia outbreak and a lot of children died.
13:31It turns out it's not a meningococcemia outbreak.
13:34It's just a coincidence that the children died of measles, pneumonia,
13:38and it was labeled as meningococcemia.
13:41We got fake news.
13:42So we are very careful about spreading fake news.
13:46And you too, my recommendation to our fellow countrymen,
13:49if you see something and you're not sure, please don't share.
13:53Verify it with your doctor friend first.
13:55Check the website of WHO, DOH, CDC to verify if it's true.
14:02There are a lot of people spreading fake news.
14:06Sometimes people want to share it right away.
14:08They think they're helping.
14:10No, we're just adding to the panic and anxiety of other people
14:15about the fake news that we spread.
14:18So think before you click.
14:20Think before you click.
14:21Because it's a coincidence.
14:23When they talk about it, of course, all the parents,
14:26father, sister, brother, are on red alert.
14:29I just want to ask, is it possible that there's a misdiagnosis that's happening?
14:34They say that there's an appearance of HIV AIDS, some symptoms.
14:39And there are also HIV AIDS cases that are diagnosed as tuberculosis.
14:46How can we prevent people from getting confused,
14:50like the one you mentioned that happened in Baguio?
14:55The very important thing is that HIV is a disease wherein the immune system weakens.
15:01If you don't have antiretroviral treatment or therapy,
15:07you're prone to all kinds of illness, impacts, TB.
15:12TB is the most common.
15:13That's why when we see someone with HIV who doesn't take medicine,
15:18later on we diagnose them to have TB.
15:21And then vice versa, if they have TB,
15:24that's why they're not getting better, they already have HIV positive.
15:28So that's really a coincidence.
15:31And that's why we're warning key populations,
15:33these are our populations that are at risk.
15:37Among themselves, be careful.
15:41We feel those that are high risk,
15:44the most important thing is to be literate or have knowledge
15:48on how to spread these diseases.
15:50And we can prevent it.
15:51That's the good thing.
15:52We can prevent it.
15:53For those who are young,
15:55tigdas and bulutong,
15:58during the summer period,
16:02there are a lot of cases.
16:04How can we make a difference?
16:06The eyes of mothers and fathers that it's not mpax,
16:10maybe it's tigdas or bulutong.
16:13That's right.
16:14Mpax is the offspring of smallpox.
16:18Smallpox has been eradicated for a long time.
16:21Chickenpox, herpes zoster,
16:24those are the offspring.
16:26Varicella zoster and herpes zoster,
16:29those are the offspring.
16:32Both of these diseases, measles, chickenpox or bulutong tubig,
16:38and herpes,
16:40those are preventable with vaccines.
16:43We call them vaccine preventable diseases.
16:47We have a national immunization program
16:51where children can receive nine vaccines that are vaccine preventable.
17:00When we came from the outbreak in Barb,
17:04because there were a lot of children there who were not vaccinated with measles,
17:07we made a measles outbreak response immunization
17:11and we were able to vaccinate 1.2 million children
17:15with the help of health workers in Barb.
17:18So the spread of measles was confirmed there.
17:22It's the same here in Pertusis.
17:25Do you remember a few months ago,
17:27all the towns had an outbreak of Pertusis.
17:31So we did a catch-up immunization.
17:34We got the pentavalent vaccine.
17:37There are five vaccines,
17:39measles, mpax, rubella, DPT, diphtheria, pertusis, tetanus.
17:44Those are five vaccines.
17:46We pushed to give all children below six years old.
17:51Actually, below two should be given.
17:54Two doses are needed.
17:56Of the many children we targeted to be vaccinated,
17:59what is the coverage that you have achieved now?
18:03If you're saying there are a lot of vaccines,
18:06how many percent of our children below six years old are fully immunized?
18:11Our record is 61%.
18:14It should be 95%.
18:16That means a lot of children are not available for vaccination.
18:21In Malu, we have zero-dose children.
18:26These are the children who were not able to receive even one more vaccine.
18:30Zero-dose.
18:31Other children who were given the first dose are okay.
18:34They are protected even partially.
18:36Before, we were number four in the world
18:39in the number of zero-dose children.
18:41But because of the efforts of the DOH,
18:44we went down and were no longer in the top five.
