On the afternoon of the 2nd of September, the Centers for Disease Control convened a meeting and review of suspected dengue fever deaths. Su Yi-Ren acted as the convener and the host of the meeting, and other committee members included Director Chuang Yin-Ching (Liouying Chi Mei Hospital), Director Liu Ching-Chuan (Director of Pediatric Diseases, National Cheng Kung University Hospital), Director Chen Yao-Sheng (Director of Internal Medicine, Kaohsiung Veterans General Hospital), and Director Liu Chien-Wei (Director of Infectious Medicine, Kaohsiung Chang Gung Memorial Hospital). The committee completed reviews of 11 deaths that initial reviews had indicated were possibly caused by dengue fever. The review confirmed that the primary cause of ten of these deaths was dengue fever. Most of the ten patients had a history or latent history of chronic diseases such as high blood pressure, diabetes, chronic kidney disease, or cancer, all of which are listed in the WHO guidelines as high risk groups for contracting dengue fever and must be carefully observed. Along with the ten dengue fever deaths that have accumulated over the summer, seven more are awaiting review, and two cases have been rejected. The Centers for Disease Control calls on clinicians to quickly report patients with suspected dengue fever and carefully observe patients for dengue fever symptoms while providing appropriate clinical treatment. 

According to the WHO’s 2009 guidelines on dengue fever, suspected dengue fever patients with latent disease factors and specific social economic situations, such as diabetes, kidney failure, chronic hemolytic disease, obesity, or pregnant women, infants, elderly people, and people living alone or in rural areas, are high risk groups for dengue fever. These patients should be hospitalized and progression of the disease should be monitored. Furthermore, if dengue fever patients exhibit warning signs such as abdominal pain and tenderness, continuous vomiting, clinical fluid accumulation, mucosal bleeding, drowsiness or irritability, enlargement of the liver that exceeds 2 cm below the ribs, and hematocrit increase with rapid decrease in blood platelets, the progression of the disease can change rapidly and can develop into severe cases that must be carefully monitored. Immediate and appropriate medical treatment must be provided. If patients are diagnosed early and given proper treatment, the mortality rate can be below 1%. 
Right now is the peak of the dengue fever epidemic and cases are rapidly increasing in the Tainan area. The Centers for Disease Control is once again asking doctors to be on high alert. When diagnosing patients, please pay special attention to whether patients have a fever, headache, pain behind the eyes, muscle/joint/bone pain, rashes, decrease in white blood cells, vomiting/nausea, positive tourniquet tests, or other suspected dengue fever symptoms. Ask patients about their travel and recent activity history. Report suspected dengue fever cases immediately. Early reporting of dengue fever cases will not only help health authorities take preventive measures immediately and prevent the spread of the disease, but will also help provide dengue fever patients with appropriate clinical treatment that can prevent severe infections and death. For more information on dengue fever, please visit the Centers for Disease Control website (http://www.cdc.gov.tw) or call the free national disease prevention hotline at 1922 (or 0800-001922) for questions.