22 September 2019, Kathmandu
Dengue has been reported as the viral fever epidemic of this year in Nepal. There is an alarming rise in the number of dengue infected people from July 1 to the middle of September in 2019 in Nepal, especially in Makawanpur, Kaski, Chitwan, Jhapa, Bhaktapur, Rupandehi and Lalitpur district.
Based on the recent update of Epidemiology and Disease Control Division, there is increased in the number of dengue patients across the country and a total of 3, 899 people had tested positive for the mosquito-borne disease.
People of hot temperature zone and Terai belt of Nepal are mostly prone to be affected from a mosquito bite and dengue disease a decade ago but due to the global warming, the temperature of the hilly belt also increases and there is also transition of mosquito from terai to mountain belts and also transmission of dengue disease from a person to another.
The epidemiological research shows that the geographical pattern of diseases transformed with the change in the climate. The study of Megh Nath Dhimal, Health Research Council on epidemiological disease find that the increase in the temperature in the Himalayan region also favors movement of vectors and disease transmission in that place.
Dengue is a vector-borne, epidemic, and public health concerned disease. Dengue viruses are arboviruses capable of infecting humans and causing diseases. It is an arthropod-borne disease transmitted by a mosquito vector Aedes Aegypti. The bite of female Aedes aegypti mosquito only transmitted the dengue virus to humans. It is likely to transmit dengue virus when the infected mosquito bites to the healthy person more in the morning or before dusk.
Rise in temperature is one of the enabling factors of mosquito breeding. Where, the mosquitoes lay eggs in the rainwater collected place as well as the pollutant environment favors the rapid spreading of the diseases in the surroundings. The growth of these types of mosquitos generally faster in mismanaged cities with improper water management.
After the bite of an infected mosquito, the victims often have intense joint and muscle pain. The complications arise due to depletion of cellular components in the blood which prevent normal clotting. The infections may be asymptomatic or may lead to classical dengue fever, or hemorrhagic fever with shock or hemorrhagic fever without shock.
The common symptoms of dengue disease include high-grade fever (104° F), body ache, joint or bone pain, severe headache, eye pain, swollen lymph nodes, rash and in some cases mild bleeding from gums or nose.
During the emergency and epidemic period, public health plays significant role for providing awareness on the use of mosquito net in the home, using the mosquito repellent products in the body parts like oil, and wearing protective clothing; loose-fitting full sleeved shirts and pants or similar dresses, and referral mechanism for the patient to the nearest health center or hospital for early diagnosis and prompt treatment.
It is also suggested for tightly covering water containers, wells, and water storage tanks which are the favorable environment for mosquito breeding. The prevention of the stagnation of water by topping up all defective ground surfaces, disposal of plastic containers, automobile tires, etc. safely also helps to reduce in the rapid breeding of the mosquito. Mass media mobilization and initiation of campaigns also leads to provide awareness about the spread of dengue in the locality of your residence and protect the infected person from further mosquito bites to avoid transmission of the disease.
The concentration of the Epidemiological Disease Control Department must be focused on developing an integrated vector control program, develop capacity and diagnosis and case management of Dengue fever as well as intensify IEC/BCC activities. For the prevention and control of dengue, strategical planning must be vital to strengthen the surveillance system for prediction, early detection, preparedness, and early response of outbreak of dengue.
During the outbreak of dengue, public health strategies must be initially planned for early case detection, diagnosis, management, and reporting. Secondly, there must be regular cases of dengue disease surveillance through EWARS (Early Warning and Reporting System) and mosquito vector surveillance in the different province, municipality, and wards. Lastly, the program planning on integrated vector control approach on health education, environmental sanitation, and community mobilization can be effective and appropriate.
Written by:
Kusum KC/Lamjung
Public Health Graduate
