The next three months were very difficult – Online Khabar

Kathmandu, June 21. The monsoon has just begun. But dengue fever is being detected across the country. According to the Department of Epidemiology and Disease Control (EDCD), dengue cases have been detected in 73 districts since January.

So far, 1,432 people have been infected, including 482 in Bagmati, 350 in Kosi, 212 in Gandaki, 171 in Lumbini, 159 in Sudurpasm, 38 in Madhesh and 20 in Karnali.

Dr Gokarn Dahal, director of the Insect Disease Control Division, said that based on a decade of data, dengue fever seemed to persist longest in June, July, August and October.

“Last year, dengue started spreading rapidly due to early monsoon activity. This year, the monsoon has already started and the number of dengue patients will increase in the coming days. “During these three months, dengue can spread anywhere,” Dahal said.

Evergreen Dengue Fever

Dengue infection caused by bites of Aedes aegypti and Aedes sanguinis mosquitoes was first detected in Nepal in 2004 by a foreigner who came to Chitwan.

Dengue was detected in some areas of the interior of Terai and Madhesh in 2006. In 2016, dengue was considered endemic in Chitwan, Jhapa and Rupandeshi.

In 2020, the dengue fever outbreak from Dhahran resulted in 18,000 infections and 12 deaths from dengue fever in 43 districts. Since then, not only has the number of dengue fever infections gradually increased, but the infection has also spread to other areas.

By 2022, dengue infection had spread to all 77 districts and more than 54,000 people had been infected. Of these, 88 had died.

In 2023, dengue fever spread in the Kochi region. When 20 people died, more than 52,000 people were infected. According to EDCD data, 31% of the infected people were from Sunsari.

“In recent days, dengue patients have been seen even in cold weather,” said Dr. Dahal. “There were no dengue patients in any month last year. Now it can be estimated that dengue will be evergreen. The infection rate is increasing.

In 2018, three people were infected per 100,000 people. In 2019, it was 60, and in 2022, it was 185. By 2023, it would be 178 per 100,000. “Based on past data, dengue seems to have spread in different places,” Dahal said. “There will definitely be an increase in dengue cases in the coming weeks.”

The speed at which mosquitoes spread the infection, the level of control awareness among the people and monsoon conditions also depend on the form dengue takes, Dahal said.

Urbanization is the main cause of dengue fever transmission

Until a few years ago, dengue infection was only seen in the Terai and very hot places. Recently, he reached the mountains by climbing them.

Dr. Yeduchandra Ghimire, Director of EDCD, said mosquitoes found in the Terai region are now adapting to the hilly and mountainous environment. “The impact of climate change is already being felt in the highlands. With the change in climate, diseases that were common in the Terai are spreading to the mountains for other reasons,” Ghimire said.

According to experts, dengue mosquitoes can easily survive even at a temperature of 12-13 degrees. Experts say the reason for the spread of dengue is the increasing urbanization. Mosquitoes that carry dengue reproduce in large numbers in densely populated cities.

Because, in such a dense city, people keep buckets and pails to fetch water. Similarly, tires in garages and bus parking lots, houses and flower pots used for cultivation will soon be infested by mosquitoes. Dengue is transmitted by Aedes aegypti and Aedes albopictus mosquitoes.

Aedes aegypti usually inhabits urban areas. Aedes viridis is found in bushes and forests. But now the habitats of both species have changed. In a study conducted by EDCD last year, Aedes viridis was found in large numbers.

“We did not expect to find Aedes albopictus in the Kathmandu Valley. However, in the valley area, Elvaupectus species were found in large numbers,” Dahal said.
There are four serotypes of dengue fever: 1, 2, 3 and 4. A government study conducted in 2079 showed that serotypes 1, 2 and 3 play a role in the spread of dengue fever. Among them, 3 serotypes showed a greater role.

Generally speaking, the growth and development of mosquitoes occurs at temperatures between 15 and 35 degrees. Temperatures between 10 and 40 degrees are suitable for mosquitoes that transmit the dengue virus.