18:47So we pushed the efforts of the health workers.
18:51The problem is we are number six.
18:54But slowly, Malu, I feel we can get out of the top ten.
18:58Is there a lack of vaccines, supply, health centers, or funds?
19:03Usually, it's the system.
19:07I think it's the logistic supply chain management.
19:11They said that when the mother goes to the health center,
19:15the day she's free, there's no vaccine.
19:18I said, what is this?
19:21You go to any island in the Philippines, there's soft drink, beer, cigarette,
19:27you go to Sari-Sari store.
19:28Why is it like that?
19:29There's a system.
19:31As I said, it's a soft drink company willing to bring with their trucks
19:36our vaccines to the farthest places.
19:40All right.
19:41Of course, it's hard to bring a bag if you're traveling for a long time.
19:47That's right.
19:48It's really hard because it's a logistic issue in the province.
19:52What I call that, Malu, is the hidden cost of healthcare.
19:57We've analyzed that.
19:58There's a vaccine in the health center,
20:00but they're spending P100 for two passengers, P50,
20:06and traveling for an hour to reach the health center.
20:10Sometimes, they need that money for food.
20:13Sometimes, there's no one to take care of the other siblings,
20:18the 4-year-old, 5-year-old.
20:20They'll bring the new child, but there's no one to buy.
20:23It's really hard.
20:25As I said, let's go to each province to find out who's not vaccinated
20:30and house-to-house.
20:32Because it's expensive.
20:34If you've been to the islands in the Philippines,
20:36in the provinces, the health center is really far.
20:39Right?
20:40Usually, it's far.
20:41Or sometimes, they don't even know where the health center is.
20:44Or what day the doctor or nurse is there.
20:47Yes, that's right.
20:48Or if the vaccine is available.
20:50That's our difficulties there.
20:52We call it the hidden cost of healthcare.
20:55Unless you bring it, you won't be vaccinated.
21:00So my order to the DOH is to partner with the barangay health worker
21:04and go to Purok.
21:06I call it Purok Kalusugan.
21:08Go to Purok.
21:09There are Purok leaders there.
21:11They know who are the children under six in one area.
21:14They know who are the pregnant mothers.
21:17They know who are the elderly with diabetes and hypertension.
21:21Let's partner with them.
21:22And then, let's offer the health services.
21:25It's a different mentality because before,
21:27they were just waiting at the health center.
21:30If that's the case, if there's no massage,
21:32there's no time,
21:33they won't go there.
21:35If you go to a house,
21:37you'll say,
21:38you'll get vaccinated.
21:39We heard that you're two years old.
21:41Here, we brought the vaccine.
21:43You'll be able to talk to the grandmother.
21:45You'll be able to talk to the mother.
21:47Sometimes, the other siblings.
21:48You'll see that the siblings are malnourished.
21:50You'll see that the grandmother has diabetes and high blood pressure.
21:53There's no medicine.
21:54You'll see that the father has TB.
21:56Right?
21:57I want to go back to that time
21:59when doctors and health workers really went to their homes.
22:03The Purok leaders know all of that.
22:05Okay.
22:06You have a lot of solidarity, Doc.
22:08I saw that there was an issue with leptospirosis.
22:13I heard that the number is lower so far.
22:172,100.
22:18Last year, it was 2,300.
22:20Same period.
22:21But how can we avoid this?
22:24The Philippines or Metro Manila and other big cities will be affected
22:30if there's a typhoon.
22:32Those are the numbers you're talking about.
22:35Those are the numbers from January to August.
22:37Correct.
22:38But our numbers after Carina and Habagat,
22:41when the president and I went around,
22:44the flood, the state of calamity,
22:47we recorded more than 700.
22:50More than that?
22:51Yes, 700.
22:53And of that 700,
22:55around 30 died.
22:57And the worst,
22:59around one-third were children.
23:02Those I saw were swimming.
23:04So I said,
23:06maybe children should be prohibited from swimming
23:09and swimming in the flood
23:10because it's high risk for leptospirosis.
23:12You know, leptospirosis is a vector-borne illness.
23:15It's like a plague.
23:16What spreads there is the flood.
23:19That's why the flood is increasing.
23:22And this is National Capital Region.
23:24Because our solid waste management is not up to par.
23:29Our surroundings are dirty.
