Looming dengue outbreak

Too many events have been taking place in recent weeks for the public to keep track of. Obviously, the most engaging among them were the violent political changes followed by the devastating flash floods in the northeastern and southeastern districts of the country affecting some 5.8 million people. With the floodwater slowly receding, the post-flood issues including the challenge of fighting waterborne infectious diseases, especially diarrhoea, will emerge. But there is yet another disease that appears with monsoon rains. Last year (2023), for instance, witnessed the deadliest form of the mosquito-borne disease, dengue, since 2000 that wreaked havoc across the country claiming over 1700 lives. In fact, over the past three years in a row, fatalities from dengue have proved to be the highest in Bangladesh among other dengue-endemic countries in the world. A research on dengue data collected between 2019 and 2023 from the world's five most dengue-affected countries including Bangladesh, Brazil, Mexico, Peru and the Philippines have shown that Bangladesh recorded the highest number of fatalities from dengue since 2021. This is concerning because, though Brazil recorded more than 10 million dengue cases over the last five years with a 'case fatality rate (CFR)' of 0.04 per cent, Bangladesh fared worse despite its record of fewer dengue cases. With half as many (relative to Brazil) documented dengue cases (0.5 million) over the 5 years' period, Bangladesh registered a fatality rate of 0.40 per cent which is 10 times that of Brazil.
In 2023, for example, Brazil reported the world's highest number of dengue cases at 30,088,223. Whereas, being in the second place, the number of dengue cases in Bangladesh in that year (2023) was 321,179. But when it came to the deaths caused by dengue, Bangladesh grabbed first place at 1705 deaths, with Brazil trailing behind at 1163. Studies further show that since 2021, Bangladesh has been witnessing a persistent rise in fatalities from dengue.
What is alarming is that the year 2024 has been registering a similarly high dengue 'case fatality rate' (CFR) at 1.11 per cent recorded between January and April this year. Consider that this is non-seasonal record of fatalities from dengue.
According to the Directorate General of Health Services (DGHS), between January 1 and August 30, the number of dengue cases recorded was 12,495, while fatalities from dengue numbered 79. Very disturbing reports of hospitalisation of hundreds of dengue patients are coming from different parts of the country.
With the mayors of city corporations, who used to look after the issue of combating dengue by way of destroying the breeding grounds of dengue-carrying mosquito aedes aegypti, now being replaced by civil servants as chief executive officers (CEOs), we are yet to notice required vector control measures being taken to fight the menace. The stagnant rainwater as well as flood can be a potential source of dengue. In that case, unless prompt measures are taken, dengue outbreak like last year may go out of control.
Are the CEOs running the city corporations in absence of the mayors aware of the magnitude of the challenge they are facing from dengue? It is important to remember that despite their having sufficient manpower, the past city corporation authorities fought a losing battle against the dengue vector. Their failures were many. They failed to take expert advice, did not follow WHO guidelines and used ineffective larvicide to eradicate the dengue vectors. Worse yet, failing to accept responsibility, the city mayors blamed the citizens for their failure to combat dengue.
The present city corporation authorities should avoid such deliberate mistakes that their predecessors committed.

[email protected]