Keep Dengue At Bay

Nepal is no stranger to repeated dengue outbreaks. The first case of dengue in the country was identified in 2004 in an India-returnee traveler. The disease has since been endemic here with all its four serotypes (DENV-1, DENV-2, DENV-3 and DENV-4) known to exist and circulate within the region. However, it was in 2022 when the outbreak reached epidemic proportion, with cases reported from all 77 districts of all seven provinces. By the end of that year, 54,784 cases and 88 related fatalities were reported. The cases were seen to be heavily clustered in Bagmati Province with the country’s capital Kathmandu being the worst affected with 14,376 cases, followed by Lalitpur with 9,614 cases. The unusually high pre-monsoon rainfall attributed to climate change and mismanaged waste disposal system were mainly blamed for the severity of this disease. 

Increased vigilance and response played a role in lowering the cases in 2023, albeit by a narrow margin. A slew of factors put us at elevated risk of dengue: incessantly expanding unplanned urbanisation, huge movement of people through porous Nepal-India border, inefficient surveillance system, and insufficient preventive efforts, among others. With the onset of hotter months, the risk of infection has soared. Rising temperature means people are collecting and storing more water, which can turn into a breeding ground for dengue-causing mosquitoes if not managed well. That's because the mosquito typically lays eggs on standing crystal water in containers, such as buckets, bowls, animal dishes, flower pots, and vases. 

These mosquitoes prefer to bite people, and live both indoors and outdoors near people. Mosquitoes also become infected when they bite a person infected with the virus. Infected mosquitoes can then spread the virus to other people through bites. There is no specific treatment for dengue. Because the re-infection has proved to be much more complicated and so deadlier, once-infected people need to be extra vigilant. Early recognition of virus infection and appropriate clinical management can reduce the severity and mortality among dengue patients. 

To fend ourselves off dengue danger, we can take a host of precautionary measures: The spots at risk in terms of mosquito presence should be identified and a campaign should be launched to destroy larvae and mosquitoes. Those with symptoms should immediately be brought to the attention of medical professionals. Since the mosquito is known to be active during dawn and dusk, special care needs to be taken during those periods. Taking personal protective measures during outdoor activities, like the application of repellents to exposed skin or clothing, and the wearing of long sleeves shirts and trousers, is advisable. 

Protection can also include the use of household insecticide aerosol products or mosquito coils. Window and door screens, as well as air conditioning, can keep mosquitoes out of a house. Insecticide-treated nets offer good protection to people against mosquito bites while sleeping during the day. Such measures also include covering, draining, and cleaning household water storage containers on a regular basis. Spraying suspicious places with insecticide is another measure. Awareness among the general public about such measures and improved surveillance of its symptoms can go a long way to effectively control the disease.