Dengue - back with a vengeance

DUNGUE fever, a serious viral disease transmitted by the bite of the mosquito Aedes aegypti is back in Pakistan with a vengeance. Known to health experts for more than 200 years, the Dengue virus has now become a health issue of epic proportions all across the world.
Although not a particularly novel phenomenon as far as South Asia is concerned, its outbreak in Pakistan has triggered a serious alarm as the death toll rises with every passing day. In the past few months, while the virus was controlled by government intervention to some extent its recurrence has sounded warning bells once again.
Commonly known to occur in two forms, ie as dengue fever and dengue haemorrhagic fever, there is no vaccine that can effectively and entirely cure dengue, despite constant attempts world-wide to find break-through solutions via the use of biotechnology and genetic engineering.
The Dengue fever is an acute flu-like condition, which affects people of all ages and can often be fatal. Moreover, its second form, DHF is an even more dangerous and lethal form of dengue. The two are essentially forms of Viral Hemorrhagic Fevers (VHFs) - a group of illnesses caused by a distinct family of viruses, transmitted to humans by an infected female mosquito Aedes Aegypti, which is commonly known as the Yellow Fever Mosquito.
It has the capability and the capacity to host various viruses such as the dengue fever virus (known as the arbovirus that is predominantly transmitted by mosquitoes and ticks), Chikungunya (a much rarer form of viral fever) virus and the yellow fever virus.
One must point out here that it is the mosquitoes that become infected with the virus when they bite infected humans. Oddly enough, this particular mosquito breeds only in clean water containers like barrels, buckets, drums, tanks, flower vases, water coolers, discarded tires, toilet bowls and other such places, including the ones where rainwater collects, which is a practice contrary to that of the malaria-causing mosquito that thrives and procreates in dingy waters.
Dengue is infectious, with the first symptoms occurring during initial five to seven days after being bitten by the infected Aedes Aegypti mosquito. It is characterised by a sudden onset of high fever accompanied by severe headaches, muscle and joint ache, nausea and vomiting as well as rashes. The dengue rash is usually bright red in colour, occurring initially on the lower limbs and the chest and in some cases, which then spreads to most of the body. Some cases also involve loss of appetite and the ability to taste things.
In certain severe cases, the Sindh Health Department advisory states that the patient may bleed from the mouth, nose, in the vomit or stool, as a result of internal or external bleeding. Symptoms, however, may not be the same for all cases as some cases develop milder indicators, which can be misdiagnosed as flu or some other viral infection and later develop into a more serious, even deadly form of the disease. It is for this reason that people may pass on the disease unwittingly until someone with more conspicuous symptoms is discovered, said a local medical practitioner, though dengue patients are usually believed to spread the infection only through mosquitoes or blood products and that too as long as they are feverish.
Moreover, all dengue patients undergo a progressive decrease in their blood platelet count which worsens the condition in cases where bleeding has already started and poses an imminent threat to the ones who aren't already bleeding, but their condition might worsen. Since bleeding with the low platelet count takes a non-stop turn, an ample supply of platelets and blood is required which may not always be available everywhere all the time. Also, all dengue patients are required to get a blood test done every day to see if the platelets count is getting better.
According to the World Health Organisation (WHO), DHF, a more acute form of dengue, has a five per cent mortality rate though this may increase if the cases are not properly handled and treated. On the other hand, with proper treatment and therapy mortality rates may be minimised. Also, according to a WHO report, people at a higher risk for dengue transmission is children, travellers and tourists, whereas adults residing in endemic areas are also susceptible to contracting the disease.
With no proper vaccines available to combat Dengue, the only effective and available method of controlling and eventually eliminating the disease is by destroying the mosquito breeding places along with effectively treating patients identified as carriers. These patients can at best be given plenty of fluids and measures should be taken to control their fever. With quick and careful treatment, most patients may survive without having to go through blood transfusion.
Also the Aedes Aegypti's breeding places can be eliminated by various means such as by tightly covering water storage containers, draining rainwater regularly and disposing off garbage. In addition, inside the home, precautionary measures such as regular use of quality pest control products like household insecticide sprays, coils, mats and liquid electrical devices are advised to be taken as seriously as possible in order to ensure adequate prevention from these disease carrying mosquitoes.
Ways to prevent dengue from spreading further, other than keeping and treating the dengue-positive patients in isolation, should focus on cleaning up the city's sewerage system and regular check ups of abandoned construction sites as well as various potholes and dilapidated streets throughout the metropolis.
The virus, it appears, cannot be prevented from spreading and the dengue-infected mosquitoes from breeding if these hygiene aspects are left unattended and currently prevention appears to be one's safest bet.
While things have become better in Karachi with regards to the diagnostic facilities available to the people according to medical experts, the current dengue problem, if considered with some insight, leads to a Pandora's Box which nobody would want to open.