We view with great concern the comment that doctors, particularly private practitioners, are to be blamed for the on-going dengue outbreak, noted to be endemic in Malaysia since more than 35 years ago.

We agree completely with the director-general of health that there is no excuse for doctors or private hospitals for not reporting confirmed cases of dengue and have been advising all our private doctors to report such cases, which I believe they have been doing so far for confirmed cases.

If all private doctors were to send all cases of viral fever to the government hospitals and laboratories, will the system be able to cope? Why report unconfirmed cases?

Patients should be aware that in the early stages of dengue fever, the signs and symptoms are common to all viral infections. The early symptoms like fever, bone aches, joint pains and pain behind the eyes are common to many viral infections.

However, none of the symptoms are unique to dengue alone. Often, a high index of suspicion and laboratory tests in the appropriate clinical situation are needed to help clinch the diagnosis.

Most dengue fever patients recover on their own with almost no therapy. Without the benefit of specific blood tests, the diagnosis may never be made. Indeed, epidemiological evidence indicates that there is a large pool of undiagnosed sub-clinical cases in most communities in dengue-affected countries.

Adequate rest and lots of oral fluid consumption to prevent dehydration is important. Patients are usually informed to see their doctors regularly for monitoring and follow-up. By the time the full-blown rash of bleeding into the skin comes, it is often serious. We do not think that any reasonable doctor will miss this diagnosis.

In the control of dengue fever, like all infectious diseases, prevention is the key. Dengue has been a major public health problem in Malaysia for more than 30 years. We recall that the ministry of health at that time had already initiated measures to try to contain the problem.

Specialists from neighbouring countries were also invited to look at regional cooperation to combat the problem.

In the past, the ministry of health has had successful programmess to eradicate malaria, TB and leprosy. With the right political will and a sustained programme focused on preventive measures, we will also be able to do the same for dengue.

In the case of dengue, we know the virus, and we know the vector which is the Aedes Egypti mosquito. We know how to get rid of the mosquitoes. We know where the larva of the mosquito dwells. What we need is a sustained effort to eradicate the mosquitoes' breeding grounds.

In homes and houses, the public is usually very co-operative. Unfortunately, at many development sites and abandoned housing projects, there are abundant opportunities for this mosquito to breed.

These are within the private properties of big companies to which the pubic has no access to. Complaints to the local authorities often fall on deaf ears. Such breeding grounds are also found in the many blocked and water-logged public drains under the care of the local authorities themselves.

Unless there is a political will to implement enforcement measures onto the many ‘big developers' and the local authorities, blaming private doctors for the dengue outbreak is just missing the point.

The writer is representative, Medical Affairs Committee, Federation of Private Medical Practitioners' Associations Malaysia (FPMPAM).