Dengue outbreak: A result of inaction and lack of farsightedness

A French animal-rights activist recently said that mosquitoes should be allowed to drink human blood, since they do it to get protein for their eggs. Aymeric Caron, an anti-specist TV presenter, further added that mosquitoes, in fact, should be allowed to bite humans, except in Africa, where people might get infected with malaria.

Mr Caron perhaps is unaware of the human toll that dengue, a mosquito-borne disease, is taking in South East Asian and South Asian countries, especially in Bangladesh which this year registered the highest number of dengue cases in its history. 

In Bangladesh, according to unofficial sources, so far this year, at least 60 people have succumbed to the deadly menace caused by Aedes mosquitoes. And a staggering 27,437 people have been infected with the disease. This is more than double the number of dengue cases last year (10,148). Government figures, however, put the death toll at 18.

With the increase in the number of dengue cases, various narratives have emerged from different quarters, including the government, the city corporation and the politicians. While the prime minister has urged the countrymen to keep their surroundings clean and has instructed her party leaders and activists to conduct countrywide cleaning campaigns to battle the dengue outbreak—with dolled-up celebrities instantly obliging by taking to the streets with brooms to swipe away the mosquitoes—the Local Government Division (LGD) minister of her cabinet, Md Tazul Islam, claimed that dengue was "under control", as hospitals kept scrambling to accommodate the influx of newly infected patients.

And although DSCC Mayor Sayeed Khokon has said that dengue "cannot be called an epidemic yet", the number of people infected by the disease is increasing by the hour, setting a new record for the country, every day. With the health minister, after his recent return from Malaysia, sensing conspiracy centring dengue, it is unclear how many more lives will be wasted before we can counter the conspiracy of the mosquitoes against the human race.

On Monday, the health minister claimed that the number of dengue cases was coming down, the same day 2,065 dengue-infected people were admitted in various hospitals across the country, the highest number of dengue patients to be admitted in hospitals in a day this year. The very same day, the country also witnessed the highest number of deaths (seven) related to dengue in a 24-hour span. Such comments coming from government authorities reflect either their ignorance or their apathy towards the sufferings of the common people.

Narratives have been quick to emerge. What has unfortunately been slow in coming, however, are initiatives by the concerned authorities to tackle the dengue outbreak. From the use of ineffective pesticides to the inadequate supply of mosquito repellents in the market, the people of this country are having to face multiple hurdles day in and day out just to protect themselves and their loved ones from lethal mosquito bites.

Adult Aedes population in Dhaka has increased manifold over the last few months. According to a report by The Daily Star, a recent Directorate General of Health Services (DGHS) survey shows that the current density of adult vector Aedes population in the country is 487, which is almost 14 times higher in comparison to only 36 in the pre-monsoon period. The pre-monsoon study was commissioned between March 3 and 12, while the recent survey was conducted between July 17 and 27, in 100 locations around the capital. The survey also reveals that the concentration of mosquito larvae is high, which essentially means more Aedes mosquitoes and a further spread of the disease.

While discussing the ongoing dengue outbreak across the country with this writer, Professor Mahmudur Rahman, former director of Institute of Epidemiology Disease Control and Research (IEDCR), suggested that the city corporations should intensively conduct anti-Aedes drives across the country round the year, since dengue is not a seasonal disease. If exhaustive drives are continued throughout the year, it will be easier to combat the prevalence of dengue during the peak season; and the comparatively limited concentration of Aedes mosquitoes in the off-peak season will only make it easier for the city corporations to contain their numbers.

Professor Rahman also added that spraying pesticides on roadsides is not very effective in containing Aedes mosquitoes; instead focus should be on destroying mosquito larvae, and for this, workers will need to visit individual houses to inspect them and destroy the larvae. A similar view has been shared by the World Health Organization (WHO) which recently suggested that fogging the streets and roadsides might not be effective in destroying mosquitoes, since Aedes mosquitoes travel less and mostly stay in darker places. The WHO recommended using mosquito aerosol at home and leave temephos, a larvicide, in water containers, to contain mosquito-breeding.

With dengue spreading across the country, one wonders how long it would take for the new insecticides to arrive and contain the situation. On August 2, DNCC Mayor Atiqul Islam said that new samples of insecticides to kill mosquitoes "will arrive in a day or two." According to a newspaper report, DSCC has started testing a sample of a new US-made pesticide since Friday, with a success rate of up to 26 percent. According to the same report, entomologist Professor Kabirul Bashar of Jahangirnagar University has suggested that the success rate of a pesticide below 80 percent is not satisfactory. Another sample of pesticides has arrived from India lately, which will also be tested to assess its effectiveness. The city corporations' fix over the pesticide issue and the lack of pace in importing an effective pesticide reflect poorly on their preparedness and ability to combat this disease. 

The authorities did take up some measures though, including waiving tax on dengue testing kits, site inspections and fixing rates for dengue tests; however, these measures can at best be considered piecemeal initiatives, with very little impact on long-term protection from the disease. The government's knee-jerk reaction to the dengue outbreak reveals the lack of a policy framework that is of the essence now, in order to combat and, if possible, eliminate this disease from the country. The government must now roll up its sleeves and get down to work to prepare a dengue prevention and control policy to curb its increasing menace.

With so many quarters making so many comments, and so little effective action being taken, people have resigned to their fate—living in constant fear of mosquito bites. News of fathers burying little children and husbands burying expecting wives and their unborn babies have become a common feature on the front pages of our newspapers. And amidst all this, the only thing that is shining bright is the failure of the concerned authorities to save people from the grip of a deadly disease that could have been contained at an early stage with comprehensive planning and effective implementation.

Tasneem Tayeb works for The Daily Star. Her Twitter handle is @TayebTasneem.