Facing up to dreadful dengue

Compared to the earlier years, this year's dengue outbreak in the country and its ferocity are strikingly different. Thanks to its fast spread, it is set to assume the proportions of a disease endemic to Bangladesh. In the year of 2000, the outbreak of the Aedes mosquito-borne disease chiefly remained confined to the capital Dhaka. The vector-borne disease had yet to emerge as one with dreadful features. In the early years, the outbreak was barely noticeable. Thanks to the ailment's isolated and scattered nature, the health authorities evidently didn't bother to keep a record of the incidenceof the scourge, either in Dhaka or elsewhere in the country. In the years around 2000, it was mostly the normal hospitalisations, accompanied by few fatalities, which defined the viral scourge.
As years wore on, the dengue fever began assuming the character of an intermittently appearing health-related menace. It had been so until the year of 2019, the year witnessing a total of 179 deaths. In 2022, the number of deaths from dengue shot to 281. With casualties continuing, the dengue death toll this year stands at over 470. Besides, the number of dengue positive cases is feared to reach 100,000 all over the country.
Coming to the difference in dengue prevalence in the country in 2023, a notable feature that warrants focus is the Aedes vector-borne disease's strong presence in other parts of the country. Its so-called perennial feature of being confined to the capital has proven a myth. Admissions are increasingly recorded at different hospitals across the country --- the highest, though, being in Dhaka. Earlier, the people in the rural areas would boast of being largely free of the dengue fever. This year comes as a striking exception. The unabatedly deteriorating dengue situation keeps worsening in many other cities and towns. Large numbers of patients, mostly children, now hospitalised in Dhaka, are from areas outside Dhaka.
In the initial stage, it was the tiny tots and older children who comprised the largest segments of the dengue patients. Now the patients aged between 20 and 40 years constitute 70 per cent of those admitted to hospital. This unexpected jump in the patients' age provides a grim but real picture of the dengue situation. As disclosed by a director of the Directorate General of Health Services (DGHS), there are a total of 2625 hospital beds exclusively meant for the two Dhaka City Corporation areas. Of the total beds, 1,890 have already been occupied. Even at larger hospitals young and older patients have been found lying on makeshift beds arranged on the floor, or even at unlikely places.A depressing scenario indeed! Many were deprived of even these rudimentaryfacilities. As a consequence, patients are seen being compelled to leave hospitals without completing their lengthy treatment.
According to observers, a veritable anarchic situation is prevailing in the area of dengue treatment in the Bangladesh cities, especially in the capital. It begins with the inordinate delay in the delivery of different test reports. The shortages of skilled technicians and inadequate testing facilities have also aggravated the depressing situation. The season of monsoon is on the way out, with the sun shining in a nearly cloudless sky. According to dengue specialists, the time is the most ideal for the Aedes mosquito to lay eggs in the stagnant rain water accumulated in assorted types of containers. There, the eggs turn into larvae which take the form of pupa, from which the adult Aedes mosquitoes come out.
The popular notion is that contrary to the common belief, the dengue fever is relatively new to Dhaka. But in reality the dreadful fever has been present in the city since the 1960s. Back then it was recorded as 'Dacca Fever'. The Bangladesh capital and the rest of the country had yet to be devastated by the dengue outbreak. However, dengue fever in some other Asian countries, the Southeast Asian belt in particular, was found raging in 2022. Three countries of the region --- Vietnam, having the highest 145,534 cases, followed by Philippines with 52,597 cases, and Indonesia with 68,903 cases comprise the vulnerable zone. Thanks to the repeated outbreaks of the dengue fever over the last twenty-three years, the scourge might emerge soon as a terribleone.
The feature that had long distinguished the country was its remaining hostage to the practice of littering. Nowadays, alongside the capital Dhaka, many smaller cities also stand witness to the menace of indiscriminate littering. The most alarming aspect of this habit is the throwaway objects that include pots and containers which collect monsoon rain water. In the last couple of decades, almost all urban centres across the country have turned into ideal dengue breeding grounds. Given the dengue scenario's worsening turn, many have started bracing for a period more calamitous than at present. The dengue cases continue to rise every passing day, deaths show few signs of abating and the hospitals are chockablock with patients.
Given the highly fraught scenario, many might feel like urging the government to declare a state ofdengue emergency. Despite the invention of vaccines and their reaching the trial stage in a couple of countries, it still remains confined to laboratories. The dengue vaccines are yet to be approved by the WHO for mass immunization campaigns. Many optimistic people, however, look to the days, not too far, when the vaccines will be widely available like the preventive invented for Covid-19.

shihabskr@ymail.com