Nepal: 2022 Dengue

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Source: https://kathmandupost.com/province-n...m-causes-alarm

Rise of dengue cases in hill district of Tehrathum causes alarm
In the past week alone, 62 fever patients who visited the district hospital for treatment tested positive for dengue virus.
Chandra Karki
Published at : August 26, 2022
Updated at : August 26, 2022 07:59
Tehrathum

Nirmal Dahal and his wife suffered from high fever last week. For a week, the couple stayed at their home in Myanglung Municipality-1, Tehrathum and took paracetamol regularly. But when their fever did not subside even after three days of self-medication, the couple went to the district hospital.

The laboratory test at the hospital confirmed dengue infection in both of them. They are currently receiving treatment at the hospital...

...Dengue appears to have spread far and wide in Tehrathum, said Dr Prerit Devkota, chief at the district hospital, adding that as many as 62 fever patients who visited the health institution for treatment in the past week tested positive for dengue virus.

“Such a huge number of dengue cases in a week in a hill district is worrisome,” Devkota said. “How does this disease, which is common in hot Tarai districts, climb to the hill district? It is an important matter to study.”...

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Source: https://english.khabarhub.com/2022/02/270606/


Dengue infection spreads to 72 districts
Bagmati and Lumbini most-affected
Khabarhub
September 2, 2022

KATHMANDU: Dengue infection has spread to 72 districts of Nepal so far.

Infection has been confirmed in 2,728 people since January this year as of Wednesday, Dr. Gokarna Dahal, official at the Epidemiology and Disease Control Division said.

So far, dengue infection has spread to 72 districts, he said with Bagmati Province and Lumbini Province having the highest number of cases.

However, cases of dengue have also been seen in other provinces.

Dr. Dahal said that 1,097 cases were found in Bagmati province alone and 666 cases in Lumbini.

According to him, Lalitpur district has reported as many as 1,056 cases since January.

Likewise, 377 cases have been reported in Rupandehi district, 332 in Kathmandu, 77 in Tehrathum, 76 in Dhading, and 61 in Sindhuli.

Similarly, only one or two cases have been found in some districts.

This is the first time dengue infection has been reported in 72 districts of the country...

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Source: https://kathmandupost.com/health/202...risks-escalate

As dengue becomes endemic to Nepal, infection, mortality risks escalate
Experts warn a lethargic approach to taming the disease could spell trouble after the havoc caused by Covid-19. As dengue becomes endemic to Nepal, infection, mortality risks escalate
Arjun Poudel
Published at : September 12, 2022
Updated at : September 12, 2022 07:26

Kathmandu reported the first case of dengue in May and a second one in June. By July-end, the caseload had increased to 35. The viral disease saw a marked surge in August, with over 700 infections reported in the month. The number has already crossed 1,000 this month – and we are not even halfway through September.

Despite this alarming rise in case-number, local authorities, especially the Kathmandu Metropolitan City, carried out a search-and-destroy drive only last week. Representatives from many other local units in Kathmandu have also said they have completed the operation...

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Source: https://kathmandupost.com/health/202...engue-epidemic

Government set to declare a dengue epidemic
At least 20 people have died and over 16,500 infected with the disease. Of the dead, 75 percent are under the age of 40.
Arjun Poudel
Published at : September 19, 2022
Updated at : September 19, 2022 08:36
Kathmandu

After over a dozen and a half people died from dengue and thousands got infected, the Ministry of Health and Population is working to declare a dengue epidemic in the country.

Officials hope that the declaration would be helpful in taking coordinated measures against the spread of the deadly virus, which has been recorded in 75 out of 77 districts throughout the country.

“The Epidemiology and Disease Control Division has forwarded us a proposal for declaring an outbreak or epidemic of the dengue virus,” an official at the Department of Health Services told the Post on condition of anonymity, as he is not authorized to talk to the media...

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Source: https://www.newsdrum.in/internationa...pal-91715.html

20 die of dengue in Nepal
NewsDrum Desk NewsDrum Desk
Sep 19, 2022 - 21:53 Updated: Sep 20, 2022 - 08:23


Kathmandu: At least 20 people died of dengue across Nepal in over two weeks as the mosquito-borne disease continues to be on the rise in the Himalayan nation, health officials said here on Monday.

