Dengue cases on the rise, COVID-19 remains a concern too

Amena Begum, 48, from Narayanganj, suffered from a high fever and body ache seven days ago. Her fever did not subside with medication. Tests revealed she had dengue.

When her platelet count dropped to 40,000, her family rushed her to Dhaka. Since 1 July, she has been admitted to the ICU at DNCC Covid‑19 Dedicated Hospital in Mohakhali, run by Dhaka North City Corporation.

This correspondent met Amena’s son, Arnab Mohammad, outside the ICU on the fifth floor of the hospital on Friday afternoon. Arnab said that his mother’s platelet count fell further to 18,000 the day after she was admitted. Arnab and his father, Md Salauddin, have been living at the hospital for the last four days to care for his mother. They sleep on mats on the corridor at night.

Another patient in the ICU is 17‑year‑old Jannatul. Her family was arranging blood for her. Jannatul’s mother, Amena Begum, told Prothom Alo that they live in Shekhertek area in Dhaka’s Mohammadpur. She said she and her daughter had gone to her (Amena) in-law’s house in Patuakhali Sadar upazila for a visit on 10 June.

When Jannatul developed a severe fever there on 27 June she had taken her daughter to Patuakhali general hospital the next day. Test confirmed that Jannatul had dengue.

The mother said that there were too many dengue patients in that hospital. On physician’s advice, they brought Jannatul to DNCC Covid‑19 dedicated hospital in Dhaka on 30 June. Her daughter has been given a bag of blood already. The physicians say she needs to be given more blood as her platelet count had fallen to 6,000 Friday.

There were 15 patients admitted in the ICU of the hospital Friday. Six of them including Amena Begum and Jannatul were dengue patients. Corporal Md Miarul Islam, in charge at the hospital Friday afternoon, said that there were total 131 patients admitted in there counting both the ICU and the wards.

Of them, 26 were dengue patients and 19 were COVID-19 patients while the remaining 86 had other illnesses. There is no arrangement to diagnose chikungunya at the hospital. Based on symptoms, they suspect some patients may have chikungunya and these patients are housed among other patients.

Currently fever, dengue, chikungunya and COVID-19 are all on the rise across the country including the capital. People are panicking as soon as they develop a fever. Physicians say that dengue is particularly on the rise now and may increase further in the next two months.

According to the Directorate General of Health Services (DGHS), as many as 204 people were admitted to hospitals with dengue across the country in 24 hours from 3 to 4 July. No deaths were reported.

During that same period, 57 dengue patients were admitted to public and private hospitals in Dhaka city. Of them, 45 were admitted in 18 public or autonomous hospitals and 12 in 59 private clinics and hospitals. Dhaka Medical College Hospital has the highest number of admission with 26.

DGHS records from 20 June show that 151 dengue patients were admitted across the country in those 24 hours. At the same time, 28 were admitted to hospitals in Dhaka that day.

Former principal of Dhaka Medical College and a medicine specialist, Professor Md Tito Mia told Prothom Alo that increasing number of dengue and chikungunya patients have been visiting both hospitals and physician’s chambers for the last two weeks.

He added that there are COVID-19 patients as well. Mentioning that dengue carries a higher risk of death, he warned that without increasing government initiatives for preventing dengue right away and raising public awareness in this regard, the crisis could intensify.

Tito Mia further said that awareness must be raised to prevent Aedes mosquito, the carrier of dengue, from breeding in the water accumulated in bathroom corners, tubs and hollow tyres.

He emphasised that anyone with fever must go for tests. A drop in blood pressure is more alarming than the drop in platelet count. If there’s a drop in blood pressure the patient must be admitted in a hospital.

According to DGHS data, currently there are 351 patients admitted to public and private hospitals in Dhaka city. A total of 57 new patients were admitted in 24 hours from 3 to 4 July.

Among the 204 new cases detected across the country in the same 24-hour period, the highest number of infections, 101 was recorded in the Barisal division.

