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Health emergency

Parts of India are in the grip of dengue fever and chikungunya, which pose a public health challenge that is yet to be met vigorously by the authorities. The lack of a swift action mechanism to counter such threats on the basis of a long-range surveillance system, aided by projections based on the cyclical patterns of seasonal outbreaks, has been tragically exposed. While major outbreaks of dengue — which is second only to malaria in worldwide distribution — were reported in India in 1996, 2003, and in 2005, chikungunya has struck on a mass scale after several decades. The simultaneity of the attacks, as much as the virulence and spread of the two mosquito-transmitted diseases, has created a grim situation bordering on panic. The mosquito season will last several more months. The incidence of chikungunya seems to be on the wane from its peak level in many States. However, 2,900 cases of dengue, and at least 43 deaths, have been reported. Delhi and Kerala account for the majority of dengue cases: the latter is under pressure on the chikungunya front as well, having recorded at least 80 deaths. The Central Government says there is no need to panic but public concern is palpable and justified. After all, dengue has reached even the Prime Minister's household.

Given the fact that modern medicine is still working on cures for such diseases and is honest enough to say so, quacks and practitioners of unproven alternative treatment systems seem to be having a field day. This is not unlike the situation that prevailed with typhoid until 1948, when American military researchers made the breakthrough discovery that the use of chloramphenicol could be `the first antibiotic typhoidal cure in history.' Relying on the available knowledge base and a symptomatic approach, prudent treatment protocols and procedures for dengue and chikungunya must be put in place right down to the primary health centre level. Meanwhile, the National Vector-Borne Disease Control Programme needs to shore up its surveillance mechanisms and watch out for any mutation of the viruses. Practitioners of modern medicine must step out of their shells to educate the public on sound methods of coping with the diseases and their aggravating effects, which, in a number of cases, have proved deadly. While giving top priority to mosquito eradication, governments can use fiscal incentives to promote the use of mosquito repellants and physical protective barriers among the masses. At another level, the tremendous morbidity, physical and mental, inflicted by chikungunya and dengue underlines the reality of mass deprivation even in regions of the country that are relatively developed. As Justice V.R. Krishna Iyer puts it: "Health is a human right and its deprivation by mosquito bites is a national challenge."

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