23:31In fact,
23:32I'm sure when you were a kid,
23:34you saw Metro Manila.
23:35It's clean.
23:36So what happens is,
23:37when you drive around Metro Manila,
23:39you'll see that all the garbage is piled up in one corner.
23:42And when it rains,
23:43that pile
23:45is where the flood comes from.
23:48Because there's food in the flood.
23:50Then the flood increases.
23:51So when your child is swimming,
23:53he's swimming in the flood.
23:55And of course,
23:56after one week,
23:57the child has leptospirosis.
23:58Right.
23:59So this transmission,
24:00the flood is a vector?
24:02Yes.
24:03So it's like a plague?
24:06Yes,
24:07because leptospirosis lives in the blood
24:10and spreads to the uterus
24:12and to the bloodstream.
24:14Dr. Ted,
24:15what should they monitor?
24:17Symptoms?
24:18And what should they do immediately
24:21when there's leptospirosis?
24:23Yes,
24:24leptospirosis is also like a flu.
24:26You get sick,
24:27but the uterus really can't move.
24:29It's just lying down.
24:30And that's what we noticed.
24:32Because I've been the head of the emergency department for a long time.
24:35We have a diagnosis that was brought to us late.
24:38The eyes turn yellow,
24:40and the kidneys shut down.
24:42So by the time that happened,
24:44we needed to dialysis it.
24:46It also needed to be put in the ICU.
24:48That's why I'm pushing for lepto.
24:51Because number one,
24:52the mortality rate is high.
24:54Almost as high as 10%
24:56can die from it.
24:58So you see,
24:5930 died out of 700.
25:01And then,
25:02it's expensive.
25:03That's why we discovered lepto.
25:05The executive director of NKTI called for help.
25:09Because he already converted his basketball court
25:13with 40 patients.
25:15And he also has other patients in the ICU.
25:18So,
25:19if you're in the ICU,
25:21you need one nurse to take care of two critically ill patients.
25:25So you can't just have one nurse in 10.
25:27You really need to have a tutor.
25:29Then,
25:30you need to dialysis it three times a week.
25:32The cost of one patient with lepto
25:35is almost 300,000.
25:37The government is paying for it.
25:40We can prevent it from spreading.
25:41Not only that,
25:42you can die
25:43if you're caught in lepto.
25:45So,
25:46it's very important for them to understand
25:48that this call I'm making
25:50is for parents only.
25:52Just stop the kids
25:54from swimming in the river.
25:55They say,
25:56it's clean,
25:57but it's dirty.
25:58Actually,
25:59it's not clean.
26:00Everyone is swimming in the river.
26:02It's the river water that's overflowing.
26:05So,
26:06it's really dirty water.
26:07Our countrymen need to be educated.
26:10But in your 700 cases,
26:12did you profile them?
26:14Who are the affected?
26:15Most of them are poor.
26:17What do you do?
26:18Well,
26:19they're in a public hospital.
26:21I also have a friend who's a doctor
26:23and has lepto.
26:24His story is different.
26:26He lives in Marikina.
26:28He evacuated his house.
26:31But he came back
26:32after the flood.
26:33He didn't drown in the flood.
26:35But he cleaned his house's gutter.
26:37He has lepto.
26:39After two weeks,
26:40he had lepto.
26:41So,
26:42it can also be in the gutter,
26:43not just in the flood.
26:45So, it's really important
26:46to have boots
26:47if you're going to clean your house.
26:48We also have cases in PGH.
26:51He had lepto,
26:52but he didn't drown in the flood.
26:54Our theory is,
26:56he drank from a can of soft drinks.
26:59If the can is filled with blood,
27:02it can also cause lepto.
27:05So, our theory is,
27:06he got lepto
27:07from a can of soft drinks
27:09that was filled with blood.
27:11So, it's very important
27:12to have rodent control.
27:13It should be a program
27:15of our local chief executives.
27:17And it should still be cleaned.
27:19It's still cleanliness.
27:21I just want to ask,
27:22do you have an estimate
27:25because 20 typhoons
27:27visit the Philippines
27:29every year on average.
27:31So, that means,
27:32especially if our drains
27:34and our creeks
27:36have no place
27:38if the rainfall is strong,
27:40the cases of leptospirosis
27:42will increase again and again.
