SAN PEDRO CITY — Officials in Cavite and Laguna provinces are monitoring the health of thousands of schoolchildren who have been inoculated with Dengvaxia after forensic experts from the Public Attorney’s Office (PAO) reported having found a “link” between the deaths of five children and the controversial dengue vaccine.

Dr. Erwin Erfe, director of the PAO Forensic Laboratory, said on Wednesday that the latest to be subjected to forensic examination was the body of a 13-year-old boy who died in Bulacan province on Jan. 3.

The forensic examination was conducted in Sampaloc, Manila, on Wednesday morning with consent from the boy’s parents, he said.

“[W]e found massive bleeding in the brain. There’s a lot of blood in the scalp, [in] the heart, lungs and in the stomach,” Erfe said in a phone interview.

Earlier, Erfe said the examiners had observed a pattern in the death of five children who had been inoculated with Dengvaxia.

The PAO on Tuesday examined the body of an 11-year-old boy from Bataan province. Erfe said the boy died “within 12 hours” of developing headache and fever.

Among the bodies examined by the PAO experts were those of Zandro Colite, 11, from Cavite, and Lenard Baldonado, 10, from San Pablo City in Laguna.

Baldonado’s body was exhumed and subjected to forensic examination on Jan. 7 in San Pablo.

The PAO experts also found bleeding in the lungs and enlarged organs in Baldonado’s case.

Dr. Nelson Soriano, the provincial epidemiologist of Cavite, said Colite’s death certificate indicated that he died from ruptured appendix last Dec. 27.

P3.5-B immunization program

Soriano confirmed that Colite was among the schoolchildren inoculated with Dengvaxia  under a Department of Health (DOH) P3.5-billion immunization program that had been run with the Department of Education.

The DOH halted the immunization drive last Dec. 1, three days after Sanofi Pasteur, the French pharmaceutical company that developed Dengvaxia, announced that the vaccine worsened symptoms in vaccinated people who had no previous exposure to the dengue virus.

More than 830,000 schoolchildren had already received at least one dose of Dengvaxia before the DOH stopped the immunization program.

In Cavite, records from the provincial health office showed that 68,366 schoolchildren had received the first dose of Dengvaxia, while 37,966 had received the second dose and 36,860 had completed the three doses.

Soriano said the health of the children was being monitored. So far, he said, Colite’s case was the only one in the province linked to the controversial vaccine.

In Laguna, thousands of schoolchildren aged 8 to 14 also received the vaccine between 2016 and 2017.

Dr. Rene Bagamasbad, the Laguna provincial health officer, said many more received the vaccine at private hospitals, Baldonado most likely among them because his name did not appear in the records of the government’s immunization program.

Aside from Baldonado’s case, Bagamasbad said an 11-year-old boy from Lumban town who received the full dose of Dengvaxia was hospitalized from Dec. 10 to 15, 2017, after showing symptoms of dengue. The child survived.

Enlarged organs

On Tuesday, Erfe said the children who fell ill after receiving Dengvaxia suffered from internal bleeding and enlarged organs and all died six months after they had been inoculated.

Among those examined were 10-year-old Anjielica Pestillos, who died last Dec. 15.

Erfe said the death certificate showed Pestillos died of systemic lupus erythematosus or autoimmune disease.

But initial forensic examination showed she had an enlarged liver, which weighed more than a kilo—not normal for a 10-year-old, Erfe said.

He said the girl also had enlarged kidneys and spleen.

Erfe said the children died soon after they showed symptoms of severe dengue.

Severe dengue

The latest to be examined were 13-year-old Rei Jazzline Alimagno and 11-year-old Alexander Jayme, Erfe said.

Alimagno died of dengue shock on Jan. 3 while Jayme died of septic shock on Jan. 4, he said.

Both children received Dengvaxia six months earlier.

Erfe said both showed symptoms of severe dengue and while their organs were normal in size, they had suffered from bleeding in the brain.

Jayme, he said, had suffered from bleeding not only in the brain but also in the stomach, lungs and liver. Even the boy’s scalp showed traces of blood, he said.

Dengue patients

On Tuesday, PAO chief Persida Rueda-Acosta reported that 21 people, including a 15-year-old pregnant girl, were taken to Philippine Children’s Medical Center in Quezon City with dengue symptoms.

“They all have fever and rashes and they were all inoculated with Dengvaxia,” Acosta said.

Health Secretary Francisco Duque III said on Wednesday that the DOH welcomed the PAO investigation, and offered to “extend any help in unveiling the truth.”

“Our panel of independent experts and the Philippine General Hospital have been tasked to monitor adverse events following immunization. We see [the] PAO’s efforts as complementary to our own and we would like to see the results of their probe,” Duque said. —With reports from Tina G. Santos, Tetch Torres-Tupas, and Faye Orellana