A wake-up call
DR. HIRAMALINI SESHADRI
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An effective mosquito control programme is urgently required to control dengue.
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Control it: All we need are simple measures. Photo: AFP
DENGUE fever has been pronounced the most important mosquito-borne disease on the planet in terms of morbidity and mortality — one in 100 who develop dengue haemorrhagic fever succumb to it. Dengue first reared its head around 1779 and since then this Flavivirus, which has four strains, has devastated Africa, Asia and America with epidemics roughly every 40 years or so. But after the World War II, the frequency of Dengue epidemics has increased; with increasing air travel the virus has a global reach today.
No specific treatment
We do not yet have a vaccine for Dengue; nor is there specific drug treatment. Supportive therapy with adequate fluids and nourishment, monitoring the platelet counts and prompt transfusions are all we can do. Diagnostic tests however are available; a simple blood test can pick up antibodies to the virus; but a negative test does not totally rule out Dengue. It is the bite of the female aedes aegypti mosquito, a daytime biter that results in human infection. Stagnant pools of water are the breeding grounds for this mosquito.
Sustained programmes
WHO and other studies show that in the case of Dengue, a knee-jerk reaction once the epidemic has set in will not solve the problem. A sustained, effective, mosquito eradication and control programme is required. At the civic end, all contractors at construction sites need to be fined if garbage or material collection is not dealt with promptly. The Bangalore Mahanagara Palike has been a role model in this aspect. All overhead tanks, AC water coolers and the like need to be closed; legislation and fines may be imposed if needed. Just as Rainwater Harvesting has been made compulsory for buildings, proper garbage disposal arrangements and water, sanitation and sewerage arrangements must be made compulsory before sanction is given for development of residential plots, flat and house constructions. The PHED department needs to update its larvicidal armamentarium and use effective larvicides like abate in stagnant water bodies. The introduction of larva-eating fish and crustaceans in these water bodies also helps.
Another effective control measure is protection of the population at risk with insecticide-treated mosquito nets. Kenya's National Malaria Control Authority has successfully covered the entire population at risk of malaria with the help of the Sai Organisation of Kenya. The Sai Organisation of Singapore has launched an identical programme in the malaria-ridden Mekong delta of Lao PDR. This successful experiment can be duplicated in India easily to reap a bumper crop of reduction in the prevelance of Dengue, Chikungunya, malaria and filaria.
Corporate medicine in India has taken up cudgels against hypertension, coronary artery disease, diabetes, and obesity. But basic sanitation, sewerage and garbage disposal and mosquito control, and mosquito-bite prevention are the need of the hour; for these simple measures will reduce not only mosquito-borne diseases but also waterborne ones such as gastroenteritis, typhoid, amoebiasis, bacillary dysentery... the list is endless! These diseases strike children and young adults most commonly. For the sake of our children, we have to do it. Let us act together — citizens, government and NGOs — to protect our children from disease.
The writer is a senior Consultant, Holistic Internal Medicine and Rheumatology based in Chennai.
E-mail hiramalini@yahoo.com
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