DENGUE fever is usually described as tropical fever. To explain it further it is a tropical disease caused by a virus that is transmitted by mosquitoes and marked by high fever, rash, headache, and severe muscle and joint pains. It is also called break bone fever or dandy fever.
Dr Sajjad Hyder, a family physician, giving definition of dengue fever, also known as viral haemorrhagic fever (VHF), said that in every severe case, the situation could lead to dengue shock syndrome in which the patient can bleed to death. With critically low platelet counts, infusion of platelet is the main stay of treatment.
The sudden appearance of this disease in Karachi and elsewhere in Sindh has begun to take an alarming situation. A conservative estimate shows that at an average 100 to 200 patients are being admitted to government hospitals of Karachi. The admission to private hospitals and clinic is going unreported.
Similarly, district hospitals of the 33 district hospitals of Sindh and a large number of taluka level hospitals and smaller health care outlets in the rural areas do not have a unified system of reporting. Only a few hospitals send daily report to health directorates and the rest are satisfied with occasional filing of reports when asked for.
In this situation the extent of dengue fever cases in Sindh is just not possible. It is only guesswork on which the entire health system of the province works.
After the recent heavy rains across Sindh mosquito population has increased manifold and swarms could be seen in accumulated rainwater. In Karachi the entire Lyari River is the breading area and the population living on its bank is the most vulnerable to VHF. In addition to this river, there are hundreds of cesspools throughout the low income housing colonies and shantytowns. Old residential areas in Karachi and other cities of Sindh have poor sewer disposal system.
Because of this situation sewer remains accumulated near the houses, which are poorly maintained. Mostly the houses are in clusters and open space is limited or encroached upon by the landless people. More people and less space and that too unclean is adding to problems associated with dengue fever. It is transmitting from one person to another.
There are three major steps that should have been taken by the health authorities much earlier than the breakout of this disease: disposal of stagnated water, large scale fumigation/spray to check mosquito populations and adequately laboratory tests arrangements.
The situation is likely to become complicated as the number of patients being admitted to hospitals is increasing. It began from one patient admitted to Civil Hospital only about a week ago to more than 14 cases admitted to the hospital by Thursday last. The first case of kept secret but later the report leaked out and more admissions were made public.
The secrecy maintained in case of first patient created curiosity of the people and it transpired that Civil Hospital despite being a teaching institution did not have the capacity to deal with this case. The facility as updated as the doctors found situation becoming complicated and more cases were reported.
What is worrying is that the health authorities remain oblivious to likely spread of a disease that may prove fatal and become uncontrollable before taking any notice of its effects. In case of dengue fever the health authorities took it lightly, as they could not make out what it was.
The disease was confused with simple fever, cold and cough and exhaustion because of fasting. Pathological examination of the first case was carried out only after trying to treat the patient with simple medication. It did not strike to physicians that pathological test should be carried out to diagnose the disease.
However, the dengue fever has exposed the state of readiness big government hospitals attach to emergencies, handling of unusual cases and outbreaks.
(An interview with family physician.)
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