Eight more areas are expected to declare a dengue outbreak as cases continue to surge in Region IV-A, Region III, and Metro Manila, the Department of Health (DOH) said on Monday, Feb. 17.

This development follows Quezon City’s declaration of a dengue outbreak after reporting 10 deaths, including eight minors.

“Mayroon pang walo kaming area na hinihintay na mag-declare [ng dengue outbreak]. Tatlong rehiyon kasi ‘yung tumaas ang numero (We are waiting for eight more areas to declare a dengue outbreak. Three regions have seen a rise in cases),” Assistant Secretary Albert Domingo, the spokesperson of DOH, said in a radio interview.

According to him, within these three regions, nine local government units (LGUs) have reported a significant uptick in dengue cases, including Quezon City, which officially declared an outbreak on Feb. 15.

However, Domingo did not provide the list of the eight LGUs expected to declare a dengue outbreak.

Domingo noted that the early onset of rainfall, which is unusual for this time of year, has created ideal breeding conditions for mosquitoes, further exacerbating the dengue problem.

“Ang kakaiba kasi rito (ay) iyong talagang maagang pagpasok ng ulan. Hindi siya panahon ng tag-ulan. Pero iyong tinatawag na shear line, Intertropical Convergence Zone (ITCZ), at easterlies, dumadami ‘yung buhos ng tubig; at kapag dumami ang buhos ng tubig, talagang naiipon iyan sa paligid, kaya dumarami rin ang mga lamok (What’s unusual here is the early arrival of rains. It’s not the rainy season. But due to the shearline, ITCZ, and easterlies, there’s been more rainfall. And when water accumulates, mosquito populations increase),” he said.

Climate change impacting mosquito behavior

Domingo also noted that mosquito behavior has changed, making it harder to predict dengue outbreaks.

“Nag-iba na nga ‘yung behavior ng lamok. Actually, sa epidemiology, tatlong bagay ang binabantayan—iyong tao, mikrobyo o virus, at iyong nagdadala nito (Mosquito behavior has changed. In epidemiology, we monitor three things—the person, the microorganism or virus, and the carrier),” he said.

This was also the observation of infectious disease expert Dr. Rontgene Solante, who attributed the surge in dengue cases to changes in mosquito behavior caused by climate change and environmental factors.

He pointed out that dengue infections are climbing in densely populated cities.

The DOH spokesperson noted that while dengue cases were previously tied to the rainy season, climate change has disrupted this cycle, leading to outbreaks at unexpected times.

“So iyong mga lamok, kung noong unang panahon, remember ang laging sinasabi nga sa amin noon ay may oras… pero pati iyon parang nagbago na rin. So even iyong season na sinasabi dati, talagang nagma-match iyan sa tag-ulan. Eh ngayon, wala na siyang sinusunod na pattern dahil sa climate change (Before, mosquitoes had specific active periods. But even that has changed. Previously, outbreaks matched the rainy season. But now, there is no longer a pattern because of climate change),” said Domingo.

Watch for warning signs

The health department reminded the public to seek medical attention if fever persists for more than two or three days, as dengue symptoms can worsen rapidly.

“Kapag ang lagnat [ay] high-grade fever, pumapalo iyan ng 39 degrees, minsan 40 degrees pa po iyan. At maaaring tumagal ng lampas dalawa o tatlong araw (If the fever is high, reaching 39-40 degrees, and lasts beyond two or three days, it must be monitored),” Domingo stated.

He warned that dengue can appear to improve before worsening suddenly, making early medical consultation crucial.

“Ang kakaiba ho sa dengue, kunyari biglang gumaling ang lagnat after mga apat o limang araw, minsan doon tayo mas mag-iingat (What’s unusual about dengue is that the fever may suddenly disappear after four or five days, and that’s when we need to be more cautious),” the DOH spokesperson noted.

“Kapag nawala na ‘yung lagnat, saka lumalabas ‘yung ibang warning signs—pagdurugo ng gilagid, pagpapantal, at pagbabago sa kulay ng dumi, na nangangahulugan na maaaring may internal bleeding na sa katawan (When the fever disappears, other warning signs appear—bleeding gums, rashes, and changes in stool color, which may indicate internal bleeding),” he explained.

The DOH urged the public to monitor fever levels closely and seek medical help if symptoms persist.

“So as early as kapag dalawa o tatlong araw hindi pa nawawala ‘yung lagnat at mataas pa rin, kumuha ho kayo ng temperature. Kapag napansin na hindi bumababa kahit binibigyan ng paracetamol at naglalaro pa rin sa 39-40 degrees, magpakonsulta na ho sa isang health center o ospital para masigurado kasi may test para diyan (If after two or three days the fever is still high, take the temperature. If it remains at 39-40 degrees despite taking paracetamol, seek medical consultation at a health center or hospital because there is a test for dengue),” Domingo advised.

Quezon City’s dengue response lauded

The DOH praised Quezon City’s swift response, particularly Mayor Joy Belmonte’s decision to immediately declare an outbreak, which allowed for aggressive cleanup operations and public awareness campaigns to be launched.

“Actually, gawin nating halimbawa ang Quezon City. Maganda ‘yung approach nina Mayor Joy [Belmonte]. Iyong pagdedeklara niya kaagad, na-mo-monitor namin. Kami ay natutuwa sa ginagawa ng Quezon City—sunod-sunod kaagad ‘yung mga cleanup drive, mga paalala, at mga abiso sa ating mga mamamayan (Let’s use Quezon City as an example. Mayor Joy Belmonte’s approach has been good. By declaring an outbreak early, we were able to monitor the situation. We are pleased with Quezon City’s actions—immediately launching cleanup drives, advisories, and reminders to residents),” said Domingo.

He emphasized the importance of eliminating stagnant water, especially with unexpected rainfall becoming more frequent due to changing climate patterns.