700 soldiers to combat disease

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By 2017-03-19

By Amanda Guyes

Dengue is one of the rapidly spreading mosquito-borne viral infections throughout the tropical regions of the world. Dengue not only causes bodily pain but also makes the patient a burden to society. In a developing country such as Sri Lanka dengue has forced the authorities to close down schools in some parts of the country.

The highest number of dengue patients was reported in 2016. According to the Epidemiology Unit website of the Ministry of Health there had been 51, 823 dengue cases across the island and around 75 deaths.

During the past three months, 21, 541 suspected dengue cases were reported, Epidemiology Unit sources said.

Meanwhile, the Kinniya Division of the Trincomalee District has become dengue affected area. The education authorities of the Eastern Province in the Trincomalee District ordered the closure of 66 schools in the Kinniya Education Division on Wednesday (15) due to the rapid spread of dengue fever.

Highest number

Zonal Director of the Education, A.M. Ahamed Lebbe told Ceylon Today that the highest number of dengue cases in the Trincomalee District was reported from the Kinniya Division and the surrounding educational zones. He said a significant number of students and teachers are suffering from dengue fever in the Kinniya Divisional Secretariat Division. Thirteen patients have died of dengue fever during the past three weeks.

A six-year-old child died on Thursday night (16) on admission to the Anuradhapura Hospital. Out of the patients admitted from Trincomalee 14 have died so far.

Meanwhile, 700 Army personnel have been deployed for field operations to prevent the spread of the disease.

"During the past three days many volunteer groups, Public Health Inspectors (PHIs), health organizations, armed forces and members of the public participated in activities to prevent the spread of dengue. They were seen going from house to house educating the people on preventive methods and giving other instructions to get rid of the disease. We hope that there would be a reduction in the dengue menace in the coming weeks," sources said.

Meanwhile, there had been nearly 2,100 dengue patients reported in Trincomalee, the Health Director of the Eastern Province Dr. K. Murugananthan said. He told Ceylon Today that arrangements have been made to curtail the spread of the disease.

Viral infection

According to the World Health Organization (WHO), dengue is a mosquito-borne viral infection which causes flu-like illness and occasionally develops into a potentially lethal complication called severe dengue. Severe dengue is a leading cause of serious illness and death among children. There is no specific treatment for dengue/severe dengue, but early detection and access to proper medical care would lower the fatality rates below 1 per cent. Dengue prevention and control depends on effective vector control measures.

Dengue virus is transmitted by female mosquitoes mainly of the species Aedesaegypti and the mosquito also transmits chikungunya, yellow fever, and Zika infection. Dengue is widespread throughout the tropics, with local variations in risk influenced by rainfall, temperature and unplanned rapid urbanization.

Transmission

The Aedesaegypti mosquito is the primary vector of dengue. The virus is transmitted to humans through the bites of infected female mosquitoes. After virus incubation for 4–10 days, an infected mosquito is capable of transmitting the virus for the rest of its life.

Patients who are already infected with the dengue virus can transmit the infection (for 4–5 days; maximum 12) via Aedes mosquitoes after the first symptoms appear.

The Aedesaegypti mosquito lives in urban habitats and breeds mostly in man-made containers. Unlike other mosquitoes, Aedesaegypti is a daytime feeder; its peak biting periods are early in the morning and in the evening before dusk. Female Aedesaegypti bites multiple people during each feeding period.

Dengue fever is a severe, flu-like illness that affects infants, young children and adults, but seldom causes death. It should be suspected when a high fever (40°C/104°F) is accompanied by two of the following symptoms: a severe headache, pain behind the eyes, muscle and joint pains, nausea, vomiting, swollen glands or rash. Symptoms usually last for two to seven days, after an incubation period of 4–10 days after the bite from an infected mosquito.

Severe dengue is a potentially deadly complication due to plasma leaking, fluid accumulation, respiratory distress, severe bleeding or organ impairment. Warning signs occur 3–7 days after the first symptoms in conjunction with a decrease in temperature (below 38°C/100°F) and include: severe abdominal pain, persistent vomiting and rapid breathing, bleeding gums, fatigue, restlessness and blood in vomit. The next 24–48 hours of the critical stage can be lethal; proper medical care is needed to avoid complications and risk of death.

Treatment
There is no specific treatment for dengue fever. For severe dengue, medical care by physicians and nurses experienced with the effects and progression of the disease can save lives – decreasing mortality rates from more than 20 per cent to less than one per cent. Maintenance of the patient's body fluid volume is critical to severe dengue care.

The absence of a proper drainage and garbage disposal system in Sri Lanka has resulted in more breeding places for mosquitoes.

At present, the main method to control or prevent the transmission of dengue virus is to combat vector mosquitoes through preventing mosquitoes from accessing egg-laying habitats by environmental management and modification; disposing of solid waste properly and removing artificial man-made habitats; covering and emptying and cleaning of domestic water storage, containers on a weekly basis; applying appropriate insecticides to water storage outdoor containers; using of personal household protection such as window screens, nets and long-sleeved clothes; insecticide treated materials, coils and vaporizers; improving community participation and mobilization for sustained vector control; applying insecticides as space spraying during outbreaks as one of the emergency vector-control measures; active monitoring and surveillance of vectors should be carried out to determine effectiveness of control interventions.

We see field staff of numerous other agencies such as the local government institutions, security forces, Divisional Secretariats, Grama Niladharis and Samurdhi and other private institutions are spearheading dengue control activities. Moreover, it has become an urgent need to establish a structure with legal and institutional capacity in order to coordinate the activities that are conducted countrywide. A collective of human resources and technology could pave the way to eliminate the breeding sites effectively and sustainably. Encouraging the Sri Lankan environmental researchers for nature-based solutions for the dengue prevention will be highly impactful in the long term.

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