Dengue spreads, inadequte action  

cticidesDengue cases in the country have increased more than twice in August compared to July. Even deaths have increased more than twice. Public health experts say that the weather conditions show clear signs of a spike in dengue infection.

However, the health ministry and the local government agencies have become almost ineffective to prevent this disease borne by Aedes mosquitoes. Though donor organisations have insisted on dengue prevention, there’s not much being done by the ministry of health.

There are two reasons to be worried about dengue this time. First, the number of dengue cases this year is a lot lower than that from last year. So is the number of deaths. However, the mortality rate so far this time is quite higher than that from last year.

Second, dengue is an infection that is usual in monsoon. However, Bangladesh’s experience from 2022 at least showed that the highest number infection was recorded in October that year.

Though, the number of cases and deaths has been low so far this time, the condition of the weather especially the heavy rainfall after the monsoon is showing danger signs of dengue, commented public health expert Mushtaq Hossain.

A total of 6,999 people were infected with dengue in August while 30 people died. And in July, the number of dengue patients was 2,699 with 12 deaths recorded. The number of dengue patients has been rising for four weeks.

The number of dengue cases on 1 August was 6,517. After a week this number rose to 7,563 and it increased to 8,980 in the next week. The number of patients was respectively 1,076 and 2,185 in the next two weeks.

The number of total dengue cases from January to July in the current year was 6,320. And, this number rose to almost 7,000 in August alone. There have not been as many deaths in any of the previous months as that in August.

There was a large-scale dengue outbreak in the country back in 2000. Meanwhile, the highest number of dengue infection and deaths in the history of the country was recorded just last year (2023).

Last year, basically in September the number of dengue cases increased so much that it was the highest among the previous 23 years. The number of deaths last year surpassed the number of deaths in all the previous years.

The mortality rate in dengue was 0.55 per cent last year. And, this rate was the highest among all the countries in the world. Though the number of people affected by dengue is way lower this time, the mortality rate is high. The mortality rate this time it is 0.64 per cent.

Bangladeshi scientist Najmul Haider, a researcher of mosquito-borne diseases at Keele University in the United Kingdom, has conducted several studies on the dengue situation of Bangladesh. He told Prothom Alo that from 2019 to June last year, the ‘Den-3’ variant was predominant among the four variants of dengue.

Since June last year, the ‘Den-2’ variant has been spreading at a massive rate. Many of those who are being affected now were previously affected by ‘Den-3’. Therefore, when these people are being infected the risk of death as well as the mortality rates is increasing, he added.

Sources from the Dhaka South City Corporation (DSCC) stated that the equipment used for spraying dengue-carrying Aedes mosquito insecticide of 25 wards under DSCC was either damaged or stolen in vandalism during the mass movement in August.

The source, who did not want to be named, said that the equipment that was stolen or damaged will undoubtedly hamper the work of preventing dengue.

Health officer at Dhaka North City Corporation (DNCC), Md Emdadul Hoque told Prothom Alo that the dengue eradication equipment of 15 wards has been damaged more or less.

Ward no. 24 and 34 have been affected the most. In ward no. 34, all the mosquito insecticides were destroyed. Meanwhile in ward no. 24, though the drugs were not destroyed, all the equipment was destroyed, he added.

Mushtuq Husain said that there’s more attention being paid to the treatment of dengue now. Yet again that is not enough. However, dengue is not just about the treatment. Complex issues of public health including cleanliness are involved here. And. those questions are remaining unspoken or not being paid heed to at all.

After the interim government took charges, Robed Amin was appointed the director general of the directorate general of health services. However he couldn’t join the post even till this 4 September, due to opposition from a section of physicians.

There are no directions or initiatives from the ministry of health on the issue of dengue, according to an official from the World Health Organization (WHO) who does not want to reveal his name.

He told Prothom Alo that the dengue infection keeps rising. However the ministry of health is in a sort of ‘nonfunctional’ state for about a month. No response from them can be noticed for dengue prevention. Meanwhile, the strong efforts against dengue have been hampered from the local government agencies being disbanded.  

While attempts were made to contact health adviser Nurjahan Begum several times over the phone to speak on the matter. She did not reply to the call.

The meteorological department has stated that there has been 46 per cent more rainfall than usual in this August. It has been found in several studies done by the meteorological department that the rainfall during the post-monsoon period has increased over the last decade or so. And, this has had an effect on the spread of dengue.

Dengue spreads by Aedes mosquito that reproduces in water. As a result of post-monsoon rains, there was the highest spread of dengue in October 2022, exceeding all previous records. As many as 21,932 people were infected in that month.

And there was the highest number death with 113 people dying of dengue in November that year. Public health experts believe that the ‘untimely’ dengue outbreak that year contributed to the unusual outbreak the next year.

The meteorological department forecasts that the rainfall might increase even in the current September. This rainfall and the lack of coordination among the local government agencies may contribute to the rise of dengue even this year, believes Mohammad Shafiul Alam, a scientist at the communicable disease department of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b).

He told Prothom Alo, “We have the memories from 2022. So, there is a risk of dengue spike in the post-monsoon period this time as well. There is no way but to increase public awareness.”