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Long-term strategy needed to tackle dengue

Statesman News Service |

Hundreds of people in the Capital have been struck by dengue and chikungunya fever in recent months, putting medical services under strain and highlighting the need for a long-term strategy to fight the potentially lethal vector-borne diseases. 

Health experts opine that it&’s a sort of annual plague and hidden epidemic. As many as 2,800 cases due to the two vector-borne diseases have been reported so far this year and a committee set up by the Delhi government to look into the recent deaths has claimed that there has been no confirmed fatalities due to the two vectorborne diseases so far. 

However, a total 20 fatalities -13 chikungunya-related and seven due to dengue -have been reported by several hospitals, including Sir Ganga Ram, Apollo, AIIMS, Hindu Rao and Max,were reviewed by the committee. Seven of the 13 chikungunya victims belonged to Uttar Pradesh, including two from Ghaziabad, and five from Delhi. 

"Many of the patients diagnosed in Delhi are coming from the NCR region. Hospitals are overwhelmed as thousands of people with symptoms such as high fever, vomiting and joint pain seek treatment," said Dr NP Singh, Max Hospital. 

Experts say there is no dedicated treatment for the virus, and patients are generally asked to rest, drink plenty of fluids and take medication to bring down fever and reduce joint pains. "Outbreaks like the current dengue and chikungunya cases can have significant impact on health system. These patients are acutely ill with severe symptoms and need to be treated fast to avoid complications," said Singh. The size of the outbreak has forced some hospitals to make tough choices. 

At the government-run Safdarjung Hospital, the fever clinic having 22 beds struggled to deal with patients.Staff from non-clinical wards of the hospital was also deployed and the hospital claimed they were conducting tests and providing blood reports to patients within two hours. At the All India Institute of Medical Sciences (AIIMS), the authorities also devised a series of public lectures to prevent the spread of panic. 

According to AIIMS spokesperson Dr Amit Gupta, "Lab technicians have been specially deployed in the emergency to run public campaigns and public lectures on chikungunya and dengue. This has been happening since before the monsoon."

Health experts said that explosion in dengue and chikungunya cases is closely linked to rise in urban living as well as increased movement of people and goods. "For dengue to strike you needs concentrated areas of people – it’s a city-based disease and a tricky one to eradicate because the dengue mosquito bites during the day, unlike the malaria mosquito," said an expert said. 

The dengue mosquito usually lives inside houses or in courtyards and typically lays its eggs in flower pots or other places with a water source. Dengue fever is a mosquito-borne disease with no known cure or vaccination that strikes fear into the hearts of the Delhi’ites when it arrives with the monsoon rains. Health experts say that while much attention was focused on eradicating malaria, which has higher mortality rates,the fight against dengue and chikungunya lacked a long-term plan and focused on controlling outbreaks instead. 

Instead, it requires a shift in approach from responding to isolated outbreaks to investment in strategies that cover effective vector control, access to health services and early clinical management. Out of the total cases this season, 202 have been recorded in south Delhi, followed by 148 in north Delhi and 57 in east Delhi, the report said. 

For South Corporation, which reported the highest number of people diagnosed with chikungunya, its fourzone recorded cases are as follows–West (56), Central (57), South (56) and Najafgarh (33). According to South Corporation, 64 cases of chikungunya were reported last year. Meanwhile, IMA president-elect Dr K K Aggarwal cautioned about chikungunya virus (CHIKV) that can cause CHIKV-associated encephalitis.

"Children younger than one year and adults over 65 years or older have the highest incidence of CHIKV-associated encephalitis," he said, claiming such cases are occurring in Delhi.