MALAYSIA has recorded 56,752 dengue cases as of Aug 13, 2026, with 49 deaths reported by Aug 9. The Health Ministry has linked the increase to dengue’s cyclical pattern and the nationwide dominance of the DENV-3 virus type.
Against this backdrop, people living with chronic conditions may face greater risks once infected.
A 2026 study of hospitalised adults in northern Vietnam found that those with chronic illnesses were about twice as likely to develop severe dengue, while a Brazilian study reported mortality to be about 11 times higher among certain hospitalised dengue patients with underlying health conditions.
“The patients I see affected most are often older adults living with obesity and diabetes. When they come to us late, management becomes much more difficult,” said Assunta Hospital consultant emergency physician Dr Ganasan Chelladurai.
His message for World Mosquito Day is simple: do not wait for dengue to look dramatic before taking it seriously.
The danger can begin as the fever falls
Dengue often starts with familiar symptoms such as fever, body aches and tiredness. For some people, however, the illness worsens just as the fever subsides.
Persistent vomiting or diarrhoea, severe abdominal pain, spontaneous bleeding, difficulty breathing, confusion, poor appetite or sudden deterioration all require urgent medical attention.
Dr Ganasan recalled treating a young man who arrived exhausted, vomiting and dehydrated, but without a fever. Only later did he mention having been feverish three days earlier. His blood pressure and platelet count were dangerously low, and tests confirmed dengue.
“The fever can disappear just as complications begin. In older people and those living with chronic illness, deterioration may be faster and more severe,” he remarked.
When the body has fewer reserves
Chronic conditions such as diabetes, hypertension, heart disease, kidney disease and obesity do not guarantee severe dengue, but they can leave the body with fewer reserves to cope with infection.
One patient still weighs heavily on Dr Ganasan.
A man in his early 50s, who lived with diabetes and obesity and was also a smoker, kept working through two days of fever because he was his family’s sole breadwinner. By the fourth day, he could barely eat or drink, yet delayed seeking treatment because he feared losing his job.
He finally came to hospital after vomiting blood, and despite blood transfusions and intensive care, he passed away.
Within days, his family lost not only a husband and father, but also their main source of financial security. His wife was left to raise two young children alone.
“Doctor, I don’t know how to take care of my children. I don’t know how to move on,” she told Dr Ganasan.
For him, it remains a painful reminder that dengue’s consequences often extend far beyond the patient.
Grace’s second dengue infection
Grace Ooi, 45, knows how deceptive dengue can be.
She first contracted the disease as a teenager. When she became infected again in 2013, the experience was far more severe.
Her fever came and went for almost a week before dengue was diagnosed. By the time she was admitted, her platelet count had fallen into single digits. She needed a blood transfusion and spent three days in intensive care.
“I didn’t know a second dengue infection could be more severe, or that having hypertension could make things worse,” she recalled.
She spent her birthday in intensive care instead of celebrating with her family.
“I wasn’t afraid for myself as much as I was afraid of leaving people behind.”
A previous dengue infection usually provides long-lasting protection only against the infecting virus type, meaning a later infection with a different virus type can carry a greater risk of severe disease.
Prevention remains the best defence
The current dominance of DENV-3 does not automatically make it more dangerous than other virus types. Its significance is that many people may have little immunity to it.
Dr Ganasan said protection requires multiple layers: removing stagnant water, covering water containers, using repellents and screens, wearing protective clothing, joining neighbourhood clean-ups and discussing dengue vaccination with a healthcare professional where appropriate under Malaysian guidance.
“Dengue does not affect only the person who falls ill. It can disrupt an entire family. That is why prevention matters,” he stressed.
For people living with chronic illness, taking extra precautions is not about panic. It is about recognising that the stakes may be higher and acting early when symptoms appear. ‒ Aug 20, 2026
Main image: Unsplash/Mithil Girish
