More than 4 years ago, the corona virus was wreaking havoc around the world.
The corona vaccine has reached the majority of the people and due to increasing awareness, now the infection and effects of corona have completely disappeared. Dengue disease is taking a violent form in most of the districts of the country before the corona virus subsides and life returns to normal.
What is dengue?
Dengue is a viral disease transmitted by the bite of a species of mosquito. It has been found that the species of Aedes mosquito is increasing and the increase in the movement of people and entry into the country is also the reason for the increase in dengue infection. There are four species of dengue virus transmitted by Aedes mosquito in Nepal, of which dengue virus-1 (DENV-1) is the most common.
It is estimated that the origin of dengue is about 500 to 1000 years ago. This disease first appeared in Nepal in 2004 and has since spread rapidly in various tropical and sub-tropical regions. Factors that play an important role in spreading in tropical regions are heavy rainfall, temperature, air humidity, urbanization and inability to prevent vectors. For the first time, the infection was found to spread in Nepal in 2006, in which 32 infections were found in different parts of the Terai during the post-monsoon season, in which all four species of virus were found. It has been found that there has been a significant increase in the number of infections since the last 5 years and it has been found that there is an increasing infection in Jhapa, Chitwan, Rapandehi Mahottari, Kaski, Sunsari and other districts. In 2019, the highest number of 14,662 infections was observed, among which 68 out of 77 districts were infected.
The death rate due to this disease in the world is less than 1 percent annually and in 2019, 6 people lost their lives due to this disease in Nepal. Although the Kathmandu valley is not suitable for dengue vectors, due to increased urbanization, unsafe waste management and rapid population growth, 1583 infected people were also found in the capital. Now, from July to August of 2022, more than 1400 infections have been found, which is many times more than the same period of the previous year. Similarly, this year also, it has been found that most of the infected are in the Kathmandu Valley. It cannot be said that it will not take the form of an epidemic at any time if it cannot be controlled in time. Especially since it is rainy season with this summer, its risk will increase, so it is necessary to take more precautions in this regard.
How does it move?
The female Aedes aegypti mosquito is the main vector of dengue. This species, which lives by sucking human blood during the day, is attracted by the natural smell of the human body and has the ability to spread disease to many people. After the vector bites, the virus accumulates in the human blood and spreads throughout the human body. After eating blood, it looks for a vessel with fresh water and lays its eggs. It can lay 100 to 200 eggs in one water source, but it collects eggs in several sources at one time. As its eggs are resistant to dehydration, the population of this vector is increasing rapidly. Sucking the blood of an infected person can spread the virus to non-infected mosquitoes and increase the transmission process. Once infected, a person gets lifelong immunity from that type of virus. Therefore, 4 types of viruses can infect a person 4 times.
What are the symptoms?
The symptoms of dengue begin to appear in 2-7 days. In which high fever (104 degrees Fahrenheit) is the main symptom. At the same time, other symptoms include headache, muscle pain, pain behind the eyes, nausea, vomiting, and swelling of the glands.
The World Health Organization (WHO) has divided dengue into dengue and complicated dengue. Common symptoms and self-limiting disease are called dengue and those with warning symptoms are called complicated dengue. After 3-7 days of infection, the fever will decrease and warning symptoms may appear. Some of which can be fatal. These symptoms include a lot of abdominal pain, vomiting, bleeding from the gums, water in the stomach and chest, shortness of breath, etc. Possible complications of dengue include dengue hemorrhagic fever, dengue sick syndrome, etc. In these cases, plasma is lost from the blood, bleeding easily, stagnation occurs, and the blood becomes thick and does not reach the various organs and the organs deteriorate. The period in which these complex symptoms appear is called the critical phase, and this period can last from 24 to 48 hours. During this period, if too much water accumulates in the body, fatal respiratory diseases will appear. Also, there is a possibility that the liver and other organs will fail due to too much plasma or blood and heart attack. This condition is called dengue shock syndrome.
Due to which the patient may die. Based on these signs, the doctor admits the patient to the hospital and keeps them under their supervision to prevent complicated problems. After this period, the infected gradually improves, the appetite increases, the symptoms disappear, and in some cases, a rash may appear on the body.
Examination and Treatment Procedures
In patients with suspicious symptoms, PCR is used to confirm the infection. Similarly, RDT is used to prevent the spread of infection. (R.D.T.) can also be used.
It has been found that anti-viral drugs are not effective for dengue virus. To treat dengue, first various information inquiries and blood tests are done, the symptoms and complications of the infected person are estimated and the treatment system is decided. There are 3 types of treatment system under this. Patients who have visited risk areas in the last 14 days, have symptoms similar to high fever and dengue, but do not have complicated symptoms, are treated according to normal symptoms and sent home. In case of complicated symptoms, treatment is done in the hospital. In case of complicated symptoms, emergency treatment is required. Adequate fluid intake, prevention of fever and bed rest are advised to prevent general symptoms. Patients with complicated symptoms are kept in the hospital, the condition of the blood is improved by using intravenous liquid medicine, and the blood is checked from time to time. At the same time, the condition of various organs is measured. In the case of complicated dengue, in addition to supplementing with large amounts of fluids, as indicated by the examination, blood transplantation may also be required. After the patient’s condition improves and the blood density decreases, the amount of medicine is reduced and after the symptoms improve, the patient is discharged and sent home. Although the symptoms are normal in the elderly group, the death rate is higher than the younger group, so special attention should be paid.
Vector targeted measures should be adopted to prevent dengue. Measures to prevent mosquitoes from breeding and settling around the house are important. Under the Integrated Vector Management system, how to stop the vector from living around the house, how to avoid mosquito bites, the process of destroying eggs, etc. are included. Using insecticide-treated mosquito nets, spraying insecticides in the corners of the house and places where mosquitoes can live, using space spray that can be sprayed in the air, covering surfaces where water collects, covering dishes, spraying mosquito repellent (larva killer) drugs on the water surface, Measures such as keeping fish and other animals that eat insects are effective. Similarly, it is important to use lotions like repellent for your safety, and to use mosquito repellant incense. Likewise, the proper management of waste and the use of water should be done in a systematic manner. Because the mosquitoes that spread dengue bite more in the morning and evening, it is important to be careful. In order to control dengue outbreak, dengue ravages can be controlled in risky areas by conducting prevention programs in collaboration with various health institutions, various organizations working in the health sector and the government from local to central. Also, it is necessary to conduct public awareness programs across the country to teach the common people how to avoid dengue.