The first death due to dengue this year was reported from Kaillai district in Far-West Nepal where a 35-year-old woman succumbed to the disease on September 1.

Twenty people died due to dengue across the country in the last 18 days, health ministry spokesperson Samir Kumar Adhikari said.

Dengue has spread in 75 districts of the total 77 districts in the country. The number of dengue cases has so far reached 16,587, he said.

Ten districts hold 85 per cent of the dengue cases. These are Lalitpur, Kathmandu, Makawanpur, Dang, Bhaktapur, Rupandehi, Chitwan, Gulmi, Darchula, and Kavrepalanchok.

Lalitpur has the highest number of dengue patients with 4,604 infections, followed by Kathmandu with 4,445 cases, Makwanpur 1,597 cases and Dang 994 cases...

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Source: https://english.khabarhub.com/2022/24/274231/

Dengue claims 29 lives so far in Nepal
Khabarhub
September 24, 2022

KATHMANDU: The number of deaths due to dengue infection has reached 29 in the country.

According to the Ministry of Health and Population, dengue has spread in 76 districts and 22,988 people have contracted dengue so far...

...According to the ministry, the highest cases of dengue — 17,731 – has been recorded in Bagmati Province followed by 2,821 cases in Lumbini, 777 in Sudurpaschim, 591 in Province 1, 515 in Gandaki, 323 in Madhesh and 230 in Karnali Province...

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Source: https://thehimalayantimes.com/nepal/...d-in-september

Dengue cases near 26,000, above 80pc cases recorded in September
By HIMALAYAN NEWS SERVICE
Published: 11:53 am Sep 27, 2022

KATHMANDU, SEPTEMBER 26

Dengue, which has been spreading through all the districts except Mustang, has afflicted almost 26,000 people in Nepal.

As of yesterday, a total of 25,543 people had contracted dengue. Over 82 per cent of the cases were reported in September, while 32 people have died of dengue after cases started to soar from July onwards.

Inside the valley, the situation is even worse with 8,895 people contracting the disease in Kathmandu district alone in July, August, and September.

In July, 35 people had contracted the mosquito-borne disease. The number increased to 727 in August and 8,132 in September...

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Source: https://english.onlinekhabar.com/den...-3-months.html

Dengue in Nepal: 38 dead, over 28,000 infected in 2.5 months
Onlinekhabar September 29, 2022

Kathmandu, September 29

The government says at least 28 people had died of dengue in Nepal in the past two and a half months. Likewise, over 28,000 people have been infected in the period.

Just on Thursday, the Ministry of Health and Population recorded two deaths and 540 new infection cases.

As the case count since mid-July 2022 has hit 28,109, all districts except Mustang have at least one case. The Kathmandu valley has emerged as the most critical hotspot...

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Source: https://www.who.int/emergencies/dise...em/2022-DON412


