“Dengue is here to stay and we will be facing these outbreaks. But no government can deal with the disease where community ownership is lacking. A lot of ownership has to come from the community to prevent dengue,” says Manish Kakkar, Head of Zoonotic Diseases, Public Health Foundation of India.
However, he adds, there is a lot of scope for improvement as far as reporting is concerned. According to Dr. Kakkar, there is underreporting of cases because of high dependence on private health care — particularly small clinics — and lack of adequate testing facilities. “Sometimes, the symptoms of dengue are similar to those of seasonal viral and hence, it goes unnoticed. Also, suspected cases are not counted since it has not been declared a notified disease. It is only confirmed cases which are reported.”
But, Dr. Kakkar says, there is also a deliberate attempt to underreport the cases as it reflects on the performance of the agencies responsible for its control. Underreporting is also due to the absence of a diagnosis and surveillance network, and improper methods used.
Dengue is reported from across the country. More than 32,000 cases have been reported so far this year, with 188 deaths, according to the National Vector Borne Disease Control Programme. Tamil Nadu’s toll of 54 is the highest, followed by Maharashtra with 50.
There are 311 public sentinel surveillance hospitals and 14 referral hospitals in 35 States and Union Territories where pathological tests are conducted for detection of dengue and chikungunya, and cases are monitored.
From the government side, the strategy is basically one of surveillance, vector control, laboratory diagnosis and focus on behavioural change, communication through information, education and communication. The strategy holds good for most other vector-borne diseases as well.
“For all vector-borne diseases, all stakeholders must take effective steps for elimination of breeding places. Dengue mosquito breeds in and around the house, and hence we must ensure that there is no freshwater collection on our premises,” says Anshu Prakash, Joint Secretary, Ministry of Health and Family Welfare. People can take steps for personal protection against bites.