27:44Do you have an estimate
27:46like a medium-term plan?
27:47Or what you're saying
27:49is a whole-of-government approach?
27:51Yes.
27:52Well, I think
27:54it's part of public health
27:56because I already thought
27:58about this problem
28:00by the original director
28:01and undersecretary.
28:02Because every year,
28:03that's my only problem.
28:05When you find out
28:07what lepto is,
28:08it's a vector-borne illness.
28:10In public health,
28:13how do you control
28:14vector-borne illness?
28:15You control the vector.
28:17So, like in dengue,
28:19if you reduce the mosquito,
28:20the dengue will decrease.
28:21It's the same with lepto.
28:23If you reduce the dengue,
28:24the lepto will decrease.
28:26So, how do we reduce the dengue?
28:28Well, solid waste management.
28:31Let's fix it.
28:32Let's put them in containers.
28:34Make sure that it's not spread.
28:36And then, it has a cover.
28:38Or it can be disposed of
28:39and brought to the dump site
28:41or some place
28:43where it will be cleaned.
28:45There are a lot of
28:46suggestions, right?
28:48The illness that we're still
28:50concerned about
28:51when it comes to the public health system
28:53is dengue.
28:54What's the situation now?
28:55Has it increased in some places?
28:57And in other places,
28:58have they declared
28:59a public health emergency?
29:01Outbreak.
29:02We have students
29:03and municipalities
29:05that have declared
29:06because their cases have increased
29:08by more than 50%
29:09from the previous year.
29:11So, we're in the national
29:13like we're in the 30%
29:15according to the Epidemiology Bureau.
29:18Actually,
29:21it's dengue season.
29:23Usually, bare months
29:24is dengue season.
29:26September, October,
29:27November, December.
29:29And in our epidemiology curve,
29:32the dengue is really high.
29:34It almost disappeared
29:36during COVID.
29:38I thought COVID
29:39will completely disappear
29:40because maybe people
29:41are not moving.
29:43Maybe there's a little trash
29:44because everyone is at home.
29:46So, again,
29:48this is a mosquito.
29:49Mosquitoes are eating
29:51the water collected
29:52on the sides.
29:53And the mosquitoes are laying eggs
29:55there.
29:57So, to me,
29:58vector control.
29:59And if we know the season,
30:01let's take care of the kids.
30:03Buy insect repellent,
30:06mosquito repellent
30:07that they can spread
30:08so that they won't bite in school.
30:10Long sleeves or
30:12long pants
30:14so that they won't get
30:16mosquito bites.
30:19And make sure that
30:21other LGUs spray
30:23if there's a lot of mosquitoes
30:25during the season.
30:27So, that's what we're doing.
30:29The good news,
30:30Malu,
30:31hospitals used to be full
30:33during the dengue season.
30:35Now, we're able to control
30:37because we already have
30:39a rapid test,
30:40the NS1.
30:41So, my mom is panicking
30:43because we'll go to the emergency
30:45and we'll test the blood
30:47of her child.
30:48If it's dengue,
30:49we'll know if it's really dengue
30:51or not.
30:52Although it's not 100%,
30:54it also has false negatives.
30:56It can still be dengue.
30:58The case management,
31:00the early detection,
31:01and the danger point.
31:03Because as you said,
31:04there's something
31:05that needs to be monitored
31:06because it's also
31:07difficult to start.
31:09We've become better.
31:10You know,
31:11our mortality rate
31:12for dengue is
31:130.01, I think.
31:15It's just a little bit.
31:16Unlike when I was young,
31:17I died of HPV.
31:19Now,
31:20you can test
31:21and monitor.
31:23You'll be hydrated
31:24because good hydration
31:25is usually dehydrated.
31:27So, the sperm can be hydrated
31:28if you're vomiting
31:29and you can't eat.
31:30And,
31:31the platelet is monitored
31:32so that before it goes down,
31:34there's blood transfusion.
31:36So, it's self-limiting.
31:38In fact,
31:39I'm happy
31:40when I see
31:41the pediatricians
31:42who are already good
31:43at treating dengue.
31:44It's just important
31:45to go to the doctor
31:46right away
31:47because
31:48some will say,
31:49it's nothing,
31:50it's just a flu.
