Unbeaten dengue: the outbreak creates health menace in Dhaka city
Kamruzzaman
Md Alauddin, a rickshaw puller and his wife Shima were trying to manage a government hospital bed for their beloved daughter, Sultana, who is only 5-year-old. She was suffering from dengue fever for the last couple of days. But her parents could not find any bed for her treatment which is crucial to save her life.
Eventually, the hopeless couple admitted their apply-of-eye Bangladesh Children’s Hospital and Institution, a Dhaka based government hospital, on 13 November. But getting a bed remained elusive: her daughter took treatment lying on the hospital’s floor.
Sultana’s mother, Shima, said to a local media, ‘A doctor at the hospital has been helping us.’ But she expressed frustration as medicine was not readily available at the hospital. They don’t have money to purchase essential medicines from outside of the hospital, said Shima.
It is dengue which is responsible for the miserable condition in the Dhaka city hospitals since last September. Many people, like Alauddin and Shima, faced the crisis due to the lack of medical facilities. Hospital authorities also passed difficult time to manage the wave of patients with the lack of infrastructure, manpower and other resources.
Directorate General of Health Services (DGHS) briefs about dengue outbreak update in every day.
According to the DGHS, 61,844 dengue cases have been reported from January 1 to December 22 and, 62% patients recorded in Dhaka Metropolitan area. Although, health specialists think the actual figure of dengue cases are more than that of the official figures.
Many patients living in remote areas remain uncounted in the figure.
Record death and public health in danger
According to the DGHS data, this year dengue casualties became the highest since 2000 when the government formally started keeping records on dengue case. As of 22 December, 274 people died from this mosquito-borne viral disease in the country.
However, in 2019, the highest 1, 01,354 dengue cases and 179 deaths were reported and in 2000, the figures went down, at 5,551 patients and 93 deaths.
Although dengue usually prevails between April to September every year in the country, this year’s October and November witnessed record number cases and deaths.
According to government data, in October, highest 21,932 cases and 86 deaths reported. In the Next month, dengue cases slightly downgraded to19, 334, but in this month, deaths were 113 which are the monthly-based highest casualties in the current year.
Kabirul Bashar, medical entomologist and professor of zoology at Jahangirnagar University, said the accumulation of water around houses and random rains amid climate change hazard are blamed for higher breeding of Aedes mosquitoes this year.
Kabirul Bashar added, ‘If we are able to destroy dengue hotspots across the country, then the crisis will fade away. It is mandatory to maintain public health.’
70% dengue cases in Dhaka division
Dhaka has become the main dengue hotspot in recent years. DGHS data shows as of 22 December, almost 70% cases reported in the Dhaka division; among them, 38,943 cases were in Dhaka Metropolitan area and 4,061 cases in other areas of Dhaka division.
There are highest 171 deaths recorded in this division as well. About two-third of total deaths recorded in Dhaka division. But most of the deaths (169) reported in Dhaka Metropolitan area. Chittagong division followed Dhaka where 8,970 cases and 66 deaths reported from 1 January to 22 December.
Besides, 3,328 cases in Khulna, 3,136 in Barishal, 2,101 in Rajshahi, 1,008 in Mymensingh, 725 in Sylhet and 172 in Rangpur division reported as of 22 December.
Dr. Mushtak Hossain, Advisor of IEDCR and public health specialist hinted that Dhaka is a densely populated city that is the main reason of dengue cases spike in the city. Huge people live here, so the breeding of the dengue virus bearer Aedes mosquitoes is high in Dhaka. But there is lack of activities to bust out the mosquito breeding that is important to contract dengue cases.
Mushtak Hossain added, if you want to control the dengue outbreak, at first have to obstruct the sources of dengue breeding. Public consciousness is also important.
Dengue variants: DEN-4
DEN-4, a form of dengue is currently dominant in Bangladesh. According to IEDCR, most of the dengue patients were infected with DEN-4 this year.
Professor Tahmina Shirin, director of IEDCR, said there are four types of dengue in the world: DEN-1, DEN-2, DEN-3 and DEN-4. No one was affected with DEN-1 since 2018 in Bangladesh. In 2021, majority percent of dengue patients were infected with DEN-3. Now, we are experiencing the dominance of DEN-4. People are being infected with DEN-3 and DEN-1 as well. That means these three forms of dengue are now active in our country. It is one of the causes of dengue outbreak.
Dr. Mushtak Hossain said the dominance of DEN-4 is the main reason for increasing death from dengue in this year. People in Bangladesh did not infect with this type before. So, the immune system of people is low against the newly spreading variant.
Children are vulnerable
Dhaka city resident Abul Kalam Azad was a happy family. However, Azad, his nine years old son Mohammad Siam and eight years old daughter were infected with dengue all together in the end of October. Although Azad and his daughter recovered, Siam died on 29 October at a hospital in Dhaka city, capital of Bangladesh.
According to government information, 38 children died from dengue as of 7 November, which is the highest child casualty in the country history. It is about 25% of total death. 20% dengue infected patients are children.
DGHS data shows that among 38 children, who died from dengue, eight were under 5-year-old, 14 were 5 to 10, nine were 10 to 15 and seven were 15 to18 years old. According to child law in Bangladesh, one to below 18 years old counts as a child.
Siam’s father Azad who recovered from dengue said, ‘his son was a third grader. I dreamt my son will be a good doctor and provide health services to the poor people one day. But we never think we will lose our son forever at early ages.’
Azad enraged adding ‘Dhaka city is the worst place for living, but we are forced to live here for only job purpose.’
He lamented saying if there would availability of health care service, they didn’t lose their beloved son.
Specialists and doctors say, dengue virus not only has become severe, but also its symptoms and patterns have been changed over time. As a result, everybody should be extra careful about dengue; especially, when children are suffering from fever, they should be taken hospitals as early as possible for consultancy.
Dr. Mushtak Hossain hoped that next year dengue situation will be control, because those who already infected with new type of dengue, they probably will be secured from the disease. He also expressed that getting experience from the previous year dengue cases, authority will take action against dengue hotspots in Dhaka city in the next year.
Dengue situation in other countries
Dengue, the fastest spreading mosquito-borne disease, has been ranked by the World Health Organization (WHO) as one of the top 10 global public health threats.
According to WHO, dengue has spread to 129 countries almost in Latin America and Asia, with 400 million annual infections and 40,000 deaths. To put it more simply, almost all of them are third-world countries. Brazil, Vietnam, the Philippines, Indonesia and Peru are the worst affected. It is followed by Colombia, Nicaragua, Malaysia, Bangladesh, Sri Lanka, Singapore, India and Thailand.
In Bangladesh, dengue was first documented as ‘Dhaka fever’ in 1964, with the first official outbreak occurring in 2000.
Despite being so widespread, 70 percent of the disease occurs in Asian countries. Singapore, Thailand, Malaysia, Philippines and Vietnam experienced the spike of dengue virus like Bangladesh, suggests WHO data.
See Timeline of dengue outbreak:
https://medium.com/@kzamanmcj/dengue-a-month-by-month-timeline-of-the-outbreak-in-2022-4aa1e768730f
