Threat of dengue variant DEN-2 to stay two years: Health experts
The widespread presence of the Den-2 serotype, dominant since 2023, is a key factor in the ongoing crisis
- Den-2 dominates dengue cases (85%) in Dhaka
- Second time infections increase death risk
- 90% patients infected with Den-2 serotype in Chattogram
- Elderly persons, women at higher risk
- Female deaths higher despite lower rate of hospitalisation
- 108 dengue deaths nationwide within 26 days of October
- Den-2 linked to severe complications
- Decentralised health care could reduce fatalities, experts suggest
Over 85% of this year's dengue patients in the capital city have been infected with the dengue virus serotype 2 (Den-2), a recent study on dengue strains by icddr,b has found.
The findings highlight a significant public health concern, as health experts fear that the Den-2 serotype may persist for the next two years.
The study indicates that the majority of remaining dengue patients are suffering from Den-3, while a smaller number are infected with Den-1. In Chattogram, about 90% of dengue patients have also been infected with Den-2.
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Last year's severe dengue outbreak continues to impact the country, with a similar death rate this year, though total deaths are slightly lower. The widespread presence of the Den-2 serotype, dominant since 2023, is a key factor in the ongoing crisis.
Health experts said with the high prevalence of Den-2, patients experiencing second or third time dengue infections face a higher risk of death. Elderly individuals and women are particularly affected, with higher fatality rates. Those with heart, kidney, diabetes, or other complex conditions face an increased risk of death if infected.
Dr Mohammad Shafiul Alam, Scientist of the Infectious Diseases Division at icddr,b told The Business Standard, once a person is infected with a type of dengue, they develop immunity against it. But when infected with another type, the situation turns severe and the risk of death rises.
"Among four serotypes of dengue, Den-2 and Den-3 are the most prevalent in the country, while Den-1 cases are rare. Once infected with a specific dengue serotype, a person develops immunity against that type and cannot be reinfected by it. However, subsequent infections with different serotypes can lead to severe complications," the scientist added.
He further said, "Most dengue patients die due to negligence, with many dying from shock syndrome due to inadequate treatment. Although fewer women are affected by dengue this time compared to men, their death rate is significantly higher. This discrepancy is largely due to the increased risk faced by physically weaker individuals."
Experts say that usually one serotype of dengue prevails for three to four years. Serotype-2 predominance was seen last year as well. Since this time there is a serotype (Den-2), people have immunity to the previous serotype.
According to data from various hospitals, patients are coming with two types of problems, shock syndrome and hemorrhagic fever. Last year there were more patients with shock syndrome. If anyone has symptoms of shock syndrome or hemorrhagic symptoms, experts have advised the patient to be rushed to the hospital.
In October, 108 dengue deaths were reported in 26 days. This month has seen the highest cases and fatalities of the year, bringing total hospitalizations in 2023 to 55,663 as of yesterday.
According to Directorate General of Health Services (DGHS) data, the year's death toll has reached 271, marking the third-highest since the 2000 outbreak and potentially set to surpass the second-highest. Female hospitalisation rates stand at 36.7%, with males at 63.3%; however, females account for 53.5% of deaths, despite their lower case numbers.
Public health expert Mushtaq Hossain told TBS, "If the medical system remains centralised, reducing dengue fatalities will be challenging. Community clinics and accessible testing facilities are essential so that individuals can be tested for dengue promptly upon developing a fever."
"Additionally, if the government structures dengue treatment into three tiers—primary, secondary, and advanced—it would streamline care and help lower the dengue mortality rate," he stated.
In 2019, 1.19 lakh patients were affected and 179 deaths by the new type of dengue 'Den-3' in the country, breaking the record of all previous years. In 2023, dengue deaths reached an all-time high of 1,705, compared to 281 in 2022.