31:51But it's dengue.
31:52So, those are the late cases
31:53that cause problems
31:54in the ICU.
31:55There are complications.
31:57There are cerebral
31:58and cardiac complications
31:59in the end.
32:00But if it's early,
32:01you get checked right away,
32:03you get hydrated,
32:04you recover.
32:05Most,
32:0699% of dengue
32:07recovers.
32:08Alright.
32:09How many days
32:10does it take
32:11for the onset
32:12of the fever
32:13and the bruise
32:14to heal?
32:15Anywhere from
32:164 to 10 days.
32:17That's fast.
32:18That's faster.
32:19And,
32:20for the flu,
32:21as you can see,
32:22they have spots
32:23that are common.
32:24Like,
32:25the bruise
32:26that is a sign
32:27of dengue.
32:28So,
32:29it's very common
32:30if the doctors
32:31suspect
32:32that there are
32:33dengue rushes.
32:34Is the dengue
32:35bruise
32:36red and not
32:37blue?
32:38Yes,
32:39it's red
32:40and not blue.
32:41Yes,
32:42it's red.
32:43It's not watery.
32:44So,
32:45it's red
32:46like an allergy.
32:47Yes.
32:48Is it itchy?
32:49It's not itchy.
32:50It's itchy,
32:51but
32:52usually,
32:53it's not itchy.
32:54It's noticeable,
32:55especially
32:56in children.
32:57In the chest
32:58and here
32:59in the arms.
33:00The smell
33:01of white blood
33:02cells.
33:03The platelets.
33:04The platelets
33:05really
33:06go down.
33:07What period
33:08is
33:09your
33:10case?
33:11So,
33:12after some
33:13time,
33:14that's the
33:15time
33:16when the
33:17fever
33:18rises,
33:19that's the
33:20time the
33:21platelets
33:22start to
33:23drop.
33:24So,
33:25below
33:2610,000
33:27platelets.
33:28So,
33:29below
33:3010,000
33:31hemorrhagic
33:32dengue
33:33fever.
33:34So,
33:35hemorrhagic
33:36dengue
33:37fever.
33:38So,
33:39that's what
33:40we don't
33:41want to
33:42reach.
33:43And that's
33:44the one
33:45that has
33:46a high
33:47mortality
33:48rate.
33:49The
33:50profile
33:51of those
33:52who are
33:53infected with
33:54dengue,
33:55especially
33:56in the
33:57provinces
33:58with
33:59outbreaks,
34:00how many
34:01years
34:02are the
34:03children
34:04or groups
34:05vulnerable?
34:06So,
34:07the first
34:08dengue is
34:09going to
34:10be mild.
34:11But the
34:12second time
34:13you have
34:14dengue,
34:15it will
34:16activate
34:17the antibody
34:18response
34:19of your
34:20body.
34:21And
34:22this is
34:23the cause
34:24of the
34:25platelet
34:26count,
34:27capillary
34:28leak,
34:29dehydration.
34:30So,
34:31the second
34:32dengue
34:33is more
34:34serious.
34:36And
34:37usually,
34:38these are
34:39the children
34:40who are
34:419 years
34:42old and
34:43below.
34:449 years
34:45old,
34:46yes.
34:47You can
34:48get infected
34:49with dengue
34:50every year.
34:51What
34:52variety?
34:53We also
34:54monitor
34:55the predominant
34:56dengue
34:57for that
34:58season.
34:59So,
35:00I have
35:01that data
35:02as soon
35:03as we
35:04have
35:05that
35:06data.
35:07So,
35:08that's
35:09the
35:10reason
35:11why we
35:12have
35:13that
35:14data.
35:15So,
35:16that's
35:17the
35:18reason
35:19why
35:20we
35:21have
35:22that
35:23data.
35:24So,
35:25that's
35:26the
35:27reason
35:28why
35:29we
35:30have
35:31that
35:32data.
35:33So,
35:34that's
35:35the
35:36reason
35:37why
35:38we
35:39have
35:40that
35:41data.
35:42So,
35:43that's
35:44the
35:45reason
35:46why
35:47we
35:48have
35:49that
35:50data.
35:51So,
35:52that's
35:53the
35:54reason
35:55why
35:56we
35:57have
35:58that
35:59data.
