Nepal is well familiar with repeated dengue outbreaks. Since detecting its first dengue case in an India-returnee traveller in 2004, the country has witnessed multiple outbreaks. Significant outbreaks occurred in 2005 and 2010. However, it wasn't until 2022 the outbreak reached its epidemic proportion, with cases reported from all 77 districts and all seven provinces. By the end of that year, 54784 cases and 88 fatalities were recorded, with cases clustering in Bagmati Province and the Kathmandu Valley being the worst affected. Hospitals were overwhelmed with dengue patients. The unusually high pre-monsoon rainfall blamed on climate change and mismanaged waste disposal were said to be behind the explosion of the cases. Last year, it caused 20 deaths and infected over 52,000 people across the country.
This year, the country has, of late, witnessed a surge in dengue cases with 1,732 new infections reported over August 5-19, along with two deaths. According to the Epidemiology and Disease Control Division (EDCD) of the Ministry of Health and Population, over 4,097 cases have been reported since January this year. By 5th of August, 2,365 cases were recorded nationwide. Dengue is a viral infection transmitted by female Aedes aegypti and Aedes albopictus mosquitoes, and is more common in tropical and subtropical climate. As such, our southern plains, marked by such a climate, had long been a breeding ground of the mosquitoes, and therefore, its hotspot.
However, the disease is now increasingly being detected at higher elevations. That hilly districts like Tanahun, Kathmandu, Kaski, and Parbat have recently reported more cases compared with the Tarai region serves as testament to this sobering reality. Health experts attribute this to factors such as climate change, population pressure and rapid urbanisation. Making things worse, huge unhindered movement of people through porous Nepal-India border, inefficient surveillance system, and insufficient preventive efforts – all elevate the risk. The peak of the dengue epidemic period is from June to August during the rainy season, and climate plays a key role in its transmission. So, during this time vigilance should be upped.
To keep the dengue danger at bay, we can take a host of precautionary measures: The spots at risk 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. Because the mosquitos are known to be active during dawn and dusk, special care needs to be taken during these times of the day. Taking personal protective measures during outdoor activities, such as application of repellents to exposed skin or clothing, and wearing long sleeves shirts and trousers are advised.
Protection measures also include the use of household insecticide aerosol products or mosquito coils. Windows 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 asleep. 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 steps and improved surveillance of its symptoms can go a long way to effectively contain the disease. Equally important is ensuring the availability of essential supplies, such as dengue kits and medicines needed for treating patients.