Dengue cases rising, government remains indifferent

Dengue has now become a permanent public health concern in Bangladesh. This year, dengue patients have been identified in 63 districts of the country. Several variants of dengue infection are being noticed currently.

Public health experts believe the infection is spreading so extensively and in such a critical manner that managing the situation is becoming increasingly difficult.

Government data shows that only the northern district of Joypurhat has yet to report dengue cases this year. However, the civil surgeon in the district said that patients were detected there last year.

Over two decades of experience show that the government only springs into action when the dengue situation deteriorates. The ministry of local government, rural development and co-operatives claims to be working on mosquito control.

On the other hand, the ministry of health insists that controlling mosquito is not its responsibility and that they have full preparation to treat dengue patients.

While both ministries asserted their responsibilities, the reality is that the dengue situation shows no signs of improvement. Every year people continue to get infected and die from dengue.

A 2019 study by the Institute of Health Economics at Dhaka University found that the minimum treatment cost for a dengue patient in public hospitals exceeded Tk 5,000, while in private hospitals it ranged from Tk 53,000 to Tk 150,000. People continue to bear this financial burden every year.  

The first major dengue outbreak in Dhaka occurred in 2000, infecting 5,551 people and killing 93. The disease was completely new to the public back then. The worst year on record was 2023, when more than 300,000 people were infected and 1,705 died. Yet there has been no visible change. Even after 25 years, dengue still causes widespread fear among people.

In Mirpur, the home of bank officer Sadrul Amin is surrounded by wire netting, making it difficult for mosquitoes to enter. His workplace in Tejgaon also has strong preventive measures. Yet he still contracted dengue. “

I commute home from Karwan Bazar by metro rail,” he told Prothom Alo. “Though I’m not sure, I think I was bitten by a mosquito in Karwan Bazar. It could have happened at home also.”

Sadrul Amin came down with fever on 1 October. Then he tested positive for dengue on 5 October. He stopped going to work and has been following his physician’s advice at home. “I can’t describe how weak I feel. I was bedridden from 1 to 5 October. I don’t know when I’ll be fit to return to work,” he said.

There are many others in Dhaka in situations similar or worse than that of Sadrul Amin. Some are hospitalised, some have travelled from their home districts to the capital, lacking faith in local medical care.

Public health expert Abu Jamil Faisel told Prothom Alo, “The government doesn’t care. People may fall sick or die; it makes no difference to them. They have practically done nothing and they remain indifferent. Dengue has now become a permanent concern. What’s alarming is that signs suggest the situation will become even more complicated in the future.”

According to the Health Emergency Operations Centre and Control Room of the Directorate General of Health Services (DGHS), dengue cases have been reported in 63 out of the country’s 64 districts this year.

An exceptional development this year has been the dengue outbreak in the southern district of Barguna, where 8,160 people had been hospitalised with the infection and 14 had died of it till 20 October. Outside Dhaka, no other district has seen such a high number of dengue cases.

As of 20 October, as many as 60,791 people had been hospitalised and 249 had died of dengue across the country. The highest number of patients was reported in Dhaka division.

However, this is not the actual number of dengue infections. These are government statistics, based on data collected from all public hospitals and a few private ones. Many people who test privately and seek treatment on their own are not included in this official count.

Entomologists say that detection of dengue cases across almost the entire country indicate that Aedes mosquitoes, the carriers of the virus, are now found everywhere.

Kabirul Bashar, entomologist and professor of zoology at Jahangirnagar University said, “Aedes mosquitoes are found all over the country, and their density is extremely high.”

There are two main species of Aedes: Aedes aegypti and Aedes albopictus. Aedes aegypti is typically found in urban areas, while Aedes albopictus thrives in rural environments. However, almost every upazila headquarters now resembles the cities, making them suitable habitats for Aedes mosquitoes.

Bashar added, “We’ve found Aedes aegypti at the upazila level. We suspect it is Aedes aegypti that has been spreading dengue in rural areas. Our research is ongoing, and we’ll soon publish our findings confirming whether it’s Aedes aegypti or Aedes albopictus driving rural transmission.”

When major public health concerns arise, international organisations, particularly the World Health Organization (WHO), are always ready to stand by Bangladesh with technical support and guidance.

However, the officials at the local government ministry and the health ministry rarely take their advice seriously. There are many such instances.

In 2017, WHO consultant K Krishnamurthy prepared an interim plan for dengue and chikungunya prevention, detailing integrated mosquito control and disease management measures.

Reportedly, the health department worked on disease management, but the local government ministry did not even discuss the mosquito control plan let alone implement it.

There are more examples like this. During the major dengue outbreak of 2019, WHO sent senior entomologist BN Nagpal to Dhaka. He explained the behavioural traits of Aedes mosquitoes in detail and advised that the limited manpower of the city corporations could not possibly identify all breeding sources or prevent egg-laying. He stressed that community participation was crucial for mosquito control.

Yet, the local government ministry has failed to engage the public in mosquito control even in 2025. While community participation in anti-dengue drives was noticed in 2000 or 2001, it has virtually missing in 2023, 2024, or in 2025.

Experts say dengue has four variants (serotypes): DEN-1, DEN-2, DEN-3, and DEN-4. Infection with one type produces antibodies that protect against reinfection by the same type but not the others, meaning a person can potentially contract dengue up to four times. A second infection, however, often causes more severe illness and increases the risk of death.

According to 12 years of monitoring by the Institute of Epidemiology, Disease Control and Research (IEDCR), dengue serotypes are now recurring more frequently.

From 2013 to 2016, DEN-2 dominated, with only some DEN-1 infections. Meanwhile during 2017 to 2018, although DEN-2 remained prevalent, DEN-1 and DEN-3 infections were noticed as well.

The 2019 outbreak saw DEN-3 as the dominant strain. While in 2023, DEN-2 re-emerged strongly. Currently, both DEN-2 and DEN-3 are circulating in Dhaka, while in Barguna, most people are getting infected with DEN-2.

IEDCR Director Professor Tahmina Shirin told Prothom Alo, “The dengue variants (serotypes) are showing a tendency of rapid change. After one strain spreads, it is taking less time to return. This increases the risk of people being infected with dengue multiple times.”

Effective mosquito eradication is essential to control dengue. Irregular or seasonal anti-mosquito drives in Dhaka or a few large cities are not enough. Alongside use of modern technology, the government must implement sustained, nationwide campaigns that actively involve the public.

Public health expert and former chief scientific officer at IEDCR, Mushtuq Hossain told Prothom Alo, “There’s no shortcut or piecemeal way to control mosquitoes or dengue anymore. It has to be a year-round, nationwide effort. Mosquitoes control must be turned into a social movement, with citizens’ participation. If such a campaign continues for several consecutive years, results may finally emerge. But, a strong political commitment is essential for that.”