Jul 31, 12:08 PM EDT
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Dengue Fever Rages Across Asia*

By MARGIE MASON
AP Medical Writer

HANOI, Vietnam (AP) -- Dengue fever is raging across Asia, prompting the
World Health Organization to warn that the region could face the worst
outbreak of the mosquito-borne virus in nearly a decade.

The disease, commonly called the 'bone breaker' illness because of the
excruciating joint pain it causes, has flared everywhere from
ultramodern Singapore to poor Vietnam. There are four different types of
dengue, but none have a cure or vaccine.

Cambodia is now one of the most worrisome spots, where the disease has
attacked about 25,000 people and killed nearly 300 children this year.
That's about three times more than the number of cases for all of 2005,
according to WHO.

Sick children have overwhelmed ill-equipped hospitals there, forcing
babies burning with fever to wait for beds outside with IV drips
attached to their arms.

The last major outbreak to hit Southeast Asia was in 1998, when about
350,000 cases were reported in the region, including nearly 1,500
deaths. Indonesia and Thailand were not included in that tally.

John Ehrenberg, WHO's regional adviser on vector-borne diseases, said it
could potentially reach that level this year.

"It looks like it might be a bad year," he said. "I think we're in the
building-up stage, but it could very well peak by August or September."

Malaysia has seen a 50 percent jump in cases this year over the same
period in 2006, with more than 1,000 patients admitted every week for
the past month and 56 deaths recorded through June, according to Health
Ministry figures.

In Indonesia, more than 100,000 infections have been reported this year,
including 1,100 deaths. That compares to 114,000 cases and the same
number of fatalities for all of 2006, said Nyoman Kandun, a senior
health ministry official who predicted the number will hit 200,000 by
year's end.

More than a dozen children infected with dengue filled beds in Jakarta's
Tarakan Hospital. Some had IV drips in their hands while others had
tubes in their noses.

Muhammad Wildan, 5, was hospitalized last week and remained in critical
condition due to internal bleeding. Doctors said he was lucky his family
did not wait any longer to bring him in.

"It did not come to us that it was dengue," said Padmi Sari, the boy's
grandmother. "We thought it was just a common fever."

Singapore, known for its spotless streets and cutting-edge health
facilities, has not escaped dengue this year. The government has
reported nearly 5,000 cases and at least three deaths. Early rains also
caused a surge in cases in Thailand, with more than 20,000 cases
reported through June, including 17 deaths.

In Vietnam, which also typically logs a high number of annual cases,
health officials have seen a 40 percent increase over last year,
reporting more than 33,000 infections this year and 32 deaths.

In addition to joint pain, rashes, nausea, severe headaches and high
fever that typically accompany the disease, patients stricken with a
more serious form, called dengue hemorrhagic fever, can experience
internal bleeding, liver enlargement and circulatory shut down.

"You don't want to have people staying at home and starting to bleed,"
Ehrenberg said. "By the time they go to the hospital they're in shock
and they will die."

The disease is not nearly as lethal as malaria, which kills more than 1
million people annually. But WHO estimates dengue infects up to 50
million people every year worldwide, mostly in Asia and Latin America.
About a half million of those cases are severe, and some 19,000 deaths
were recorded in 2002.

"We always think next year it will get better, but we always find next
year it gets worse," said Kroeger Axel, a dengue research coordinator at
the WHO in Geneva. "There's a very clear upward trend."

He said outbreaks run in cycles, occurring roughly every four years.
Mosquitoes breed in stagnant pools of water ranging from flower pots to
old tires, and residents across the region are urged to avoid letting
water collect near houses.

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Associated Press reporters Heng Sinith in Phnom Penh, Cambodia; Sean
Yoong in Kuala Lumpur, Malaysia; Tran Van Minh in Hanoi, Vietnam, and
Zakki Hakim in Jakarta, Indonesia contributed to this report.