Every year dengue causes suffering, after the spread of the infection, the government just heats up

 Every year dengue causes suffering, after the spread of the infection, the government just heats up

Lalitpur Metropolitan Municipality is running a free 'Fiber Camp' from October 4th after dengue which is caused by mosquito bites has spread widely in the community. Lalitpur Metropolis was forced to run free health camps in all 29 wards due to the spread of dengue infection at the community level.

According to experts, it is necessary to conduct 'search and destroy' campaign twice every week to control dengue. However, this year too, the local levels did not prioritize the campaign.

As the outbreak of dengue infection became dire, the government finally announced a nationwide campaign to control it. The meeting of the Council of Ministers decided to conduct larva destruction campaign every Friday at 10 am only last Thursday.

Prime Minister KP Sharma Oli has called on all citizens to participate in the campaign through social media. He requested to destroy mosquitoes and their breeding places through video messages and statuses.

"Dengue disease transmitted by mosquitoes is still present in some districts," said Prime Minister Oli.

Within the last 10 months, the number of deaths due to dengue infection has reached 12. During this period, the number of infected has exceeded 28 thousand. Even after mid-October, dengue infection and risk have not stopped. They allege that due to government negligence, dengue infection could not be brought under control this year.

According to experts, 80 percent of dengue patients are asymptomatic. Head of Epidemiology and Disease Control Division Dr. Yaduchandra Ghimire estimates that around 4 lakh people have been infected with dengue this year.

Considering that 80 percent are asymptomatic, 250,000 have been infected. Even though some have similar symptoms, they are resting at home, Dr. Ghimire told Online News, "We have estimated that four lakh children have been infected this year."

Ministry of Health mute audience

The Ministry of Health remained a silent spectator while the experts were warning that a dire situation could occur this year as well. Officials of the ministry blamed the local level for dengue control.

According to experts, to control dengue, the larvae search and destruction campaign should be conducted intensively before the onset of monsoon. However, the government has started the 'larva search and destruction campaign' only after dengue has spread. This year too, the government repeated the same mistake. The campaign that started late has not been conducted effectively.

It seems that the high officials of the Ministry of Health are also satisfied with their regular work. No visible work has been done in dengue prevention. Instead, they are trying to get immunity by blaming the lower level.

Experts say that the infection is spreading rapidly due to the weak leadership and careless management of the Ministry of Health in controlling dengue.

As soon as the monsoon started, the search and destroy campaign should have been expanded. This situation would not have happened if it had been controlled in the larval stage,' former head of the Epidemiology and Disease Control Division, Dr. Baburam Marasini says, "But the government is doing weeding only after the spread of dengue."

It seems that the high officials of the Ministry of Health are also satisfied with their regular work. No visible work has been done in dengue prevention. Instead, they are trying to get immunity by blaming the lower level.

Dengue infection caused by the bite of Aedes aegypti and Aedes alluvopectus mosquitoes was first detected in Nepal in 2004 in a foreigner who came to Chitwan.

Then in 2006, dengue patients were found in some districts of Terai and interior Madhesh. In 2016, dengue was seen as an epidemic in Chitwan, Jhapa and Rupandehi.

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In 2020, 18 thousand people were infected by dengue spread from Dharan, 12 people died due to dengue spread in 43 districts. Since then, not only the number of dengue infected people has gradually increased, but the infection has also spread to other districts.

By the year 2022, dengue infection had spread to all 77 districts, and more than 54,000 people were infected. 88 of them died.

In 2023, dengue spread in Koshi region. When 20 people died, more than 52 thousand were infected. According to EDCD data, 31 percent of the infected were from Sunsari.

In the last two to three years, dengue has not only appeared as an epidemic, it is gradually increasing in the hilly districts which are called cold places. While the risk of dengue is increasing year by year, the officials of EDCD give the same kind of answer, saying, "Strategy for dengue control has been made and delivered to the local municipality." We have given the budget. We have trained some health workers.

According to experts, dengue cannot be controlled until the search and destruction campaign is made effective from the center itself.

These 6 districts are at high risk of dengue

Looking at the data so far, 6 districts are at high risk of dengue. Out of which Gandaki province has been affected the most. Eight people have died in Gandaki province due to dengue. Almost 50 percent of the infected people found across the country are from Gandaki province.

13 thousand 898 have been infected in Gandaki province alone. The most infected people in the province are 7,161 in Kaski and 2,226 in Tanahun.

Looking at the district wise details, Kaski is the most affected district. Tanahun ranks third among the 10 most affected districts. There are 4 thousand 313 infected in Kathmandu, 1 thousand 677 in Parbat, 1 thousand 111 in Lalitpur and 1 thousand 99 in Chitwan.

Teku Hospital Chief Consultant Physician Dr. According to Bimal Sharma Chalise, some patients had to be treated in the ICU due to double infection.

According to the official of EDCD, most of the 12 people who died were chronically ill. People with high blood pressure, diabetes, heart problems or other diseases with reduced immunity have more deaths. Ghimire said.

