Advisory for the Prevention and Control of Dengue Fever (DF)

Objectives

Mitigate the anticipated 2026 seasonal dengue surge through earlier detection and reporting, standardised clinical management, integrated vector control, and community mobilisation, with the aim of keeping dengue fatality rates below 1%.[1]The strategic focus responds to transmission linked to Aedes aegypti and Aedes albopictus, stagnant water, urbanisation, inadequate waste management, and climate variability, especially during monsoon and post-monsoon periods.[1]

• Strengthen surveillance to identify suspected cases promptly, detect clusters and hotspots, apply standard case definitions, and support immediate reporting through established channels.[2]
• Improve clinical outcomes through prompt assessment, recognition of warning signs and shock, appropriate referral, and consistent case management across health services.[1][2]
• Reduce mosquito breeding through source reduction, particularly the mechanical elimination of breeding sites, with World Health Organization-approved larvicides used only when removal is not feasible.[2][3]
• Target preventive activity at settings with elevated breeding potential, including schools, hospitals, construction sites, tyre shops, junkyards, domestic water containers, and other locations where stagnant water may accumulate.[2]
• Promote public awareness of mosquito control, personal protection, early recognition of dengue danger signs, and participation in community mosquito-control activities.[3]
• Use targeted fogging and indoor residual spraying only around confirmed cases and only following entomological assessment, rather than as routine blanket interventions.[2][3]
• Support laboratory confirmation through dengue enzyme-linked immunosorbent assay and polymerase chain reaction where available, while referring representative samples for serotype detection at the National Institute of Health when required.[1][2]

Implementation

Implementation relies on coordinated federal, provincial, district, facility, laboratory, local-government, and multisectoral action, combining surveillance, clinical preparedness, laboratory diagnosis, outbreak response, environmental management, and risk communication.[1][2][3]Health authorities are expected to work with the National Institute of Health, including the Virology Department of its Public Health Laboratories Division, alongside provincial laboratories and district response structures.[1][2]

• Coordinate dengue prevention and control across health departments, district authorities, local government, public-health institutes, malaria-control bodies, environmental and waste-management agencies, water and sanitation services, education, agriculture, parks and horticulture, forestry, wildlife and fisheries, communications and works, tourism, and other relevant organisations.[3]
• Prepare designated hospitals for peak periods by providing additional isolation beds, dengue-management supplies, insecticide-treated bed nets, vector surveillance on hospital premises, and refresher training for healthcare personnel.[3]
• Manage uncomplicated cases with supportive care, including acetaminophen and oral hydration; avoid aspirin, non-steroidal anti-inflammatory drugs, and corticosteroids; and reserve platelet transfusion for severe thrombocytopenia accompanied by active bleeding.[2]
• Collect 3–5 millilitres of venous blood with relevant clinical history, maintain cold-chain transport, use NS1 antigen testing or real-time polymerase chain reaction during days 1–7 after symptom onset, and use immunoglobulin M enzyme-linked immunosorbent assay after day 5.[1]
• Conduct weekly emptying and cleaning of water containers, undertake intensive inspections in priority sites, remove breeding habitats mechanically, and apply approved larvicides only where source removal cannot be achieved.[2]
• Deliver health education through community sessions and print, electronic, and social media; distribute information on mosquito control and danger signs; and encourage long-sleeved clothing, repellents, window screens, and bed nets.[3]
• Compile line lists for suspected cases containing demographic, clinical, and risk-factor information; enter records into District Health Information Software 2; and share data with the District Dengue Surveillance and Response Unit, the provincial Director General Health Services Office, and the National Institutes of Health.[3]
• Engage Field Epidemiology Training Programme fellows and alumni in outbreak investigation and response, share findings with provincial and national health authorities, and seek technical assistance from the National Institutes of Health Centre for Disease Control when needed.[3]
• Review surveillance data, field performance, and intervention outcomes regularly to identify implementation gaps, take corrective action, and improve prevention and control measures.[3]

