Infectious Diseases in the Philippines: A Handy Guide

By Philip Omictin

“A 22-year old male consults with the in-house clinic doctor of a leading BPO in Makati because of a fever. The condition started a day before, accompanied by joint pain and sore throat. He feels weak and wants to go home.”

This is how Dr. Johnny Sinon, Medical Director of Makati Medical Center (MMC), opened his talk on Infectious Diseases in the Philippines. The event, held last July 20, was organized by the American Chamber of Commerce of the Philippines, in partnership with the Overseas Security Advisory Council (OSAC) and MMC. To give the audience a closer feel for the topic, the talk was actually held at the MMC auditorium.

Going back to the case, the early symptoms could mean any disease, considering that almost all infectious diseases start with a fever. With this, Dr. Sinon enumerated the most common and prevalent diseases in the country.

He started with Dengue, a disease that has resulted in an average of 12,000 deaths per year worldwide. There are four distinct but related viruses that cause dengue, all transmitted through bites of the female Aedres aegypti mosquito. Recovery from one gives lifelong immunity to that particular strain. However, a second infection by one of the remaining strains can lead to Dengue Hemorrhagic Fever (DHV), which has a 2.5% mortality rate. While a vaccine has already been developed, many issues involving its efficacy have yet to be resolved by experts. At the moment, there is no specific treatment for dengue fever, only supportive treatment such as maintenance of the patient’s body fluid volume.

The next disease discussed was Chikungunya, another mosquito-borne disease that derives its name from the Makonde language in Tanzania/Mozambique that means “that which bends up” because of its painful effects. Mosquitoes acquire the virus by biting an infected person, and transmit it when they bite someone else. Similar to dengue, there is no treatment besides supportive care. A vaccine is still being developed.

Here’s an interesting trivia from Dr. Sinon: Tuberculosis (TB) is second only to HIV/AIDS as the greatest killer worldwide due to single infectious agent. It is caused by the Mycobacterium tuberculosis bacteria that most often affect the lungs. While it is completely curable and preventable, it is a highly communicable disease, spreading from person to person through the air.

The most important factor in getting TB is the state of a person’s immune system. Everyone is exposed to TB every day. However, not everyone gets it because of a person’s immune system. For children, it is commonly called Primary Complex. Data from the World Health Organization (WHO) reports that an average of 4,900 people die from TB every day. TB is treated with a standard six-month course, to be strictly followed daily. Failure to complete the whole course may result to the disease developing resistance to the drug.

Most especially on rainy days, people should be careful of wading through floods or puddles of water, or else risk getting Leptospirosis. It is transmitted from direct contact with the urine of infected animals or urine-contaminated water, damp soil or mud. The Journal of Travel Medicine also notes that adventure travelers engaging in activities like freshwater swimming, rafting, kayaking, canoeing, fishing and trail biking are most likely at risk. Symptoms include high fever, chills, jaundice, red eyes and diarrhea. However, some people show no symptoms at all. Leptospirosis is treated with antibiotics, which should be given early in the course of the disease.

An old disease that is still considered serious, yet preventable and treatable is Malaria. It is caused by Plasmodium parasites from mosquitoes. Every year, an average of 10,000 travelers are reported to become ill with malaria after returning home. Furthermore, in Africa alone, a child dies from malaria every 60 seconds.

MERS-CoV, a shortcut for Middle East Respiratory Syndrome — Corona Virus, was first detected in humans in April 2012. It is an acute, serious respiratory illness with symptoms of fever, cough, shortness of breath, breathing difficulties, pneumonia, gastrointestinal symptoms, and kidney failure. All cases reported had some connection with the Middle East. New research has found evidence of the virus jumping directly from a camel to a human.

Zika is an emerging mosquito-borne virus, spread through the mosquito bites from the Aedes species. The virus was first identified in humans in 1952 in the United Republic of Tanzania and Uganda. At present, the Zika virus outbreaks have been recorded in Africa, the Pacific, Asia and the Americas. Only 1 in 4 people with Zika infection develops symptoms. Symptoms are similar to other arbovirus infections such as dengue. It is not dangerous for healthy adults, but the virus can be transmitted to babies, resulting in microcephaly. There is no specific treatment, medicine or vaccine for Zika infections as of this writing.

Avian influenza A (H7N9) is a subtype of influenza virus that has been detected in birds in the past. This particular virus was discovered in China in March 2013. Most of the cases of human infection have reported recent exposure to live poultry or potentially contaminated environments, especially markets where live birds are being sold. Most patients experience severe respiratory illness. Symptoms include fever and cough, progressing rapidly to shortness of breath and pneumonia, and usually develop within 5–10 days following exposure to infection. Aside from avoiding contact with birds and poultry, prevention also includes maintaining high levels of hygiene. This includes making sure that poultry is thoroughly cooked.

At this point, let’s go back to the case earlier. The patient’s vital signs were stable except for a fever of 38.5C. The physical examination was normal. He got wet in the sudden downpour the day before he got sick. He had no history of wading in the flood. No history of travel outside of Metro Manila.

The diagnosis? A systemic viral illness. The patient was given paracetamol for fever, vitamin C + Zinc, and was advised one day’s rest.

In the end, the common flu is still the most prevalent disease.


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About the author:

Philip is currently a managing consultant for the Executive Search and Selection Division of John Clements Consultants. Prior to joining John Clements, he worked for several companies like San Miguel Corporation, Petron, Smart Communications, and International SOS. He graduated from UP Diliman, with a Bachelor of Science degree in Industrial Engineering. Outside of work, Philip is into music, basketball, and video games.

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