Health department has no idea which strain of dengue is spreading

Dengue patients under treatment at a Dhaka hospitalFile photo

The government has limited information regarding the prevailing type of dengue virus in the country this year, out of the four established variants. Furthermore, due to funding constraints, the health department is unable to monitor the dengue situation.

The Institute of Epidemiology, Disease Control and Research (IEDCR) monitors the disease situation in the country. The institute was able to provide the information as to which type (variant) of dengue affected people more. However, in a press conference organised on 'One Health Conference' regarding human, animal and environmental health at the IEDCR conference room on Sunday, professor Tahmina Shirin, director of the institution, said that they do not have any information about the strain of dengue virus that broke out this year. She said, the institute does not have the funds to monitor the situation.

The dengue outbreak has reached alarming levels this year. Public health professor Be-Nazir Ahmed has commented that it is unfortunate and unwarranted that IEDCR's monitoring activities have been help up due to lack of funds. He told Prothom Alo that it is necessary to know about the variant of virus affecting to understand the pathological risk. Secondly, it is necessary to know the variant of dengue for proper treatment.

Visiting 12 districts including two city corporations of Dhaka, it was found that there is a lack of coordination in mosquito control and disease control procedure. The districts include: Chattogram, Chandpur, Khulna, Narail, Narayanganj, Rajshahi, Cox's Bazar, Mymensingh, Barguna, Jashore, Kushtia and Rangpur. Several civil surgeons of these districts told the Prothom Alo correspondent that they fear the number of dengue patients may rise this year.

Which variant turns dangerous?

According to pathologists, there are four types of dengue virus serotypes -Dengue-1, Dengue-2, Dengue-3 and Dengue-4. After infected with a type, the body produces antibodies, that is, the body develops immunity to the disease that prevents recurrence of the virus. However, there remains a risk of contracting the other three strains.

Public health experts say that recurrence of dengue means being affected with a different variant. Professor Be-Nazir Ahmed told Prothom Alo, if somebody contracts dengue for the second or third time, the severity and complications increase.

According to Ekramul Haque, the sub-programme manager of the disease control branch at the Directorate General of Health Services (DGHS), last year's data showed that a significant majority of patients admitted to the hospital were affected by the Den-3 variant of dengue, accounting for approximately 90 per cent. Additionally, he revealed that around 9 per cent of the patients were infected with the Den-4 variant.

Abul Bashar Mohammed Khurshid Alam, director general, DGHS told reporters on Saturday, that shock syndrome was more common among dengue patients this year.

When asked about the suspension of dengue monitoring by IEDCR due to scarcity of funds, the director general told Prothom Alo yesterday, "If they (IEDCR) asked, we would have tried to arrange funds."

Situation may deteriorate

As many as 547 dengue patients were admitted to hospitals across the country from 1 January to 11 June last year. No death was recorded in the country at the time. A total of 3210 patients have been admitted to hospital from 1 January to 11 June this year and 24 people died. Among them, 189 people were admitted to the hospital on Sunday. Of them 2 persons died. Many fear that the situation will deteriorate.

Civil surgeons of Chattogram, Narayanganj and Rajshahi have apprehended that dengue cases may increase during the monsoon.

Prothom Alo correspondents spoke to people of various professions about the dengue situation. Senior lawyer of Cox's Bazar Ayasur Rahman said, “Monsoon is around the corner. The drains of the city are clogged. Those need to be cleaned quickly. Water accumulates on rooftops, in flower pots, discarded coconut shells and so on. This can exacerbate the dengue situation."

Civil surgeon of Chandpur Shahadat Hossain said that number of dengue patients is increasing every day in Chandpur as people infected with dengue are coming from Dhaka to Chandpur. Many people work in Dhaka. On the other hand, civil surgeon of Rajshahi Abu Sayid Mohammad Faruk said people from different areas will come to Rajshahi during Eid ul Adha. Dengue cases may rise at the time.

No mosquito eradication

The transmission of the dengue virus occurs through the Aedes mosquito, and its outbreak has spread to nearly every district in the country. Although surveys on mosquito presence were conducted in the two city corporations of Dhaka, there is a lack of information regarding similar surveys being conducted in other cities, as reported by Prothom Alo correspondents.

The correspondents found out that there was absence of mosquito control operations in Barguna town, occasional repellent spraying in Chattogram, and no observable activities in Jashore. Residents of several wards in Kushtia city have not witnessed any mosquito repellent measures. The districts of Chattogram, Khulna, Narayanganj, Cox's Bazar, Mymensingh, Barguna, and Jashore have been heavily impacted by dengue.

DGHS officials have said on several occasions that there is a risk of dengue spreading in hospitals where dengue patients are admitted. That is why instructions have been given to separate dengue wards and use mosquito nets in those wards. However, separate wards for dengue were not seen in government hospitals of Chattogram, Chandpur, Mymensingh and Rangpur. Mosquito nets were seen to be used for dengue patients in hospitals in Chattogram, Chandpur, Khulna, Narail, Narayanganj, Rajshahi, Cox's Bazar, Mymensingh and Barguna.

Updates from Dhaka

Total 2,412 dengue patients have been admitted to hospital for treatment in Dhaka South and North City Corporation so far this year. Of the 24 deaths in the country this year, 20 died in different hospital of the two city corporations.

There are 880 workers in Dhaka North City Corporation. They work in turn to repel mosquitoes daily in different wards. North City conducted a week-long special mosquito control programme from 29 May to 5 June.

Apart from this, 250 BNCC and 300 Rover Scouts trained in North City are carrying out door-to-door public awareness mobilisation. They work in 10 areas of Dhaka. A meeting was organised with the imams of the mosque on 4 June, with 1200 imams participating. Dhaka North City Corporation has a Covid specialised hospital in Mohakhali. There are no Covid patients in it now. Director (Acting) colonel AKM Zahirul Hossain told Prothom Alo that the hospital has been made ready for the treatment of dengue patients.

Meanwhile, there are 1,500 workers in Dhaka South City Corporation with 14 people working in each ward in the morning and afternoon shift. The South City Corporation had written to 22 organisations asking them to keep their areas clean in May.

Citing that preparations are underway to curb dengue since January, South City Corporation chief health officer Fazle Shamsur Kabir told Prothom Alo that it is not possible for the city corporation alone to control the dengue. It requires collective participation and collaboration from individuals and institutions across the country.

[Correspondents of Chattogram, Chandpur, Khulna, Narail, Narayanganj, Rajshahi, Cox's Bazar, Mymensingh, Barguna, Jashore, Kushtia, Rangpur and Dhaka helped filing this report]

*This report, originally published in Prothom Alo print edition, has been rewritten in English by Farjana Liakat