Pune: Rajendra
Kumar, Rajkot’s district collector, has had a first-hand experience of
the disease his office is tracking. "On the very first day of fever, I
had my blood tested to rule out dengue," he says. "I was extremely weak
and had to be hospitalised in the first week of September." The district
has seen 280 cases of dengue so far this season.
In
Pune, National Institute of Virology deputy director Dr M S Chadda has
had dengue infection earlier. In Ahmedabad, senior IPS officer Rahul
Sharma’s wife Sumita died in August this year, one of three victims out
of 900-odd cases. And in Mumbai, the death of filmmaker Yash Chopra has
created greater panic than ever that the disease can afflict anyone.
Greater Mumbai has had 500 cases this year, out of over 2,600 statewide
including 31 who have died.
National Vector Borne
Disease Control Programme officials have counted more than 32,000 cases
of dengue and 100 deaths in the country this year. Kerala has had the
highest number of cases at nearly 7,000. The fatality rate is not as bad
as it was last year, when 240 of 50,000 cases died across the country.
Dr A C Dhariwal, director of NVBDCP, points out there are guidelines on
combating the disease and there is no cause for panic.
Dengue
does, however, present fresh challenges. It is no longer a cyclical
problem, though that depends on where the outbreak occurs. The virus
transmits itself round the year in Kerala, Andhra Pradesh and
Maharashtra, while it has remained a seasonal phenomenon in the
northern, central and eastern states, NVBDCP officials say. In the
latter areas, transmission tends to pick up in the post-monsoon months
from September to December. Dengue has become endemic with even places
like Samba in Jammu having reported an outbreak; last year it was
Palighat in Arunachal Pradesh, says Dr Kalpana Baruah, NVBDCP joint
director.
Another challenge is that there are now
four serotypes of the virus. Dr Anita Chakravarti, director of
microbiology at Maulana Azad Medical College, New Delhi, has been
studying the relationship between the serotypes and says it is a
challenge to prepare a vaccine. Dr Renu Bharadwaj, head of microbiology
at B J Medical College, says some of the serotypes are, however, mild.
It is serotypes 2 and 4 that are critical; these could lead to bleeding
and a drop in the platelet count.
Doctors say
symptomatic treatment is the only answer and not all cases need
hospitalisation. "Patients can be easily managed at home if there is no
bleeding," says Bharadwaj. Doctors say the high number of cases is also
due to increased reporting.
Health Minister Ghulam
Nabi Azad told the Lok Sabha recently there was no single reason for
the increase in cases. "It is governed by various man-made and
environmental factors including unprecedented growth in population,
unplanned and rapid urbanisation and inadequate waste management."
Dr
Chakravarti stresses prevention. "After the monsoon, fresh water does
tend toaccumulate and it is important the water should not become a
breeding ground for the Aedes aegypti mosquito," she says.
In
Mumbai, additional municipal commissioner Manisha Mhaiskar has rolled
out a Rs-70-lakh campaign under which the authorities have printed three
lakh posters, trained schoolchildren as health ambassadors and
initiated proceedings against 290 people for neglecting mosquito
breeding sites.