The Hindu : Pre-emptive approach needed to face dengue threat

Online edition of India's National Newspaper
Saturday, Apr 12, 2003

Southern States

Southern States - Tamil Nadu-Chennai

Pre-emptive approach needed to face dengue threat

By Saptarshi Bhattacharya

CHENNAI APRIL 11. Though there is no immediate threat of a major outbreak of `dengue', medical institutions have suggested a pre-emptive approach to prevent mosquito-genic conditions to reduce the threat of its incidence during summer.

While the public health bodies do not prioritise preventive steps but rather wait for the occurrence of the disease, a huge segment of uninformed population is working counter to all efforts to control the disease, medical practitioners involved in management of the disease said here.

Though sporadic cases are detected throughout the year, dengue, as with most other notifiable diseases, is seasonal and occurs mostly in the summer. The dengue vector, Aedes aegypti mosquito, had an ideal breeding place in fresh water stored in containers in households during the scarcity period.

Between August 2001 and January 2003, the Kanchi Kamakoti CHILDS Trust Hospital treated 967 cases of serologically confirmed dengue of which eight children died due to late hospitalisation. There could be a three-fold increase in the numbers in the government hospitals, said S. Balasubramanian, senior consultant paediatrician.

Early recognition of the clinical manifestations and prompt therapy with fluids was sufficient in management of most of the cases, but low level of awareness among doctors and paramedics had an impeding effect in the management of the disease, he said.

Correct management of dengue should not be confined to tertiary care centres, said K. Mathangi Ramakrishnan, Director, Intensive Paediatric Burns Care Unit and Chief of Plastic Surgery, Kanchi Kamakoti CHILDS Trust Hospital. The diagnosis should take place before the child enters the haemorrhagic fever or shock syndrome state.

With a focus on proper care and prognosis of the disease, the CHILDS Trust Hospital will organise a workshop on dengue on April 12 followed by a CME programme the following day. Sponsored by the National Academy of Medical Sciences, the event is likely to draw about 100 participants from all over the country and experts from abroad.

For a more effective campaign against diseases, the public health governing bodies in the State should include philanthropists who would contribute towards financing of various projects, NGOs who could have a field level presence in any project, and other stakeholders to the public health bodies, Dr. Mathangi said.

Although a predominantly urban disease, public health authorities were reporting cases from districts including Neyveli, Tirunelveli, Salem and Madurai, which is directly attributed to unprotected storage of water in those regions.

Public health officials of the Chennai Corporation, however, were sceptical about a total prevention of the disease blaming it mostly on public apathy and lack of a strong deterrence. The campaign against malaria holds good for dengue too as the breeding ground for both Aedes aegypti and Anopheles stephensi (malaria vector) was the same. But the civic body has not met with much success in its decades-old anti-malaria campaign for lack of public participation, officials said.

After a severe outbreak of dengue in Delhi, which claimed 324 lives in 1996, the Delhi Government introduced harsh penalties on households that are found to have uncovered breeding sources. A similar amendment to the existing municipal laws was pending with the Government for over a decade, the officials said.

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