Health officials have warned that 2003 could see a major outbreak of dengue fever,

with Phnom Penh and Kandal province predicted to be the worst hit. More than 600

cases of dengue have been reported in the first two months of the year, resulting

in the deaths of seven children.

A Cambodia Red Cross (CRC) bulletin released late February described that as "a

significant increase" on the same period in 1998, the last major outbreak year.

The CRC stated that it was still too early to predict an outbreak, but described

the epidemiological pattern as "alarming".

"This year is a little bit strange because the cases appeared in January and

without any rain," said Dr Duong Socheat of the Ministry of Health (MoH). He

said Thailand and Malaysia were facing similar outbreaks.

MoH officials warned in January that delays in drug procurement meant they had insufficient

"infusion sets", which rehydrate patients, to cope with a dengue outbreak.

The infusion sets, to be imported from Thailand by Suoy Chheng Company, have not

yet arrived. However Dr Chroeng Sokhan of the MoH's Essential Drugs Bureau said the

government had purchased 700,000 bottles -two to three months supply - from the national

budget and distributed them on March 10.

Cambodia's mortality rate from dengue is typically below 2 percent, but without appropriate

treatment the more serious hemorrhagic dengue fever can kill 10 percent of patients.

Dr Duong said environmental changes, including increased urban density, had resulted

in higher numbers of infections each year.

A major outbreak of dengue, which is a viral disease spread by the tiger mosquitoes'

bite, typically occurs every three years. The peak season between June and August

coincides with the annual wet season.

CRC's director of communications, Men Neary Sopheak, said the agency would start

mobilizing volunteers on March 18 to conduct education campaigns in Kandal. Mass

application of larvicide would not take place before the wet season.

Around 12,400 people were infected with dengue last year, of whom 153 died.