There have been a total of 5,376 cases of dengue in Tamil Nadu, the highest in the country this year.

Provisional figures listed on the website of the National Vector-Borne Diseases Control Programme under the Union health ministry revealed that the State recorded 39 deaths from dengue this year — the highest, again.

The state with the second highest number of cases is Kerala, but it is way behind at 2,995 cases (11 deaths). Karnataka records 2,403 cases but it has the second highest number of deaths at 21.

The data, based on information given by the State governments, have been updated up to September 26, this year, and more cases have occurred since.

This is the highest number of cases that Tamil Nadu has seen so far, at least over the past decade for which figures are available. But the last three years have not been good for the State in terms of dengue incidence. In 2011, the number of cases was 2,501, and in 2010, it was 2,051. The State seems to have managed to control the number of deaths up until this year, with 8 in 2010, and 9 in 2011.

Given the ratio of dengue cases to the number of fever cases, it appears dengue is in alarming proportions in the three southern States of Tamil Nadu, Kerala and Karnataka, said S. Elango, former director of Public Health. “When a comparison of viral activity over the last 10 years shows a definite increase in the number of cases, and when the case fatality is high, it is time to be worried,” he said.

A new trend this year is the co-existence of a number of infections simultaneously, Dr. Elango said. Dengue, this year, is presenting itself in combination with leptospiroris, typhoid, and in one case, even tuberculosis. Multi-organ failure as a cause of death, being reported widely, is likely to occur along with the other infections.

The only thing the health department can do at this stage, in an epidemic caused largely by domestic breeding of mosquitoes (Aedes aegypti and Aedes albopictus breed only in clear water), is to step up awareness, a public health expert said. In addition, being prepared to prevent deaths is also key, he said.