Tackling the winged intruders

Nearly, 237 cases have been registered in Delhi-NCR this year so far among which 118 cases of dengue and 32 cases of Chikungunya are in Delhi alone – this is worst figure in comparison to data from the last five years. Whereas in the year 2012, there was only one case reported in the month of July.

That is what the shocking figures from the month of July reveal which is considered to be the first month of monsoon. In the last week of July itself, as many as 63 cases of dengue and 79 cases of malaria had been reported in the national capital, which is considered to be the worst outbreak of the vector-borne fever, since 2012. The civic administration maintained its official dengue death toll - nill, however, in a report released recently by SDMC, which compiles the data on behalf of all the civic bodies in the city, two official deaths due to dengue were reported.

While Rakesh (name changed), 23, became the latest victim of dengue at Sir Ganga Ram Hospital( SGRH), a three-year-old had succumbed to death at Lok Nayak Hospital earlier in June.

Dr Atul Kakar, vice-chairman at internal medicine department of SGRH said, "Rakesh came to us in a very bad condition. He already had suffered co-morbidity with kidney and heart-related issues. He suffered multiple organ failures and died of dengue." "We have at least 12 dengue-positive patients here," said another doctor.

Dr JC Passey, director at LNJP, informed about a dengue fever death of a three-year-old patient in June. "Farhan succumbed to dengue on June 5 here," he said. He also added that the three-year-old had complaints of multiple organ failures and was diagnosed with dengue encephalopathy. Moreover, Dr Passey said: "Till now we have had 63 dengue, 20 malaria, 131 chikungunya, and three swine flu cases in LNJP hospital alone."

In the year 2016, according to the South Delhi Municipal Corporation report on vector-borne diseases, 4431 cases of dengue were detected and 7760 cases of chikungunya were reported. However, there was only one case in the month of July 2016. The total number of dengue cases reported in 2015 in Delhi stands at over 15,500, even as the first week of this month saw 365 cases. A total of 277 cases were reported in the second week of November making the situation quite alarming for the authorities to handle. While 7,283 cases were reported in October, the maximum for all the months, dengue is supposed to hit a plateau in November this year. With 15,867 cases, the dengue outbreak in 2015 was the worst that the city witnessed, when 423 people died reportedly.

Of the total number of cases reported till November 14, south Delhi recorded the maximum with 3,148 cases, followed by north Delhi with 2,903 cases, while east Delhi recorded the lowest incidence of dengue with 1,737 cases. Among the civic zones in the city, Najafgarh Zone under South Delhi Municipal Corporation (SDMC) recorded the highest number (972) of dengue cases. Also, 2,634 people diagnosed with the deadly disease came from outside Delhi. In 2014, the city had reported three deaths and recorded nearly 1,000 cases. Meanwhile, till November 14, the same year the number of houses found positive for mosquito breeding stood at 2,35,661 while prosecution launched in the same period was for nearly 23,341 cases, according to the report.

"Whereas across the country figures are worse, nearly 11, 832 more cases of dengue, compared to 2016, and the number of deaths from the vector-borne disease has reached 46, which is eleven more than last year," officials said. According to the Directorate of National Vector Borne Disease Control Programme (NVBDCP), until July 30, 2016, the total dengue cases in the country were 16,870 while for the same period in 2017 they numbered 28,702 – showing a high rise in the number of patients. The last one week alone saw 2,536 cases resulting in 10 deaths. Kerala reported the maximum number of dengue cases (13,913), followed by Tamil Nadu (5,474), Karnataka (4,186), Andhra Pradesh (798), West Bengal(571) and Maharashtra (460). Kerala has reported 23 dengue related deaths – highest in the country - while Uttar Pradesh stood second with 15 deaths. The National Vector Borne Disease Control Programme (NVBDCP) also came out with statistics on chikungunya, another vector-borne disease which saw a steep rise last year in Delhi. Overall, until July 30, 2017, India has seen a total of 18,466 cases of chikungunya - a whopping 45,591 cases less than last year leaving a ray of hope among citizens to avoid falling prey to the virus.

