Dengue takes a critical turn

The death toll in dengue crossed 200 this year. And chances are, these deaths can go up even further in numbers.

The Directorate General of Health Services (DGHS) is thinking of tackling the situation putting emphasis on the management of dengue patients.

They are saying that the dengue situation is taking a critical turn.

DGHS’s Health Emergency Operation Centre and Control Room reported three more deaths from dengue on Sunday. With this, a total of 202 people died of dengue this year.

The annual death toll from dengue never crossed 200 before. The dengue outbreak had taken the severest turn in 2019. And, 179 people died of dengue that year.

Earlier it has been noticed that the dengue outbreak takes a downward turn towards October-November. However, about 22,000 people were infected with dengue in October this year. And, 86 of them have died.

DGHS’s disease control unit and the Bangladesh Society of Medicine jointly organised an event on the treatment and management of dengue at a city hotel this Sunday.

About 250 physicians participated in the event. Apart from them, physicians from all government hospitals of the country connected to the event online. The event discussed about what physicians should do in the current situation.

Additional director general (administration), DGHS and secretary general, Bangladesh Society of Medicine, Professor Ahmedul Kabir, told Prothom Alo, “A guideline was made for dengue treatment in 2018. That guideline has been updated very recently.  Physicians have been informed about dengue patients’ management , using that guideline.”

Ahmedul Kabir further added that patient's relatives and physicians are reporting that the dengue patient's condition is suddenly deteriorating this year.

The situation is somewhat critical because three different variants of dengue are active at the same time, he added.

Physicians said there are four variants of the dengue virus. They are DEN-1, DEN-2, DEN-3 and DEN-4.

When a person gets infected with one of these variants, he develops an immunity system against that variant and doesn’t get infected with the same variant twice.

A person infected with DEN-1 will never get infected with DEN-1 again. However, there runs a risk of falling prey to rest of the three variants.

When a person gets infected with a second variant after being infected with one variant already, the condition of the person turns more critical.

For instance, when a person recovers after being infected with DEN-1 and then contracts DEN-2, DEN-3 or DEN-4, the criticality level goes up.

DGHS doesn’t have data on whether people dying from dengue this year had prior records of dengue infection or not.

However, an official from the Communicable Disease Control (CDC) unit of the directorate said they are trying to this find out. CDC has already collected files of 120 patients who died of dengue from different government and private hospitals, he added,

Meanwhile, DGHS in September reconstituted a dengue-induced death review committee with Institute of Epidemiology, Disease Control and Research (IEDCR) director as the president to investigate actual reasons behind the deaths.

IEDCR director Tahmina Shirin told Prorthom Alo Sunday, the committee has held two meeting till now. It might take this month to know the results of the review on causes of the deaths.

Tahmina Shirin also said, people in this country were infected with DEN-1 and DEN-2 variants till 2016. In 2019, 90 per cent of the patients were infected with DEN-3. But, the situation is different this year.

DEN-1 has been detected in Cox’s Bazar area this year. Meanwhile DEN-3 and DEN-4 are being found in Dhaka.

She said, “We still don't know whether those being infected with DEN-3 or DEN-4 in Dhaka have been infected with dengue in the past or if they have, which variant was it.”

When it comes to division wise death toll, as usual the highest number of deaths occurred in Dhaka division this year as well.

DGHS control room has given the information of 121 deaths in Dhaka division. And, 119 of them died in different hospitals of Dhaka city.

Next in line comes Chattogram division with the second highest number of deaths. 50 people have died so far in this division and 24 of them died in Cox's Bazar district alone. The majority of them were Rohingyas who have taken refuge in Bangladesh.

After reviewing information on 148 deceased persons, CDC recently said that 64 per cent of the patients are dying within three days of being hospitalised.

This means, most patients are coming to hospitals only after theie condition has deteriorated.