By: Dr. AZIZUR RAHMAN
At the year’s onset, experts had issued warnings regarding the dengue condition. However, the issue of dengue control was given insufficient attention. Presently, the dengue virus has manifested perilously. In July, a staggering number of 304 individuals succumbed to the effects of dengue, surpassing all previous mortality figures. Amidst the prevailing circumstances, a query has emerged inside the collective consciousness of individuals: What factors have contributed to the sudden worsening of dengue’s severity?
The prevalence of dengue infection in Bangladesh has shown an upward trend over the years. However, the current year has witnessed a significant increase in the severity of dengue cases, mainly attributed to the heightened virulence of the disease-causing virus and inadequate measures taken to combat its spread.
In Bangladesh, dengue was previously perceived as a disease that occurred only during specific seasons. However, there has been a notable shift in recent years as dengue outbreaks have been observed consistently throughout the year. Consequently, the virulence of the four viruses associated with this disease has increased. The phenomenon has been disseminated over all regions throughout the nation.
However, this year has surpassed 2019 as the worst year for dengue cases and 2022 as the worst year for deaths. Especially July. During this period, 204 dengue patients died, which is seven times more than in June.
Dengue is now heard throughout the country. Relatives are running around with the patient, causing admission confusion. And getting treatment in acute bed shortage has become very difficult. Patients are forced to take treatment on the floor. The picture of most government hospitals in the country is so dire. Private hospitals are not left out. The crisis is there.
The current situation is out of control as dengue patients are increasing at an increasing rate in the country. So far, according to official estimates, the number of dengue cases across the country this year has exceeded 50,000. More than three hundred people died. The health department is thinking about compulsory vaccination.
What is dengue vaccine?
Work on the dengue vaccine started around 1920. In 104 years, only two vaccines have been approved on the market. Vaccines currently on the market include Denvaxia and Qudenga. Denvaxia is mainly given to people who have had dengue before, and Kydenga is given to those who have not yet had dengue.
Denvaxia came to the market mainly by Sanofi company. According to the information provided by the US-based Centers for Disease Control and Prevention (CDCP), Denvaxia may cause side effects in those who have not previously had dengue.
Those who have previously been infected with dengue or in areas where dengue has become an epidemic said to apply this vaccine. A person needs to apply 0.5 millilitres of Denvaxia in three doses every six months.
A new vaccine, Qudenga, has come into the market to treat the side effects of Denvaxia. In the last four years, Qdenga has gone through 19 clinical trials to reach its current status. However, it is said that kydenga should be given to those who have not been infected with dengue before. But currently, doctors are of the opinion that anyone can take Kyudenga.
According to the European Medicines Agency, this vaccine is administered in two doses. Qidenga is over 80 percent effective against dengue. On the other hand, if this vaccine is applied, the hospital admission rate drops by 90 percent below. While Denvaxia is less effective against serotypes 1 and 2, Qydenga has gained popularity with 70 to 95 percent efficacy.
Why has the dengue situation become so dire?
Although dengue infection has continued for several years, it has not been given much importance. As a result, it has become evident before the season this year. Compared to the last few years, the condition of dengue patients is deteriorating very quickly.
In the current situation of dengue, it is not the case that we will soon be able to control the Aedes mosquito or reduce the number of dengue cases. The current situation is going to be worse than 2019.
To address the present circumstances, it is imperative to prioritise the effective management of individuals afflicted with dengue fever. There is a pressing demand to augment the quantity of medical practitioners within the hospitals located in Dhaka. In addition to this, it is imperative that medical professionals, including doctors and nurses, receive comprehensive training in the effective management of patients afflicted with dengue fever.
Meanwhile, the Department of Health is saying to continue preventive activities against dengue throughout the year.
The highest number of dengue patients died in 2022. That year, 281 people died out of 61,000 patients. The number of dengue cases was high in the previous year as well. The most affected was in 2019. And this year, before the season, the number of infected and dead has exceeded the figures of 2022.
There was no break in the arrival of dengue patients between last year and this year. We got patients even in winter. This time, we are getting more patients even one-and-a-half months before the start of the season.
Four types of serotypes of dengue are found among infected people. Among those who are infected, the number of second infections is high. Before 2000, we saw that people were infected with a form of dengue. As a result, resistance would develop in them. But when people start getting all four types, immunity also doesn’t work. Then, the risk of infection increases three times.
The type of measures being taken to deal with dengue is very traditional. Those concerned think it may be a temporary disease that will go away after a few days. As a result, no effective or long-term measures are being taken anywhere. As a result, dengue has completely stopped. That is not happening with the importance we need to jump on. As it is an epidemic, no measures are being taken.
This year, the dengue outbreak came much earlier than other years. It has now spread across the country. As a result, it is heading towards an epidemic. Now, there is a health emergency situation in the country. Special plans need to be taken apart from conventional measures to deal with it. Otherwise, the situation cannot be handled.
At present, all the government hospitals in Dhaka have more dengue patients than their capacity. Most of the patients admitted to private hospitals are dengue patients.
According to the Department of Health’s information, dengue patients have been identified in 64 districts of the country. The number of infected has become alarming even before the period which is considered as dengue season in the country. People between 25 and 40 years of age are especially affected by dengue. Most of the victims are residents of Dhaka city.
Most of the people outside Dhaka are infected for the first time. Compared to the last two years, the number of patients in rural areas has increased. If it continues to spread like this, in the near future, its terrible form will also be seen in rural areas.