Dengue devilry afoot … 

Mankind often has to submit to the caprice of the winged tiny blood-sucking vermin called mosquito. Mighty king Namrud (Nimrod in the Bible) in the days of antiquity was finished off by a single mosquito, so goes the story. Even in the era of remote-controlled modern living, humans are found to be running to and fro like Namrud in search of permanent solution to the pestilence of the most persisting kind.

These pests are harbingers of diseases like malaria, cerebral malaria, dengue, chikungunya etc., and among the diseases dengue remains a deadly one today. Dengue manifests like the curse of an angry god, more like the stories encrypted in the ancient scriptures.  It may bring upon the patient untold suffering and even death. So, treat dengue with respect. Take its dreadful manifestation into full cognizance and go for proper medical intervention.    

The nation is now in the grip of a rogue dengue virus in the midst of the Corona-19 pandemic. Undoubtedly, Covid-19 and dengue have appeared as a double whammy for the beleaguered citizens.  The unchecked breeding of the aedes mosquito in this crowded megacity of 20 million people finds victims too easily who remain exposed and vulnerable. And it helps to spread fast.

Dengue, this year, has come to exacerbate the already fragile healthcare system of the country with great many limitations, like shortage of testing kits, treatment regimens and hospital beds for serious patients. Hospital beds are mostly occupied by Covid patients hence serious dengue cases find it difficult to get admitted for treatment. Often it becomes difficult for the healthcare providers to diagnose dengue in the first attempt. Many dengue patients had to run to hospitals for Covid test when their fever went up to 102 and did not come down for days.

 It is apparent that the primary symptoms of both the diseases look similar, and this may lead to confusion. The deadly disease has already claimed life and the number of patients with dengue fever symptoms is increasing on a daily basis. Alarmingly, more and more children are falling victim to the disease needing hospitalization for appropriate treatment. 

There was an outbreak of dengue in 2019 which had infected more than 80,000 people with 67 deaths in a matter of months. Surprisingly, the infection rate in 2020 was not so high, as informed by the government health officials. In the year 2020, 1,405 patients were diagnosed across the country with seven deaths only.      

Health experts in WHO issued a warning: “Dengue remains a deadly mosquito-borne viral disease in the world. It is the most rapidly spreading mosquito-borne viral disease, with a 30-fold increase in global incidence over the past 50 years. The organization estimates that 50–100 million dengue infections occur each year and that almost half the world’s population lives in countries where dengue is endemic. Currently close to 75% of the global population exposed to dengue live in the Asia-Pacific region.”  

According to WHO dengue is caused by a virus with four distinct strands following mosquito bite. One may recover from one type and develop lifelong immunity against it, but he may fall victim to severe dengue if infected by another variant. According to DGHS and IEDCR, most dengue patients this year are being infected with DEN-3, a variant of the dengue virus that can even put the life of the patient at risk. In some cases, patients experience plasma leakage, respiratory distress and other complications.

Health experts give emphasis on timely and coordinated efforts to control the disease. The strong message is: Timely diagnosis and treatment can save lives of those infected.  The WHO global strategy for dengue prevention and control (2012-2020) , was aimed at responding to an emergency situation, to proactive risk assessment, early warning systems, and preventive measures, guided by entomological as well as epidemiological surveillance. Among the strategies vaccination is considered an important one as it can reduce morbidity and mortality.

According to health experts, a complex disease like dengue demands a multipronged, coordinated and multisectoral response under the leadership of experienced professionals. Primary disease control and municipal health experts must join the team to take an integrated approach to vector control and management.

 Social awareness plays a vital role in keeping dengue at bay. Effective communication can bring about the desired behavioral changes in people living in dengue-prone areas. It is said that continued research is needed to find ways to reverse the trend in dengue by improving methods and systems for surveillance, prevention and control. It needs no emphasising that reversing the trend will require commitments and obligations from all stakeholders keeping in view that the disease is a major public-health concern throughout tropical and sub-tropical regions of the world.

When we talk about all stakeholders, we also include the citizens being one of them. If the people in general take the responsibility of keeping their own premises like the backyards and roofs clean by throwing away all containers where mosquito can lay eggs, we believe we shall see substantial improvement of the situation.

Historically, before it was identified clinically in 1964, it was named Dhaka Fever as it was limited to Dhaka city only and no laboratory test was done in the 50s when there was an outbreak. Worldwide it was known as ‘Breakbone Fever’, because of extreme pain and stiffness of the joints suffered by the patients.

 We the informed and responsible citizens should follow the instructions given by the WHO, DGHS and the   mayors of the two city corporations as to how to keep our compounds clean of aedes mosquito and thus keep dengue at bay. No denying, prevention is better than cure.

The writer is the Associate Editor at The Business Post