36:00So,
36:01that's
36:02the
36:03reason
36:04why
36:05we
36:06have
36:07that
36:08data.
36:09So,
36:10that's
36:11the reason
36:12why
36:13we
36:14have
36:15that
36:16data.
36:17So,
36:18that's
36:19the
36:20reason
36:21why
36:22we
36:23have
36:24that
36:25data.
36:26So,
36:27that's
36:28the
36:29reason
36:30why
36:31we
36:32have
36:33that
36:34data.
36:35So,
36:36that's
36:37the
36:38reason
36:39why
36:40we
36:41have
36:42that
36:43data.
36:44So,
36:45that's
36:46the
36:47reason
36:48why
36:49we
36:50have
36:51that
36:52data.
36:53So,
36:54that's
36:55the
36:56reason
36:57why
36:58we
36:59have
37:00that
37:01data.
37:02So,
37:03that's
37:04the
37:05reason
37:06why
37:07we
37:08have
37:09that
37:10data.
37:11So,
37:12that's
37:13the
37:14reason
37:15why
37:16we
37:17have
37:18that
37:19data.
37:20So,
37:21that's
37:22the
37:23reason
37:24why
37:25we
37:26have
37:27that
37:28data.
37:29So,
37:30that's
37:31the
37:32reason
37:33why
37:34we
37:35have
37:36that
37:37data.
37:38So,
37:39that's
37:40the
37:41reason
37:42why
37:43we
37:44have
37:45that
37:46data.
37:47So,
37:48that's
37:49the
37:50reason
37:51why
37:52we
37:53have
37:54that
37:55data.
37:56So,
37:57that's
37:58the
37:59reason
38:00why
38:01we
38:02have
38:03that
38:04data.
38:05So,
38:06that's
38:07the
38:08reason
38:09why
38:10we
38:11have
38:12that
38:13data.
38:14So,
38:15that's
38:16the
38:17reason
38:18why
38:19we
38:20have
38:21that
38:22data.
38:23So,
38:24that's
38:25the
38:26reason
38:27why
38:28we
38:29have
38:30that
38:31data.
38:32So,
38:33that's
38:34the
38:35reason
38:36why
38:37we
38:38have
38:39that
38:40data.
38:41So,
38:42that's
38:43the
38:44reason
38:45why
38:46we
38:47have
38:48that
38:49data.
38:50So,
38:51that's
38:52the
38:53reason
38:54why
38:55we
38:56have
38:57that
38:58data.
38:59So,
39:00that's
39:01the
39:02reason
39:03why
39:04we
39:05have
39:06that
39:07data.
39:08So,
39:09that's
39:10the
39:11reason
39:12why
39:13we
39:14have
39:15that
39:16data.
39:17So,
39:18that's
39:19the
39:20reason
39:21why
39:22we
39:23have
39:24that
39:25data.
39:26So,
39:27that's
39:28the
39:29reason
39:30why
39:31we
39:32have
39:33that
39:34data.
39:35So,
39:36that's
39:37the
39:38reason
39:39why
39:40we
39:41have
39:42that
39:43data.
39:44So,
39:45that's
39:46the
39:47reason
39:48why
39:49we
39:50have
39:51that
39:52data.
39:53So,
39:54that's
39:55the
39:56reason
39:57why
39:58we
39:59have
40:00that
40:01data.
40:02So,
40:03that's
40:04the
40:05reason
40:06why
40:07we
40:08have
40:09that
40:10data.
40:11So,
40:12that's
40:13the
40:14reason
40:15why
40:16we
40:17have
40:18that
40:19data.
40:20So,
40:21that's
40:22the
40:23reason
40:24why
40:25we
40:26have
40:27that
40:28data.
40:29So,
40:30that's
40:31the
40:32reason
40:33why
40:34we
40:35have
40:36that
40:37data.
40:38So,
40:39that's
40:40the
40:41reason
40:42why
40:43we
40:44have
40:45that
40:46data.
40:47So,
40:48that's
40:49the
40:50reason
40:51why
40:52we
40:53have
40:54that
40:55data.
40:56So,
40:57that's
40:58the
40:59reason
41:00why
41:01we
41:02have
41:03that
41:04data.
41:05So,
41:06that's
41:07the
41:08reason
41:09why
41:10we
41:11have
41:12that
41:13data.