In 2016, India registered a total of 64,057 cases of chikungunya, with Karnataka topping the list with a total of 15,666 cases, with Delhi claiming the second highest spot with 12,279 cases. As of July 31, this year, Delhi has recorded a total of 220 cases of chikungunya. Karnataka has so far seen the highest number of chikungunya cases at 10,241, followed by Maharashtra with 2,379 cases. According to NVBDCP, India also saw an increase of both Acute Encephalitis Syndrome (AES) and Japanese Encephalitis (JE) cases.

As per records until July 30, 2017, India has had 4,681 AES cases with 344 deaths compared to 3,711 cases and 409 deaths in 2016. Similarly, this year, 729 cases of JE have been reported with 78 deaths, while last year there were 445 cases and 85 deaths. Last week alone saw 535 cases of AES with 39 deaths and 112 cases of JE with 10 deaths. As part of the initiative to control the rise in such cases, a training programme was organised at Kolkata on dengue, chikungunya and JE case management on July 28-29, 2017, for Northeastern states, where a total of 81 participants from medical colleges and districts hospitals were trained. Taking self-initiation over the massive spread of vector-borne diseases, the Union Health Minister JP Nadda asked all states to mount aggressive information, education and communication campaigns to enhance the awareness on prevention and control of vector-borne diseases in their surrounding areas and neighbourhoods. He also added that the Health Department has provided all the logistical and technical support to the states, including Delhi, in terms of surveillance and diagnostic kits to strengthen their efforts in combating these mosquitoes borne diseases.

While addressing the rising cases of malaria and chikungunya in Delhi, he said, "The Union government is adequately prepared and more diagnostic kits would be supplied, meanwhile, central hospitals are equipped to handle any situations. The ministry has also conducted review meeting with the states and more than 13 advisories have been sent to all of them, as early as January for strengthening their preparedness before the season kicked in."

Battling rising number of dengue cases, Delhi government has converted 55 government-run dispensaries into 'Fever and Dengue Clinics'. Delhi Health Minister Satyendra Jain also reviewed the situation as he held a meeting with three MCD commissioners and directed them to take all possible steps to curtail the dengue-causing mosquitoes. These clinics, which have started operation, will run from 7 am to 9 pm on all days, including Sundays and holidays, till further orders. The city government had also decided to immediately increase approximately 795 beds in 48 new private hospitals and nursing homes on a temporary basis by granting them provisional registration certificates for three months.

The Delhi government had on June 23 issued instructions to state-run and private hospitals and nursing homes to increase their bed capacity by up to 20 per cent for the next six months to deal with a possible outbreak of dengue and chikungunya.

The MCDs have intensified fogging across Delhi as fresh showers have stoked fears of dengue cases flaring up. The Union Health Ministry has issued an advisory to Delhi government to "intensify" measures to check the breeding of mosquitoes. All the three municipal corporations have stepped up awareness drives -- distributing pamphlets and plying vehicles with loudspeakers issuing 'dos and don'ts' on prevention of the diseases.

Dengue and chikungunya are caused by the Aedes agypti mosquito, which breeds in clear water. The Anopheles mosquito, which causes malaria, can breed in both fresh and muddy water. Breeding of mosquitoes has been reported at 80,411 households in Delhi, according to the report.

Massive awareness and campaigns have been launched by the authorities and several initiatives have also been taken to curb the menace of vector borne diseases. Consequently, people, administration and NGOs are taking all the precautionary steps to eliminate the larvae of the Aedes agypti mosquito which causes dengue and chikunguniya. Paradoxically, people have been too concerned with clear water bread mosquitoes and unknowingly gave a chance to Anopheles mosquitoes to breed and create serious tropical diseases like malaria engulfing lives across the country.