According to entomologists, the average lifespan of a mosquito is up to 30 days, but if the environment is right, the flowers where the mosquitoes lay can last for a long time. That’s when they become larvae. The larvae turn into adults in seven to ten days.

An infected female mosquito can produce up to 1,000 flowers during its life cycle. Egg development takes 8 to 10 days. All mosquitoes produced by an infected flower will be infected with dengue.

Mosquitoes have black and white bodies. Mosquitoes that spread dengue usually bite during the day. Female mosquitoes bite others when they are not feeding on human blood, which results in many people being infected with dengue, Dahal said.

There is no specific treatment for dengue fever. Doctors say if dengue patients are monitored as directed, deaths due to the infection can be reduced to zero.

Symptoms of dengue fever

The main symptom of dengue fever is a sudden high fever. This fever can last for five to seven days. If you are infected with dengue fever, your blood cells decrease and your immunity also decreases. As a result, the patient becomes weak.

In most cases, dengue fever is not serious, but in some cases, dengue infection may lead to complications. Persistent vomiting, severe abdominal pain, bleeding, bleeding from the nose or gums, fainting, a rapid decrease in the number of platelets in blood tests, etc. are considered signs that dengue fever may develop into a complicated condition. In such cases, treatment or consultation must be carried out under the supervision of a doctor.

Dr. Shukraraj Bimal Sharma Chalise, chief consultant physician at Shukraraj Tropical Infectious Diseases Hospital, said that if the serotype of infection is different, there will be more complications. According to him, if you are infected with the same serotype of dengue for the first time, you will not be infected with the same serotype of dengue the next time. But the second time – infection with a different serotype is more complicated.

Persistent vomiting, severe abdominal pain, bleeding, nose or gum bleeding, fainting, and a rapid decrease in the number of platelets in blood tests are all considered signs that dengue fever may develop into a complicated disease.

Research shows that dengue is fatal when a person infected with one virus (serotype) is bitten by a mosquito carrying another virus. With dengue, which is spread by this type of virus, the body’s blood coagulation (clotting) process becomes disrupted. Its deadly effects can cause bleeding throughout the body.

“If you are infected with one serotype, the same serotype will not cause another infection during your lifetime. But infections with other serotypes are very serious and can cause death,” Challis said. “Last year, many patients with complications were found to have repeated infections.”

Don’t take medicine randomly

According to doctors, dengue fever can be divided into three types, namely common dengue fever, hemorrhagic dengue fever and sick syndrome dengue fever. Hemorrhagic and sick syndrome fever are dangerous.
When normal dengue is not controlled, when it turns into hemorrhagic or sick syndrome, it becomes very difficult to control.

Dengue fever can be critical for three to seven days. In this case, more caution is needed at this time because some infected people may fall into a “sucking” state. In this case, the patient needs to be admitted to the hospital to be monitored by a doctor.

Infectious disease expert Dr.: If you observe or confirm symptoms similar to dengue fever, do not buy medicine on your own. Sher Bahadur explained again. He said it is recommended to take medicine only after consulting a doctor.

“It is natural to try to get rid of dengue fever because it causes excessive pain, but if you take medications haphazardly, you will see negative effects,” said Dr. Pun. “But excessive use of painkillers such as ibuprofen, Flexon, aspirin, etc. increases the possibility of complications from this disease.” If painkillers such as aspirin, Flexon, etc. are used, the infected person may bleed.

Let’s change our behavior

Dengue mosquitoes breed most commonly in discarded tires and iron and plastic barrels. To prevent dengue infection, it is necessary to search and clean water storage places and water tanks in and around houses where mosquitoes breed to eliminate mosquito breeding.

Water containers such as water tanks, barrels and buckets should also be covered to prevent mosquitoes from entering. Areas where water may accumulate should be cleaned regularly. In addition, activities to find and eliminate mosquito larvae should be intensified at the community level.

When going out, wear clothes that cover the body, hang nets on doors and windows inside the house, and take a swing when taking a nap in the afternoon. “We have learned how to deal with the new coronavirus. Similarly, we must learn to coexist with dengue fever,” said Dr. Challis. “The first way to avoid dengue fever is to avoid mosquitoes,” said Challis.