41:14So,
41:15that's
41:16the
41:17reason
41:18why
41:19we
41:20have
41:21that
41:22data.
41:23So,
41:24that's
41:25the
41:26reason
41:27why
41:28we
41:29have
41:30that
41:31data.
41:32So,
41:33that's
41:34the
41:35reason
41:36why
41:37we
41:38have
41:39that
41:40data.
41:41So,
41:42that's
41:43the
41:44reason
41:45why
41:46we
41:47have
41:48that
41:49data.
41:50So,
41:51that's
41:52the
41:53reason
41:54why
41:55we
41:56have
41:57that
41:58data.
41:59So,
42:00that's
42:01the
42:02reason
42:03why
42:04we
42:05have
42:06that
42:07data.
42:08So,
42:09that's
42:10the
42:11reason
42:12why
42:13we
42:14have
42:15that
42:16data.
42:17So,
42:18that's
42:19the
42:20reason
42:21why
42:22we
42:23have
42:24that
42:25data.
42:26So,
42:27that's
42:28the reason
42:29why
42:30we
42:31have
42:32that
42:33data.
42:34So,
42:35that's
42:36the
42:37reason
42:38why
42:39we
42:40have
42:41that
42:42data.
42:43So,
42:44that's
42:45the
42:46reason
42:47why
42:48we
42:49have
42:50that
42:51data.
42:52So,
42:53that's
42:54the
42:55reason
42:56why
42:57we
42:58have
42:59that
43:00data.
43:01So,
43:02that's
43:03the
43:04reason
43:05why
43:06we
43:07have
43:08that
43:09data.
43:10So,
43:11that's
43:12the
43:13reason
43:14why
43:15we
43:16have
43:17that
43:18data.
43:19So,
43:20that's
43:21the
43:22reason
43:23why
43:24we
43:25have
43:26that
43:27data.
43:28So,
43:29that's
43:30the
43:31reason
43:32why
43:33we
43:34have
43:35that
43:36data.
43:37So,
43:38that's
43:39the
43:40reason
43:41why
43:42we
43:43have
43:44that
43:45data.
43:46So,
43:47that's
43:48the
43:49reason
43:50why
43:51we
43:52have
43:53that
43:54data.
43:55So,
43:56that's
43:57the
43:58reason
43:59why
44:00we
44:01have
44:02that
44:03data.
44:04So,
44:05that's
44:06the
44:07reason
44:08why
44:09we
44:10have
44:11that
44:12data.
44:13So,
44:14that's
44:15the
44:16reason
44:17why
44:18we
44:19have
44:20that
44:21data.
44:22So,
44:23that's
44:24the reason
44:25why
44:26we
44:27have
44:28that
44:29data.
44:30So,
44:31that's
44:32the
44:33reason
44:34why
44:35we
44:36have
44:37that
44:38data.
44:39So,
44:40that's
44:41the
44:42reason
44:43why
44:44we
44:45have
44:46that
44:47data.
44:48So,
44:49that's
44:50the
44:51reason
44:52why
44:53we
44:54have
44:55that
44:56data.
44:57So,
44:58that's
44:59the
45:00reason
45:01why
45:02we
45:03have
45:04that
45:05data.
45:06So,
45:07that's
45:08the
45:09reason
45:10why
45:11we
45:12have
45:13that
45:14data.
45:15So,
45:16that's
45:17the
45:18reason
45:19why
45:20we
45:21have
45:22that
45:23data.
45:24So,
45:25that's
45:26the
45:27reason
45:28why
45:29we
45:30have
45:31that
45:32data.
45:33So,
45:34that's
45:35the
45:36reason
45:37why
45:38we
45:39have
45:40that
45:41data.
45:42So,
45:43that's
45:44the
45:45reason
45:46why
45:47we
45:48have
45:49that
45:50data.
45:51So,
45:52that's
45:53the
45:54reason
45:55why
45:56we
45:57have
45:58that
45:59data.
46:00So,
46:01that's
46:02the
46:03reason
46:04why
46:05we
46:06have
46:07that
46:08data.
46:09So,
46:10that's
46:11the
46:12reason
46:13why
46:14we
46:15have
46:16that
46:17data.
