Dengue outbreak to shatter all records, preparations still tepid

The trajectory of the dengue outbreak this year suggests it could break all previous records but experts believe the preparations remain faulty, despite assurances by Dhaka city authorities, and, as always, in want of research.

Last year saw the highest dengue-related deaths in the history of Bangladesh but there was no fatality at this time of the year with deaths rising later, whereas deaths have already hit 13 this year. Infections till 23 May this year have risen almost fivefold compared with the same period in 2022.

In another record year 2019, the country witnessed most cases but that year too deaths were only two by 23 May. These comparisons have led experts to forecast that this year's dengue endemic could be the worst in the country's history both in terms of fatalities and infected patients.

The pre-monsoon survey of Directorate General of Health Services, conducted between 26 January and 4 February, also support the dire forecast with aedes larvae found in 4.03% of the houses in Dhaka city mostly in multi-storied and under-construction buildings.

The dengue virus is carried by the aedes mosquito and at least four types of the virus exist in the nature with mutations occurring almost every year in a particular region or country. Therefore, area-specific research is needed to determine the strength of a dengue virus in a particular year as well as the appropriate pesticide and larvicide to apply – a scientific practice largely missing in the country despite repeated calls for undertaking it.

Professor Dr Be-Nazir Ahmed, former director of Communicable Disease Control at the health directorate, told TBS that despite successfully eradicating many diseases in the past authorities are failing to even control the dengue endemic, let alone eradicate it, largely due to the consistent adherence to faulty approaches.

"We need adequate number of entomologists and research projects in the government's anti-dengue schemes to effectively contain the endemic. The local administrations have to come forward in this regard," he added.

This year's weather situation so far hints at more wet days ahead with potentially more dengue spread leading to a devastating outbreak, the disease expert warned.

Dhaka North City Chief Health Officer Brigadier General Md Zobaidur Rahman told TBS that Dhaka North would apply bacillus thuringiensis israelensis, a type of larvicide, for the first time this year but has failed to clarify when its use would begin with infections already surging.

Insiders told TBS that the tenders for purchasing anti-viral agents for dengue disease containment in any given year are issued the previous year while in the present year authorities have to exhaust the existing stock before placing new orders – leaving little scope for applying any new time- and area-specific agents.

Therefore, it is very much likely the new bacillus thuringiensis israelensis agent would be applied towards the end of the current dengue season or, at worst, next year. Dhaka North has also reached an agreement with Jahangirnagar University for using their biological lab to determine the type of dengue virus but no practical progress has been made as of now in this regard.

For the time being, Dhaka North is resorting to awareness campaigns, fines for those failing to maintain hygiene protocols, fogging and increased larvicide use – all old and less-effective procedures.

Brigadier General Md Zobaidur Rahman further said that a letter has been sent to the education ministry urging inclusion of dengue prevention-related contents in national textbooks. Drawing books of dengue awareness will also be distributed among children free of cost, the health official added.

Dhaka South, where the virus breeding rate is higher than in the city's northern parts, has not even planned applying any new agent and is using the familiar procedures of awareness raising and fogging.

At a Tuesday meeting, Dhaka South City Corporation Mayor Sheikh Fazle Noor Taposh said a dengue awareness campaign will be conducted while fines will be imposed on the residents failing to maintain hygiene and cleanliness in their homes and surrounding areas.