Dengue fever- Nepal

10 October 2022

Outbreak at a glance
Dengue is endemic in Nepal. The country is experiencing a surge in cases that started from the week commencing 8 August to 26 August. Between January to 28 September 2022, a total of 28 109 confirmed and suspected dengue cases and 38 confirmed deaths due to dengue have been recorded, affecting all seven provinces. The causative serotype(s) is unknown. This represents the largest dengue outbreak in Nepal with regard to the cumulative number of cases reported nationwide per year.
Description of the outbreak
Between January and 28 September 2022, a total of 28 109 suspected and confirmed cases of dengue fever including 38 confirmed deaths (overall CFR 0.13%) have been reported from all seven provinces of Nepal, affecting all 77 districts in Nepal (Figure 1). Bagmati province which is the second-most populous province has reported the highest number of cases (78.2%) and deaths (68.4%).
According to the Epidemiology and Disease Control Division (EDCD) of the Ministry of Health and Population, the highest number of new cases in 2022 have been reported in the districts of Kathmandu (n=9528; 33.8%), Lalitpur (n=6548; 23.2%), and Makwanpur (n=2776, 9.8%).
Data on demographics was available for 23% of cases (n= 6734) of which 76% (5175/6734) were aged 15-59 years old, and 54% were males (n=3637). As of 28 September, 38 deaths have been verified, of which males and cases aged 15 – 59 years old each accounted for 55% (n=21) of reported deaths. Cases aged over 60 years old accounted for 39% (n=15) of reported deaths.
Dengue cases have increased since July coinciding with the rainy season with majority of the cases reported during September (83.6%; n=23 514).
Figure 1. Number of Dengue cases reported from districts of Nepal from 1 January- 28 September 2022.
Figure 2. Number of dengue cases reported by months in Nepal from 1 January to 28 September 2022
Epidemiology of the disease
Dengue is a viral infection transmitted to humans through the bite of infected mosquitoes and is found in tropical and sub-tropical climates worldwide, mostly in urban and semi-urban areas. The primary vectors that transmit the disease are Aedes aegypti mosquitoes and, to a lesser extent, Aedes albopictus.
Dengue virus (DENV) has four serotypes (DENV-1, DENV-2, DENV-3, DENV-4) and it is possible to be infected by each. Infection with one serotype provides long-term immunity to the homologous serotype but not to the other serotypes; sequential infections put people at greater risk for severe dengue. Many DENV infections produce only mild illness; over 80% of cases are asymptomatic. DENV can cause an acute flu-like illness.
There is no specific treatment for dengue; however, timely detection of cases, identifying any warning signs of severe dengue infection, and appropriate case management are key elements of care to prevent patient death and can lower fatality rates of severe infection to below 1%.

Public health response

The Epidemiology and Diseases Control Division of the Ministry of Health and Population initiated the following actions to manage and coordinate the response:

• Overall response: The Ministry of Health and Population (MoHP) together with WHO and hospitals convened a meeting to review the preparedness and map out strategic interventions for the dengue outbreak in the country. Virtual meetings have been conducted with provinces, districts, and local levels of the MoHP to review the current epidemiology and the responses required. WHO drafted the multisectoral engagement plan to accelerate the Dengue Response and submitted it to the EDCD for review and implementation of action plans.
• Vector Control measures: WHO assisted in the development of a standard operating procedure for vector control activities. Technical working group meetings have been convened to facilitate dengue response and to strengthen vector surveillance activities in high-risk/high-case reporting districts in Kathmandu valley (which is in Bagmati province) and Lumbini province). Search and destroy campaigns for mosquitoes in municipalities including Lalitpur and Kathmandu (prioritizing main breeding containers) have been initiated. Vector surveillance and sample collection in high-case reporting districts in Kathmandu have been initiated.
• Laboratory: A total of 39 000 diagnostic kits have been provided through WHO and Government funding. WHO facilitated sample collection for serotyping from ten identified hospitals nation wise in collaboration with EDCD and National Public Health Laboratory (NPHL).
• Clinical Management: A total of 200 physicians and medical officers were trained in September, in the case management of dengue fever, referral of dengue patients, and reporting for the dengue surveillance system. This included in-person attendance of 70 healthcare workers (HCWs) from major hospitals in Kathmandu Valley and an additional 130 HCWs from all Provinces who joined virtually. The video recording of the orientation has been disseminated by EDCD for its wider use.

WHO risk assessment

Nepal reported its first dengue case in a traveller returning from India in 2004. Since then, dengue has been endemic in Nepal. The country has expertise and experience in managing dengue, however, WHO considers the overall risk for the current dengue outbreak high at the national level due to the following reasons:

• As dengue is recurrent in the country, the population may be at risk of re-infection and therefore, serious complications may occur if not managed promptly and correctly. At present, severe dengue cases and case-fatality rates appear to be increasing, likely due to the limited hospital capacity in-country and limited access to and use of health care services. With the current increase in other vector-borne diseases in Nepal this year, such as Japanese Encephalitis and Scrub typhus, affecting the national health system capacity, there is a high risk of serious health impacts from dengue fever.
• Dengue virus has the potential to cause epidemics resulting in high morbidity and mortality. There is no specific treatment. Early recognition of dengue virus infection and appropriate clinical management can reduce the severity of disease and mortality among dengue patients.
• The current circulating serotype is unknown at this stage, although further laboratory tests are planned. Infection with one serotype provides long-term immunity to the homologous serotype, however, the risk for severe dengue is high in a second infection with a different DENV serotype.
• Current data suggests that dengue cases are increasing in magnitude and expanding out of the lowland areas typically suitable for the breeding of Aedes mosquitoes to higher elevations, potentially due to climate changes and rapid urbanization.

