HANOI, Vietnam - 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.
