Combating dengue epidemics a tough challenge

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Taj Nabi Khan

THE large scale outbreak of dengue epidemic in Pakistan needs more proactive response of the authorities concerned to overcome the larva breeding of dengue mosquitoes. However, efforts of the authorities are not expected to bring positive results without consistent support of the vulnerable community in dengue prone areas. Very often dengue virus targets the underdeveloped thickly populated areas of urbanized hubs. The first case of dengue was reported in Karachi in 1994, later on, the cases have started surfacing in different parts of the country with varying intensity. However, Lahore saw the worst outbreak of the disease during the last few years affecting thousands of lives. There are several theories about the existence and transportation of dengue mosquitoes — some held climate change responsible, others blamed ship carrying containers through sea routes while some said it was the evolved form of the local species. Whatever may be the reason, controlling breeding of dengue larva has become a tough challenge for the stakeholders and policymakers alike. Dengue fever is actually a mosquito-borne viral infection transmitted through the bite of infected female mosquitoes which thrive in areas with standing water: puddles, water tanks, containers and old tires. The lack of sanitation and regular garbage collection also contribute to the spread of these mosquitoes.
According to the Ministry of National Health Service, Regulations and Coordination (NHRC), more than 21,000 dengue cases have been reported across the country. Out of which, 4,800 dengue patients were reported in Islamabad followed by 4700 in Punjab. The number of dengue patients reported in Khyber Pakhtunkhwa is 4,300; whereas, 3,600 patients have been reported in Sindh, and 2,700 in Balochistan and around 800 dengue fever patients have been reported in Azad Jammu and Kashmir. This year, the twin cities of Rawalpindi and Islamabad have been badly hit by the epidemic. The outbreak still continues to trouble the residents as a large number of dengue admitted patients could be seen in almost all hospitals of these cities. According to the NHRC reports, the dengue cases reported in the twin cities make up more than 40% of the total reported cases from across the country.
The focal person for dengue fever at the National Institute of Health, Dr Rana Safdar said that more than 20,000 cases of dengue fever have been reported across the country. He said that most of these cases have been reported from the underdeveloped areas of these cities. It would not be possible for the government to deal with the dengue outbreak unless an effective surveillance system is placed in dengue prone areas. The absence of such system causes delay in early detection of dengue. Looking at the regularity and continued increase of dengue cases countrywide, the government’s response should have become more vigilant. However, instead of detecting it at early stages, the response is often initiated after the outbreak. Talking to the scribe, a dengue patient said that soon after the attack of the mosquito, “I was paralyzed and could not move my limbs due to the severity of body aches, muscle pain, fatigue and high fever.” Another dengue patient, who remained bedridden for about two weeks said, “It was really hard to go through the pain of the disease due to persistent migraines, vomiting and high temperature.” Every year, dengue fever devours a large number of those patients who either failed in taking precautionary measures, knowing nature of the disease or getting timely treatment. The dengue fever is also called the disease of dehydration in which the patient in extreme cases faces failure of organs due to complication and internal bleedings.
The safest corner of the capital city is even not safe from the dengue attack. He said that the dengue spreading mosquito is an elite breed with a capability to lay eggs and reproduce in clean and neat available water reservoirs even the size of a teacup. There was no suitable treatment for the dengue fever or an effective vaccine. The clinicians mainly treat the dengue fever patient’s symptoms and boosting their immunity for halting the progression of viral infection to its hemorrhagic state. But excessive bleeding either internally or externally was considered quite dangerous for the health outcomes. According to World Health Organization (WHO), there are three stages of dengue fever starting with a flu-like illness to hemorrhagic conditions associated with failure of internal organs leading to severe consequences. The WHO preventive measures included wiping out the egg-laying places of mosquito through water control, proper covering of water, using insecticides and fumigating the areas for curbing the mosquito population.
— The writer is freelance columnist, based in Islamabad.