From January to 4 July this year, a total of 11,660 people have been hospitalised with dengue in the country. Barishal division has reported the highest rate of infections, totalling 5,170. Among them, 45 have died.

Meanwhile, the highest number of deaths occurred in areas under Dhaka South City Corporation (DSCC) with 20 deaths reported there.

Professor Md Halimur Rashid, line director of the Communicable Disease Control (CDC) at DGHS, stated that the DGHS is prepared to take appropriate measures if the number of patients increases further.

Retired primary school teacher Khaleda Akand, 56, a Rampura resident developed a high fever last week. She experienced severe body aches as well.

As there are physicians among her relatives, she was following the medical advice suggested by them over the phone. She was consuming fruit juice, oral saline, and other fluids while her test result came back negative for dengue on the third day of fever.

But then her eyes turned red and her gums began to bleed on the fourth day. On the advice of a relative who is a physician, she was tested again, and this time she tested positive for dengue.

Her daughter-in-law, schoolteacher Sharmin Bashar, told Prothom Alo that her mother-in-law’s body ache has reduced now while her overall physical condition is improving too. They are following the physician’s advice closely.

Hafiza Begum, 22, who has been working as a caregiver for a child in a house in Dhanmondi area of Dhaka for the past one and a half years, developed a high fever of 105°F on the night of 29 June.

Along with the fever, she experienced severe joint pain and itching. Her joint pain worsened so much that she couldn’t walk and had to be taken to the Physician in a wheelchair.

Fatema Abedin, mother of the child Hafiza takes care of, told Prothom Alo Friday that she took Hafiza to see a physician at a hospital in Dhanmondi on 30 June. The test result came back negative for dengue.

Following physician’s advice, Hafiza was being given liquid food. However, she began vomiting severely and her joint pain and itching worsened two days later. That night, she was admitted to another hospital in Dhanmondi.

Based on other blood tests and platelet count, the doctors suspected dengue or chikungunya and treated her accordingly. After staying in the hospital for a day, Hafiza was taken back home. Her physical condition is stable now.

A mother named Mitu admitted her four-year-old daughter to the COVID ICU unit at the DNCC COVID-19 Dedicated Hospital in Mohakhali. Speaking to Prothom Alo at the hospital Friday, she said they live in Mohakhali.

Although the dengue test result for her daughter came back negative, the physicians say they suspect dengue based on her symptoms. Her daughter is being given IV saline, she said.

COVID-19 patients are being treated on the sixth floor of the DNCC Dedicated COVID-19 Hospital in Mohakhali. A woman named Mala told Prothom Alo that her aunt’s husband and son have passed away, and she is the only one left to care for her aunt. Her aunt, who is a kidney patient, was suffering from shortness of breath, so Mala took her to Dhaka Medical College Hospital last Thursday.

From there, she was referred to the DNCC hospital, where she tested positive for COVID-19. According to DGHS data, six people tested positive for COVID-19 from 242 samples in 24 hours from 3 to 4 July. No deaths were reported.

Entomologist and professor of zoology at Jahangirnagar University, Kabirul Bashar told Prothom Alo that the dengue situation could be terrible in August–September. Field-level research has shown that the Breteau Index, used to measure the density of Aedes mosquito larvae, is over 20 in every district of the country. This indicates a really high risk of dengue outbreak.

Professor Kabirul Bashar added that there were little to no mosquito control activities in the past 11 months as the local government structure was largely ineffective.

Although dengue is typically seen as an urban disease, it is spreading increasingly in the rural areas this time. He believes tackling the dengue situation requires scientific implementation of integrated mosquito strategies for Aedes mosquito control.

Plans need to be formulated by including experts with extensive experience in mosquito-control. Additionally, hospitals must be adequately prepared to manage the expected surge in patients over the next two months. Generally, our hospitals lack the capacity to handle such high patient volumes, he added.