Re: Sri Lanka: Dengue
Re: Sri Lanka: Dengue
Source:
http://www.nation.lk/2009/05/31/newsfe1.htm
KILLER ON THE LOOSE
Dr. Tissera also said this female mosquito prefers human blood to animal blood. It usually bites during dusk and dawn when light is not intense, and is active between 6:00am -10:00am and 3:00pm-6:00pm. The mosquito prefers cool, dark places and therefore, is mostly found in kitchens, bathrooms and bedrooms. ?Also, the mosquito is a ?fussy biter?, meaning it will bite a number of people and infect them all that way? Dr. Tissera added. Importantly, he said that an uninfected mosquito could receive the virus from an infected person, and go on to infect more people.
By Kushali Atukorale and Dilini Algama
Only five months into the year, the statistics of dengue cases and deaths have already topped the entirety of last year?s. A total of 6573 cases have been reported so far, with 85 deaths. The numbers are staggering. In 2008, 6,300 cases were reported for the entire year, while there were only 25 deaths.
The first case of dengue was reported in 1962, and by 1989 dengue viral fever rose to epidemic levels. Although, it was under control till 2000, the number of dengue patients and deaths increased, with 2004 being the last worst hit year.
What is dengue?
According to Dr. Hasitha Tissera, Consultant, Epidemologist at the Epidemology Unit, Ministry of Health, dengue is a viral disease which spreads through mosquito bites. The two types of mosquitoes involved, are aedes aegypti and aedes albopictus with aedes aegypti being the main vector.
Dr. Tissera also said this female mosquito prefers human blood to animal blood. It usually bites during dusk and dawn when light is not intense, and is active between 6:00am -10:00am and 3:00pm-6:00pm. The mosquito prefers cool, dark places and therefore, is mostly found in kitchens, bathrooms and bedrooms. ?Also, the mosquito is a ?fussy biter?, meaning it will bite a number of people and infect them all that way? Dr. Tissera added. Importantly, he said that an uninfected mosquito could receive the virus from an infected person, and go on to infect more people.
?The female mosquito will lay 100-200 eggs on the walls of preferably man-made containers? Dr.Tissera added while saying that mosquito prefers smooth surfaces such as plastic containers, bottles, tin cans, barrels and roof gutters among other similar places. While the life cycle of a mosquito is generally considered as being 10 days, an adult mosquito, in ideal conditions, will be active for well up to six weeks.
As Tissera informed, with an epidemic, there are three factors involved in initiating and spreading the disease. The mosquito is the vector, while the virus itself is the agent and the host is the infected human. These factors determine the severity, duration and outcome of the epidemic. As a viral disease you would expect there to be antibodies. But there are four types of the virus, and a person infected with one strain will only develop anti-bodies for that particular type. ?However, this will also make them more susceptible to the other varieties as formed anti-bodies will join the new viral bodies, and attack the body along with them? noted Dr. Tissera. This is also why a person could get four infections of dengue in his or her lifetime.
As a dengue epidemic progresses in an area, the severity also increases?, Dr. Tissera stressed. However, the longer the gap between two infections, the more severe the second infection would be, he warned.
Two types of Dengue Fever
He said that Dengue fever could be divided into two categories: Dengue Haemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS). Common symptoms of the first kind are high fever, headache, muscle and joint pains, nausea, vomiting and pain in the bones.
?The symptoms might disappear in three to four days, but it can develop to Dengue Hemorrhagic Fever if proper medical attention is not received, although this can also be successfully managed at home,? Dr. Tissera warned.
Explaining further about Dengue Haemorrhagic Fever, he noted that it is very important to seek medical assistance without any delay. ?Symptoms are, bleeding from the nose and gums, brown or black vomitus, continuous stomach pain and blood stained stools.?
Another category of dengue fever, which is known as Dengue Shock Syndrome can be identified if a patient still feels ill even after the high temperature has decreased. The patient will have a flushed face, although the fever may have gone down.
This can be identified by symptoms such as a drop in body temperature, paleness and restlessness.
?More than the medicine, it is rest that really matters to cure Dengue and the environment should be kept clean. All unwanted containers where water can be collected should be destroyed. Dengue victims should consume more fluids, fresh vegetables and fruits to boost their immune system,? he noted. As for medicine, there is no treatment for dengue viral fever. However, paracetamol may be given to treat symptomatic fever and patients are advised to avoid aspirin and ibuprofen as they may have adverse effects on the bleeding.
Role of the Public
?Eradicating Dengue is a collective effort in which everyone needs to participate. Public has a massive role to play along with the Healthcare Officers,? Dr.Tissera said.
He also said that people should keep their surroundings clean without waiting for the officials to do the needful. Tissera further noted that trash cans and other containers which can collect water should be destroyed at once. ?It is necessary to inspect the house and the surroundings weekly and regularly, and to discard plastic cans, tins, bottles and coconut shells. It is ideal to fill discarded tyres with sand or make holes or store them suitably to prevent accumulation of water,? Dr.Tissera asserted.
Tissera further said that people should be more vigilant about the surroundings since the numbers of the patients and deaths are increasing day by day. He further stressed that the public should seek medical attention if fever remains for more than 3 days. ?It is very important to seek a doctor?s advice rather than self medicating,? he said.
?Eradicating Dengue is not only the responsibilty of the authorities, but the responsibility of the pubic too. Therefore they should be as concerned about the surroundings as much as we are,? he added.
Prevention and Mosquito Breeding Act
With the increase of reported dengue cases and deaths, the government has passed a new Act which is cited as the Prevention of Mosquito Breeding Act, No. 11 of 2007, empowering the Health Ministry to take action against people whose negligence facilitates the breeding of the dengue mosquito.
A highly placed source in the Ministry said that the penalty for those guilty of such negligence, will be a fine up to Rs.10,000, or they will be liable to legal action. ?According to the 14 (1) of the Prevention of Mosquito Breeding Act, No 11. of 2007, the Director- General of health Services will be the Competent Authority for the purpose of the Act and will be charged with the effective implementation of the provisions of the Act,? he said.
The Nation understands that the Act will vest powers in the Ministry of Healthcare to take legal action against institutions and also judicial premises, failing to abide by the law and keep their environment clean. ?No matter what the institute is, we will take legal action against it. There should be a limit, and even people will learn a lesson when one or two are charged by a heavy levy,? the official asserted.
He also said that Section 9 (2) of the Prevention of Mosquito Breeding Act says that any person destroying the anti-mosquito measures carried out or adopted in any premises or lessening the efficacy of any such measures, will be convicted after a summary trial before a magistrate, or will be liable to a fine or to a term of imprisonment not exceeding three months. The officials also said that the maximum punishment for those charged under the earlier Act for violating rules and regulations was Rs 50.
Commenting on the current situation, they said that the situation was so bad that several schools in the South had to be closed as the number of cases were increasing day by day. The Act will therefore make people alert to their surroundings and the need to keep them clean.
Global view
The world map has what is known as the ?Dengue Belt?. It includes, the tropical countries in the Americas, Africa, Asia and Queensland, Australia. Singapore and Cuba which have notably been able to control dengue, with Singapore enforcing strict legal enactments and Cuba depending on social mobilisation.
Interestingly, India and North Korea have been able to avoid dengue altogether and, according to Dr. Tissera, this is due to controlled urbanisation.