This outbreak underscores the need for improved vector surveillance, enhanced laboratory capacity for better case detection, and improved surveillance of acute febrile illness in Nepal to effectively control the outbreak.
There is frequent population movement across the Nepal-India land border. Dengue is endemic in many parts of India including northern Indian States, which share the border with Nepal. Given the high incidence in Nepal, it is possible that dengue may spread across the border into India, although its consequences may depend on a number of factors such as the density of vectors, circulating serotypes, and level of public health response in the neighbouring Indian states. Nepal is a popular tourist destination, hence, spread through international travellers cannot be ruled out as Nepal is easing international travel restrictions imposed in response to COVID-19.

WHO advice

The proximity of mosquito vector breeding sites to human habitation is a significant risk factor for dengue virus infection. Although dengue does not spread from human to human, mosquitoes can become infected after biting infected individuals. This cycle, therefore, makes the infected mosquito capable of spreading the dengue virus among households and in the neighbourhood, leading to clusters of cases.
The prevention and control of dengue depend on effective vector control. WHO promotes a strategic approach known as Integrated Vector Management (IVM) to control mosquito vectors, including Aedes subspecies (the vector of dengue). IVM should be enhanced to remove potential breeding sites, reduce vector populations, and minimize individual exposure. This should involve vector control strategies for larvae and adults (i.e., environmental management and source reduction, and chemical control measures), as well as strategies for protecting people and households.
Vector control activities should focus on all areas where there is a risk of human-vector contact (place of residence, workplaces, schools and hospitals, and construction sites in Kathmandu Valley). Vector control activities can include covering, draining, and cleaning household water storage containers on a weekly basis. Space spraying with insecticide can be deployed as an emergency measure. Chlorination and application of suitable larvicides/insecticides for water storage in outdoor containers should also be considered.
Personal protective measures during outdoor activities include the application of repellents to exposed skin or clothing, and the wearing of long sleeves shirts and trousers. Indoors, additionally, protection can include the use of household insecticide aerosol products or mosquito coils. Window and door screens, as well as air conditioning, can reduce the probability of mosquitoes entering the house. Insecticide-treated nets offer good protection to people against mosquito bites while sleeping during the day. Since Aedes mosquitoes are active at dawn and dusk, personal protective measures are recommended particularly at these times of the day.
There is no specific treatment for dengue infection, but early detection of warning signs and timely access to appropriate clinical management (including referral to an appropriate health care facility) reduce the risk for severe dengue complications and mortality. Vector and human case surveillance should continue to be enhanced in all affected areas and across the country. Where feasible, resources should be allocated for the strengthening of a sample referral mechanism for the confirmation and sub-typing of dengue virus.
WHO does not recommend that any general travel or trade restrictions be applied to Nepal based on the information available for this event.

Further information

• WHO factsheet: Dengue and severe dengue
• WHO Q&A: Dengue and severe dengue
• WHO Health topics: Dengue and severe dengue
• WHO Dengue control strategies
• Global Strategy for dengue prevention and control, 2012–2020
• Strong country capacity, improved tools and community engagement critical to enhancing dengue prevention and control

Citable reference: World Health Organization (10 October 2022). Disease Outbreak News; Dengue fever - Nepal. Available at: https://www.who.int/emergencies/dise...em/2022-DON412

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Source: https://myrepublica.nagariknetwork.c...?categoryId=81

1,111 new dengue cases reported in Nepal in last 24 hours, No. of dengue patients in the country exceeds 40,000
Published On: October 16, 2022 07:45 PM NPT By: Republica |

KATHMANDU, Oct 16: As many as 1,111 dengue cases were reported in Nepal in the last 24 hours, according to health administration officials. With this, the number of dengue patients in Nepal has exceeded 40,000. According to the Ministry of Health and Population, the number is based on dengue patients reported in the country since July 17...

