Rather than just garbage removal, a mass elimination of breeding sources of Aedes species of mosquitoes from inside houses and in peri-domestic areas should be carried out in a campaign mode immediately in all districts, especially Thiruvananthapuram, to interrupt the transmission of dengue.
The State government has been asked to implement legislative measures, a comprehensive Public Health Act, so that vector breeding inside houses and peri-domestic areas is a punishable offence.
In their report, the Central team, led by Joint Director of National Vector-Borne Disease Control Programme Kalpana Baruah, which visited Kerala last week to assess the dengue situation has suggested that focus should also be on bringing down the density of infected mosquitoes, by destroying adult mosquitoes.
Dr. Baruah has suggested that outdoor fogging be carried out in all localities immediately during morning and evening hours when the Aedes mosquitoes are most active. This should be done in a scheduled manner, with prior intimation to the public that all doors and windows of houses be kept open during the fogging.
Indoor space spraying has also been suggested to destroy all mosquitoes resting inside houses.
Entomological surveillance reports had earlier pointed out intense breeding of both Aedes aegypti and albopictus species inside houses and peri-domestic habitats in all districts. The prevalence of A.albopictus was more than that of A. aegypti.
Conducive conditions
Apart from conducive climatic conditions — drought, followed by intermittent summer rain — rampant construction activities was one of the reasons for the high and explosive breeding of mosquitoes.
Effective community ownership of the source reduction activities and inter-departmental cooperation alone can bring down dengue, it has been pointed out.
An analysis of dengue deaths in the State revealed that all dengue deaths had occurred within seven days after admission and that the presence of two or more co-morbidities had been noted in about 23% of dengue deaths.
About 38.5% of dengue deaths were in patients with diabetes, while 23 % had hypertension. Prevalence of chronic kidney disease had been noted in 7.7 % dengue deaths.
The Central team has suggested that people with co-morbidities, who have or are suspected to be having dengue, be admitted to hospitals and monitored properly to prevent deaths.
The government has been asked to involve organisations like the Indian Medical Association in sensitising private practitioners to follow national guidelines for the clinical management of dengue