Why was Gandaki more affected this year?

This year, three districts of Gandaki province became 'hotspots'. Last year also thousands of people were infected in Tanuham.

Head of the Insect Disease Control Branch of EDCD Dr. Gokarna Dahal speculates that dengue spread by developing eggs laid by infected mosquitoes the previous year.

Last year, the citizens of Tananhu (Damauli) market were infected. But this year, a case has been seen in the surrounding municipalities and wards," said Dr. Dahal said, "Dengue has spread due to the development of eggs laid by dengue last year."

Since the data for March and February also indicated the spread of dengue in Gandaki province, Dr. Dahal said.

It is not possible to determine exactly in which area dengue spreads. But the number of cases coming from February to March can be estimated as to where it can be seen more in June and July,' said Dr. Dahal says.

A double outbreak of dengue infection

All four serotypes (types 1, 2, 3 and 4) of dengue have been observed in Nepal. Doctors say that if a person who is infected with one virus gets another serotype infection the next time, the problem can become complicated.

This year also, as the number of infected increased, double infection caused more complications in the patients. Teku Hospital Chief Consultant Physician Dr. According to Bimal Sharma Chalise, some patients had to be treated in the ICU due to double infection.

In the patients who are admitted to the hospital, Dr. Dr. Chalise said.

According to him, if one type of dengue serotype infects a person, there will be no other infection of the same serotype throughout life. The human body has strengthened its immunity against that serotype. But if there is an infection of a different serotype, complications may increase and the patient may even die.

Infectious disease specialist Dr. Sher Bahadur Pun said that if the infection is of a different serotype than the first time, the risk of health complications will be high. Re-infection of the same serotype is less complicated. But infection with different serotypes can cause serious problems,” he said.

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The first infection has already developed immunity in the body. But when there is an infection of a different serotype, the body reacts. When the virus grows uncontrollably, the immunity of a person decreases, due to which complications appear in the patient.

Dr. According to Pun, patients are feeling more pain this year compared to previous years. Dengue infection increased unexpectedly this year. As the number of patients increases, the risk of death also increases," said Dr. He says again.

How did dengue spread nationwide?

Dengue, which appeared in Nepal only two decades ago, has now spread throughout the country. Dengue, which was previously found only in the Terai, has now risen to the hilly and mountainous regions. Health experts point to climate change and rapid urbanization as the main reasons.

EDCD director Dr. According to Ghimire, mosquitoes, which are limited only to Terai, are now adapting to hilly and mountainous environments. "These mosquitoes, which were not seen in cold areas in the past, have now reached the Himalayan region with the increasing temperature," he said.

According to experts, mosquitoes that transmit dengue are able to survive even at temperatures as low as 12-13 degrees Celsius. Due to which the risk of dengue has increased even in the high mountain areas.

Impact of urbanization and climate change

Public Health Dr. Baburam Marasini said that the main reason for the spread of dengue in urban areas is water and unorganized waste management. According to him, drums and buckets kept for collecting water, old tires and garbage, pots of Kausi farming, standing water in open pits are breeding grounds for mosquitoes of Aedes aegypti and Aedes alvopectus species.

The average temperature in 1859 was 14 degrees Celsius, now it has reached 15.1 degrees. This 1.1 degree increase has accelerated the spread of insect-borne diseases.

He says that climate change and rapid urbanization have increased the risk of dengue infection in Nepal. This disease, which has spread from the Terai to the hill districts in the past decade, has now become a major public health challenge.

About 15 years ago, a dengue outbreak in Birgunj infected more than 400 people. At that time Dr. A study conducted by a team led by Marasini showed that the frozen water in the tires piled up on the road during the Madhesh movement became the main habitat for mosquitoes that spread dengue.

"Mosquitoes increased after rain water accumulated on the tires kept by the agitators for blocking the road," said Dr. Marasini says, "But after those tires were burned, the infection decreased significantly."

According to experts, the increase in atmospheric temperature after the industrial revolution is the main reason for the spread of dengue. The average temperature in 1859 was 14 degrees Celsius, now it has reached 15.1 degrees. This 1.1 degree increase has accelerated the spread of insect-borne diseases.

Infectious disease experts also consider increasing urbanization as a reason for the spread of dengue. "Mosquitoes easily breed in the water that collects water in urban areas, drums, buckets, tires of garages and pots in the garden," he said.

In order to prevent the infection of dengue, it is necessary to search and clean the places where the water is stored and the water tanks in and around the house where mosquitoes can breed and destroy the mosquito breeding.

Water containers such as tanks, drums, trays, buckets, etc. should be covered properly to prevent mosquitoes from entering. You should wear clothes that cover your body. As far as possible, the hammock should be used even when sleeping during the day. Also, small children should sleep in a swing at any time.

In the same way, you should burn mosquito repellent incense inside the room and apply ointment to prevent mosquito bites. Clothing that covers the entire body is appropriate. In and around houses and schools where mosquitoes can breed, all places where water accumulates and water tanks should be searched and cleaned.