August , 2020
Good news for Dengue management
12:39 pm

Kuntala Sarkar

The fight against coronavirus is not yet over, but India has started to face Dengue cases. North-eastern and eastern states have been more prone to this disease, thus, need robust attention. West Bengal that had reported a massive number of Dengue cases last year, has already started to testify higher positive Dengue cases in July-August this year. The state might receive approximately 100 mm rain over the week that will lead to water logging in major locations. Busy with the necessary sanitation for Covid-19 management, sanitation workers may not be able to focus on cleaning other places apart from quarantine centres, hospitals, and nursing homes. Fresh water logging is the home for Dengue virus – not adequate sanitisation may cause it to surge. 

Statistics of Dengue infection

More than 47,390 dengue cases and 27 deaths were reported in West Bengal, particularly from North 24 Parganas, South 24 Parganas, Howrah, and Hooghly during 2019. West Bengal’s Dengue case peaked immensely in the last decade. West Bengal’s Dengue breakout rate is now 8.44% while India’s overall rate is 8.8%. According to the official website of the Union Ministry of Health and Family Welfare, the total cases of Dengue were 157315 in 2019 in India. This year, the figure reached 12078 within July. In this list, Bengal’s official data was Not Registered (NR) by the state government.

Concerning Dengue management the union government has asked the West Bengal government along with Assam, Tripura, Meghalaya and Mizoram governments to be firm. Those are sharing border with Bangladesh have been asked as the neighbouring country has reported the highest number of Dengue cases this year since 2002. Usually Dengue cases starts during monsoon, but this year it started earlier both in Bangladesh and Indian states.

Current cures used to treat it

Risk of Dengue endemic occurs in the tropical and subtropical areas of Asia, Oceania, Central America, South America, and Africa with higher transmission rates during the rainy season. The viral infection, Dengue spreads through the bite of infected mosquitoes - caused by one of the four Dengue Virus (DENV) serotypes namely (DENV1, DENV2, DENV3 and DENV4).

To treat Dengue, it is important for a patient to take complete rest and keep the body always hydrated. Intravenous (IV) Therapy is also used in many cases. Additionally, if urination and vomiting is not decreased it can be a problem. Severe drop of platelet count is a major concern which needs to be focused and Papaya leaves are recommended by doctors to increase the platelet count.

Challenges to treat dengue 

Adverse consequences and apprehensive mortality rate for Dengue happens for bleeding, shock and increased (Serum Glutamic-Oxaloacetic Transaminase (SGOT) levels. Identification of these risks is a major challenge. Additionally, Dengue can be misdiagnosed for Chikungunya, Zika Virus, West Nile Virus, Japanese Encephalitis, Malaria, Typhoid or Yellow Fever. Studies had also shown increased incidences of co-infection of Dengue with Chikungunya. It happens because both diseases are transmitted by the bite of infected Aedes species mosquitoes. The diseases also share similar clinical symptoms. So, it becomes difficult to differentiate them clinically.

When India is already fighting with Covid-19, Dengue has bothered doctors on treating patients with co-infections of coronavirus and DENV. Additionally, there is no such specific treatment for Dengue making it a tough road.


Dengue breakthrough 

Recently, a study conducted in Indonesia revealed that infecting mosquitoes with naturally occurring bacteria can reduces their ability to transmit Dengue. This can lead to an elimination of the disease. The study discovered that releasing mosquitoes infected with the bacteria Wolbachia in some parts of Yogyakarta city reduced the number of dengue infections by 77%, compared with untreated areas of the country. Buckets of mosquito eggs infected with Wolbachia were distributed in the city over six months. Around 6 million mosquitoes were released across an area of 13 square km and they infected other wild mosquitoes. Dr. Katie Anders, director of impact assessment at the World Mosquito Programme, who is also the study’s lead researchers, said, “We are really hopeful this will lead to local elimination [of Dengue] in Yogyakarta city, and the next stage is to scale up beyond Yogyakarta to other parts of Indonesia.” The method can be applied in Indian states for Dengue management, where it is a vital public health concern. 

Government’s attention

Local governments like Municipal Corporations have serious roles to play in Dengue control. Aedes mosquito, the major vector for Dengue likes to live in urban environments. So, poor sanitation and drainage system, unplanned urbanisation and poor living conditions, unhealthy rain-water logging in roads increases Dengue cases - where the government should be attentive. Dr. Amitabha Nandi, senior virologist and epidemiologist recently told media, “Dengue is a tropical disease and it is a seasonal infection. But there are ways to control the spread of infection since it is vector borne. It is a failure of the state that could not arrest the rise in dengue infection and called it an unknown fever. It is a man-made medical disaster. The state needs to be very vigilant on handling dengue infections”.

To initiate prevention measures, the Kolkata Metropolitan Development Authority (KMDA) has launched a quick Dengue response team two weeks earlier. The state government has also released guidelines and protocols to hospitals for treating cases with co-infections of coronavirus and Dengue

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