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Source: https://myrepublica.nagariknetwork.c...?categoryId=81


Two patients die on Thursday, taking dengue death toll in Nepal to 51
Published On: October 20, 2022 08:18 PM NPT By: Republica |

KATHMANDU, OCT 20: Two more people infected with dengue died in the past 24 hours, taking the dengue death toll to 51.

The records with the Ministry of Health and Population (MoHP) show a total of 42,504 persons have caught the disease as of Thursday. According to the ministry, the mosquito-borne disease infected an additional 761 people in the past 24 hours...

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Source: https://kathmandupost.com/health/202...next-two-weeks


Dengue spread to continue for next two weeks
Post Report
Published at : October 25, 2022
Updated at : October 25, 2022 08:25

Kathmandu

Although new cases of dengue infection have gone down following a decline in temperatures of late, the Ministry of Health and Population said that the risk of infection continues to persist and will do so for the next several days.

With the onset of post-monsoon, which is considered a high transmission period for the dengue virus, officials asked all agencies concerned and the general public to follow proper safety measures...

...At least 52 have died and 43,685 people have tested positive for the dengue virus so far this year—a single-year record. Experts say reported cases of dengue could be just the tip of the iceberg, as around 90 percent of the infected people are asymptomatic. Many people infected with dengue have not been seeking hospital care, which is also the reason for the decline in reported cases, doctors say.

Those closely tracking the cases suspect many more people could have succumbed to the disease as not all deaths are reported. Officials at the Health Ministry concede as much.

Despite the deaths of dozens of people and thousands getting infected, no proper measure has been taken to contain the spread of the virus...

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Source: https://thehimalayantimes.com/health...000-in-chitwan

Dengue cases cross 2,000 in Chitwan
By Rastriya Samachar Samiti
Published: 12:19 pm Oct 28, 2022

CHITWAN, OCTOBER 28

The number of dengue infection cases has crossed 2,000 in Chitwan, the District Health Office Chitwan said. The Office stated that dengue has been confirmed in 2,164 persons till October 27 so far in the current fiscal year. Dengue test were conducted on 8,853 samples during this period and 2,164 of these samples were tested dengue positive.

One thousand four hundred and fifty-one among these cases are from Chitwan district and the remaining is from outside districts. Among the 1,451 cases, 822 are male and 629 are female. It is stated that 454 dengue patients are from outside districts while the name and address of 259 of them is not ascertained.

Three people have died from dengue in Chitwan district during this period, the District Health Office said...

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Source: https://myrepublica.nagariknetwork.c...-valley-alone/

Dengue infection cases cross 33,000 in Bagmati Province, over 25,000 cases reported in Kathmandu Valley alone
Published On: November 5, 2022 07:03 PM NPT By: Republica

KATHMANDU, Nov 5: More than 33,000 people in Bagmati Province so far have been infected from dengue.

According to the Health Directorate under the Ministry of Health, Bagmati Province, a total of 33,765 people have suffered from dengue, while the number is still growing day by day. Of the total number, 13,200 are from Kathmandu district, 9,200 are from Lalitpur and 3,060 are from Bhaktapur...

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Source: https://myrepublica.nagariknetwork.c...?categoryId=81

Dengue kills six in Chitwan in five months
Published On: November 15, 2022 04:20 PM NPT By: Republica

CHITWAN, Nov 15: Six people have died of dengue in Chitwan so far in the current fiscal year. The victims were from and outside the district, according to the Health Office, Chitwan.

The office's Information Officer Ram KC said the district recorded 2,949 dengue cases including six casualties since mid-July this year. A total of 10,974 samples were tested and among the infected 2,050 were from the district while the remaining were from outside the district.

According to the office, there are 291 persons whose addresses have not been disclosed and 608 persons whose addresses have been disclosed.

The highest number of dengue cases is in Bharatpur Metropolitan City. A total of 1,450 dengue cases have been recorded in the metropolis...