Monitoring & Evaluation

The framework combines epidemiological, clinical, laboratory, entomological, and operational monitoring to support early dengue detection, prompt reporting, targeted response, and review of intervention performance. It does not specify a consolidated indicator framework, reporting frequency, performance targets beyond maintaining fatality rates below 1%, or formal accountability sanctions.[1][2][3]

• Detect suspected dengue cases early, identify clusters and hotspots, apply standardised case definitions, and report cases immediately through established surveillance channels.[2]
• Classify cases as clinically compatible, suspected, probable, or laboratory-confirmed using symptom duration, clinical manifestations, laboratory findings, and confirmatory tests.[2]
• Maintain case line lists containing demographic, clinical, and risk-factor information, enter these records in District Health Information Software 2, and share them with the District Dengue Surveillance and Response Unit, the provincial Director General Health Services Office, and the National Institutes of Health.[3]
• Monitor clinical warning signs, vital signs, haematocrit in conjunction with clinical status, platelet levels, bleeding, and evidence of shock to inform referral and hospital management.[1][2]
• Confirm infection through dengue enzyme-linked immunosorbent assay and polymerase chain reaction where available, using NS1 antigen or real-time polymerase chain reaction tests during days 1 to 7 after symptom onset and immunoglobulin M enzyme-linked immunosorbent assay after day 5.[1][2]
• Refer representative samples for serotype detection at the National Institute of Health where required, supported by collection of 3 to 5 millilitres of venous blood with clinical history and cold-chain specimen transport.[1]
• Use surveillance information to assess the national burden and seasonal increase in dengue. Reported cases increased from 21,016 in 2023 to 24,182 in 2024, followed by 33,394 laboratory-confirmed cases in 2025.[1][2]
• Undertake entomological assessment before deploying fogging or indoor residual spraying, and limit these interventions to the perimeters of confirmed cases.[2][3]
• Review surveillance data, field performance, and intervention outcomes regularly to identify implementation gaps, take corrective action, and improve prevention and control activities.[3]
• Investigate outbreaks with support from Field Epidemiology Training Programme fellows and alumni, share investigation findings with provincial Director General Health Services Offices and the National Institutes of Health, and seek technical assistance from the National Institutes of Health Centre for Disease Control when needed.[3]
• Coordinate surveillance and response responsibilities across federal and provincial health departments, district authorities, healthcare facilities, provincial laboratories, the National Institute of Health, and its Virology Department within the Public Health Laboratories Division.[1][2]
• Prepare designated hospitals for peak periods through additional isolation beds, adequate dengue-management supplies, insecticide-treated bed nets, vector surveillance within hospital premises, and refresher training for healthcare staff. These are preparedness measures, but the source does not specify associated monitoring indicators or reporting thresholds.[3]

Costing & Financing

No budget, costed implementation plan, financing arrangement, funding source, funding gap, resource-mobilisation mechanism, or economic assumption is specified. The source identifies operational inputs, but does not assign monetary values, funding responsibilities, or time-bound allocations to them.[1][2][3]

• Provide laboratory and surveillance inputs, including diagnostic testing, blood-sample collection, cold-chain transport, reporting through District Health Information Software 2, and referral of representative samples for serotype detection; no costs or funding sources are specified.[1][3]
• Support clinical preparedness through isolation beds, dengue-management supplies, insecticide-treated bed nets, and refresher training for healthcare staff; no budget or procurement allocation is specified.[3]
• Undertake vector-control activities including inspection, mechanical source reduction, larvicide use where removal is not feasible, entomological assessment, and limited perimeter fogging or indoor residual spraying; no unit costs, programme budget, or financing mechanism is specified.[2][3]
• Conduct community engagement and risk communication through health sessions and print, electronic, and social media; the source does not specify communications funding or resource gaps.[2][3]
• Coordinate activity across health, local government, environmental and waste-management, water and sanitation, education, agriculture, parks and horticulture, forestry, wildlife and fisheries, communications and works, tourism, and other relevant entities; financing roles across these sectors are not specified.[3]