46:18So,
46:19that's
46:20the
46:21reason
46:22why
46:23we
46:24have
46:25that
46:26data.
46:27So,
46:28that's
46:29the
46:30reason
46:31why
46:32we
46:33have
46:34that
46:35data.
46:36So,
46:37that's
46:38the
46:39reason
46:40why
46:41we
46:42have
46:43that
46:44data.
46:45So,
46:46that's
46:47the
46:48reason
46:49why
46:50we
46:51have
46:52that
46:53data.
46:54So,
46:55that's
46:56the
46:57reason
46:58why
46:59we
47:00have
47:01that
47:02data.
47:03So,
47:04that's
47:05the
47:06reason
47:07why
47:08we
47:09have
47:10that
47:11data.
47:12So,
47:13that's
47:14the
47:15reason
47:16why
47:17we
47:18have
47:19that
47:20data.
47:21So,
47:22that's
47:23the
47:24reason
47:25why
47:26we
47:27have
47:28that
47:29data.
47:30So,
47:31that's
47:32the
47:33reason
47:34why
47:35we
47:36have
47:37that
47:38data.
47:39So,
47:40that's
47:41the
47:42reason
47:43why
47:44we
47:45have
47:46that
47:47data.
47:48So,
47:49that's
47:50the
47:51reason
47:52why
47:53we
47:54have
47:55that
47:56data.
47:57So,
47:58that's
47:59the
48:00reason
48:01why
48:02we
48:03have
48:04that
48:05data.
48:06So,
48:07that's
48:08the
48:09reason
48:10why
48:11we
48:12have
48:13that
48:14data.
48:15So,
48:16that's
48:17the
48:18reason
48:19why
48:20we
48:21have
48:22that
48:23data.
48:24So,
48:25that's
48:26the
48:27reason
48:28why
48:29we
48:30have
48:31that
48:32data.
48:33So,
48:34that's
48:35the
48:36reason
48:37why
48:38we
48:39have
48:40that
48:41data.
48:42So,
48:43that's
48:44the
48:45reason
48:46why
48:47we
48:48have
48:49that
48:50data.
48:51So,
48:52that's
48:53the
48:54reason
48:55why
48:56we
48:57have
48:58that
48:59data.
49:00So,
49:01that's
49:02the
49:03reason
49:04why
49:05we
49:06have
49:07that
49:08data.
49:09So,
49:10that's
49:11the
49:12reason
49:13why
49:14we
49:15have
49:16that
49:17data.
49:18So,
49:19that's
49:20the
49:21reason
49:22why
49:23we
49:24have
49:25that
49:26data.
49:27So,
49:28that's
49:29the
49:30reason
49:31why
49:32we
49:33have
49:34that
49:35data.
49:36So,
49:37that's
49:38the
49:39reason
49:40why
49:41we
49:42have
49:43that
49:44data.
49:45So,
49:46that's
49:47the
49:48reason
49:49why
49:50we
49:51have
49:52that
49:53data.
49:54So,
49:55that's
49:56the
49:57reason
49:58why
49:59we
50:00have
50:01that
50:02data.
50:03So,
50:04that's
50:05the
50:06reason
50:07why
50:08we
50:09have
50:10that
50:11data.
50:12So,
50:13that's
50:14the
50:15reason
50:16why
50:17we
50:18have
50:19that
50:20data.
50:21So,
50:22that's
50:23the
50:24reason
50:25why
50:26we
50:27have
50:28that
50:29data.
50:30So,
50:31that's
50:32the
50:33reason
50:34why
50:35we
50:36have
50:37that
50:38data.
50:39So,
50:40that's
50:41the
50:42reason
50:43why
50:44we
50:45have
50:46that
50:47data.
50:48So,
50:49that's
50:50the
50:51reason
50:52why
50:53we
50:54have
50:55that
50:56data.
50:57So,
50:58that's
50:59the
51:00reason
51:01why
51:02we
51:03have
51:04that
51:05data.
51:06So,
51:07that's
51:08the
51:09reason
51:10why
51:11we
51:12have
51:13that
51:14data.
51:15So,
51:16that's
51:17the
51:18reason
51:19why
51:20we
51:21have
51:22that
51:23data.
51:24So,
51:25that's
51:26the
51:27reason
51:28why
51:29we