Dengue: A third world disease that requires first world solutions

Dengue may not seem like a disease which requires as much attention as cancer, but it might become a pandemic, much like Covid-19. Photo: TBS

The top three diseases that kill most people in the world are heart attack, stroke and cancer. Since more people die from these, it is natural that there will be more cure, prevention and awareness surrounding them. 

Dengue may not seem like a disease which requires as much attention as cancer, but it might become a pandemic, much like Covid-19. The recent pandemic made people from every part of the world realise how catastrophic an invisible virus can become.  

The history of dengue is much older, and mosquitoes are extremely harmful insects. According to the World Health Organisation (WHO), mosquitoes alone kill about seven and a half million people every year. Although there are more than 3,500 species, the most dangerous are the female Anopheles and female Aedes. 

Female Anopheles transmits malaria whereas female Aedes transmits dengue and chikungunya. Dengue fever is caused by four serotypes of female Aedes. Dangerous diseases like zika and yellow fever are also transmitted by mosquitoes. 

More than 400 million people are infected with dengue every year, and about 40,000 die from it. Surprisingly, no vaccine has been discovered to prevent dengue so far. Even the WHO guidelines do not recommend any other medicine for dengue fever except simple paracetamol. 

Apart from Bangladesh, dengue epidemics have occurred at different times in countries like Mexico, Bolivia, Venezuela, Philippines. Before Covid-19, the last dengue death toll in the Philippines exceeded 1,000.  

In third world countries, dengue outbreaks are increasing year after year. At the outset, the reason is the apathy of the developed world. They do not give it much importance as the disease is not very common in their countries.  

Due to geographical reasons, dengue is more prevalent in forested, rain-prone areas. The countries that can be found on the map in these regions are not economically developed. Therefore, it is more appropriate to call the dengue problem a third world problem.

Malaria is endemic to Chattogram and the Chittagong Hill Tracts. But the rate at which dengue is increasing, soon it might reach the state of an endemic in Bangladesh.

Every year, during monsoon and autumn, dengue becomes rampant in different parts of the country, including the capital. Separate dengue wards should be opened in government hospitals for this season. Since there is no vaccine, Aedes mosquito control is the only solution. 

The government has never been able to give a solid answer as to why it takes this form every year. Even more surprisingly, in the face of dengue-related health disasters, we have no natural or artificial infrastructural preparation to prevent mosquito breeding. 

The situation did not become worse overnight, as statistics will show. 

In the 1980s, Bangladesh earned foreign exchange by exporting frogs and frog legs. 

Photo: TBS

There was a problem cultivating frogs and selling them commercially. The natural food cycle was destroyed by indiscriminate killing of frogs living in nature.

By selling frog legs and killing enough frogs, a layer had been removed from the natural food cycle. 

Natural farming based on low, medium and high levels of aquatic food cycles have been lost to the commercial model of fish farming. As a result, there are no fish, no frogs, no turtles and no birds to eat the mosquito eggs or larva. 

An open reservoir of water is like an ideal ground for mosquito breeding. Dhaka's reservoirs and lakes do not have isolated watercourses and industrial effluents are making the water more polluted every day.  

Such non-flowing stagnant water, especially in drains and sewer systems, is ideal for mosquito breeding. Due to heavy pollution, the small fish that usually live in the upper part of the water can no longer survive. As a result, the mosquitos breed freely and the eggs hatch successfully. 

Unplanned buildings, stagnant water on rooftops and unplanned roof gardens are also responsible for mosquito breeding. 

Dhaka's two city corporations, 10 mosquito control zones, at least 600 mosquito killer clerks, 1,593 manual and automatic mosquito control machines and an annual mosquito control budget of over Tk 45 crore are clearly not working. Not to mention the corruption and gross negligence of authorities and zero accountability or punishment for them. 

According to scientists, in recent years, some new and more virulent strains of the Aedes mosquito have been causing dengue. The new symptoms of dengue may be due to the development of a new type of mosquito species.  

As a result, dengue in recent years may actually be a new type of fever. With no vaccine available for the old dengue and chikungunya, the evolution of the old virus into new traits is signalling dire health risks. 

Media coverage alone will not cure the disease. Without spraying pesticides and regularly working on destroying mosquito breeding grounds, dengue will not be controlled.  

There is an opportunity to create moderate artificial currents by connecting the reservoirs and lakes of Dhaka. This may require an underground connection. Filters can be placed in the inter-connected lakes to control mosquitoes and eggs. 

Mosquito-borne diseases cannot be completely cured, it is also not reasonable to think we will be able to cure dengue overnight. So, our only chance lies with prevention and that requires government action, administrative initiatives, citizen awareness and sound urban planning. 

However, unless waste management, drainage management and urban planning are improved to a reasonable level, there is no quick fix to prevent mosquito-borne diseases. 

Rakib Al Hasan. Illustration: TBS

Dr Rakib Al Hasan is an author, activist and youth leader physician, au.

Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect the opinions and views of The Business Standard.