Dengue: Accept the problem first to find a solution

aedes mosquito

India is under attack by the Aedes Aegypti mosquito leading to hundreds of suspected dengue deaths this season. And depending on which media you follow,  Telangana and Delhi seem to be the most affected with the former having the dubious distinction of having the most affected  patients, 4500 to 10,000, with some 150 plus cases reported in Delhi.  According to News18 the death toll in Telangana on account of the dreaded vector borne illness has already crossed 56.

However, this is only a guestimate as there are no verifiable official figures available. While the deaths are reported as suspected dengue deaths awaiting confirmation post lab tests, there is quite a gap between what is reported and reality.  The real issue, is fear of political and public backlash with authorities loath to acknowledging the numbers to avoid controversies.  So much so, the World Health Organization (WHO), itself notes that dengue cases tend to be under-reported the world over.

How big is the problem?  

“There is a large discrepancy between the dengue burden estimated by academic groups and the dengue burden notified to WHO. The reasons for this include lack of resources and capacity to survey dengue effectively, and the fact that many countries report only laboratory-confirmed cases, which represent only a small majority of the total number of dengue cases recorded and reported”, says the multilateral health monitoring organization.

However, India figures in the top of the list of countries with high prevalence of dengue cases year-after-year.

There is a large discrepancy between the dengue burden estimated by academic groups and the dengue burden notified to WHO. The reasons for this include lack of resources and capacity to survey dengue effectively, and the fact that many countries report only laboratory-confirmed cases, which represent only a small majority of the total number of dengue cases recorded and reported.

Not only is the number of cases increasing as the disease spreads to new areas, but explosive outbreaks are occurring, including in Europe.  In 2015, Delhi recorded its worst outbreak since 2006 with over 15 000 cases reported, says WHO.

Dengue Deaths in India - WHO Source: WHO Dengue Data Book

In terms of the number of deaths reported 1996 was the words year with upwards of 500 people succumbing to dengue while in 2017, the number of reported deaths in India were a little of 300, according to the first Global Dengue Report by the WHO.

How is it transmitted?

Dengue is transmitted mainly by the Aedes Aegypti mosquito, which thrives in densely populated tropical climates and breed in stagnant pools of water. The mosquitoes pick up the virus from infected humans – even asymptomatic ones – and pass it along to other people through bites. It is dubbed as the “backbone fever” and is one of the world’s leading mosquito-borne illnesses.

Symptoms

Symptoms usually develop within 3-14 days after being exposed to the dengue virus (also known as incubation period). The average incubation period is around 4-7 days. The following may be the symptoms of dengue :

  1. Sudden-onset fever
  2. Headache (typically located behind the eyes)
  3. Muscle and joint pain
  4. Rash
  5. Chills (shivering)
  6. Facial flushing
  7. Loss of appetite
  8. Sore throat
  9. Abnormal bleeding such as nosebleeds, bleeding gums and/or blood in your urine.

Tackling it

Diagnosing Dengue Fever

Doctors can diagnose dengue infection with a blood test to check for the virus or antibodies to it. If you become sick after travelling to a tropical area, let your doctor know. This will allow your doctor to evaluate the possibility that your symptoms were caused by a dengue infection.

Treatment for Dengue Fever

There is no specific medicine to treat dengue infection. If you think you may have dengue fever, you should use pain relievers with acetaminophen and avoid medicines with aspirin, which could worsen bleeding. You should also rest, drink plenty of fluids, and see your doctor. If you start to feel worse in the first 24 hours after your fever goes down, you should get to a hospital immediately to be checked for complications.

Preventing Dengue Fever

The best way to prevent the disease is to prevent bites by infected mosquitoes, particularly if you are living in or travelling to a tropical area. This involves protecting yourself and making efforts to keep the mosquito population down. In 2019, the FDA approved a vaccine called Dengvaxia to help prevent the disease from occurring in adolescents aged 9 to 16 who have already been infected by dengue. But, there currently is no vaccine to prevent the general population from contracting it.

Dengue: Do & Dont's

How to protect yourself:

  • Use mosquito repellents, even indoors.
  • When outdoors, wear long-sleeved shirts and long pants tucked into socks.
  • When indoors, use air conditioning if available.
  • Make sure window and door screens are secure and free of holes. If sleeping areas are not screened or air conditioned, use mosquito nets.
  • If you have symptoms of dengue, speak to your doctor.

To reduce the mosquito population, get rid of places where mosquitoes can breed. These include old tires, cans, or flower pots that collect rain. Regularly change the water in outdoor bird baths and pets’ water dishes.

If someone in your home gets dengue fever, be especially vigilant about efforts to protect yourself and other family members from mosquitoes. Mosquitoes that bite the infected family member could spread the infection to others in your home.

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