Avoiding mosquito bites key to dengue prevention

This year, even before the monsoon season officially began, the situation regarding dengue fever, carried by Aedes mosquitoes, is showing alarming signs across the country. Everyday, countless people are rushing to hospitals due to dengue fever. Climate change, rising temperatures, changing rainfall patterns, and unplanned urbanization are all contributing to the increased risk of dengue.

The monsoon is extending the dengue season. Generally, the dengue season lasts from May to September. However, dengue is no longer just a seasonal disease; the rate of dengue infections is continuously rising throughout the year. This year's weather is unusual, with persistent rainfall. Therefore, dengue infections may continue to increase until winter arrives. According to the Health Department, over 39,000 cases of dengue have been identified this year, and nearly 200 people have died from the disease. This number may rise further in the coming days.

This year's intermittent rainfall before the monsoon has resulted in stagnant water accumulating in various places. Construction sites are seeing water accumulate day after day, leading to severe environmental degradation due to human activity. This creates a favorable environment for the breeding of Aedes larvae. Consequently, Aedes mosquitoes, the carriers of dengue, are spreading throughout the country. With an increase in mosquitoes, it is natural for them to bite people. However, this year, among the four types of dengue, DEN-2 is more prevalent. Many dengue patients are experiencing shock syndrome. When a patient goes into shock, their blood pressure drops rapidly, platelet counts decrease, and their physical condition deteriorates quickly. Many patients even die.

Does a fever always mean dengue? Initially, many people do not take fever seriously. It is true that during this time, not only dengue but also flu, pneumonia, typhoid, paratyphoid, and other infections are prevalent. Not all patients visiting hospitals or doctors have dengue. However, it is important to remember that dengue is currently widespread, and the detection rate has not declined. Therefore, if one has a fever, the possibility of dengue cannot be ruled out. While doctors can make some guesses about the cause of the fever based on various symptoms, until tests confirm it is not dengue, the risk of dengue remains.

What tests should be done? In dengue-prone countries like ours, it is advisable to get tested for dengue whenever there is a fever during the dengue season. Recently, the dengue virus has been changing its strain every year. Many of the classic symptoms of dengue are now absent. For instance, previously, high fever was common with dengue, but now the fever may not be severe. Severe headaches, eye pain, and muscle aches are also not seen in many cases. Moreover, it was previously said that complications would occur five days after the fever started, but now it is being observed that complications can arise as early as the beginning or within two to three days. Therefore, doctors are no longer able to identify dengue based solely on symptoms and signs as before. In many cases, patients are coming to doctors with complications and often with delays. Thus, it is essential to get a dengue test done if there is a fever during this time. This will help in understanding the disease early and preparing accordingly.

When and what tests? To diagnose dengue, it is best to conduct the dengue NS1 test on the first or second day of fever. However, remember that even if this test is negative, dengue may still be present. In that case, it is advisable to also perform a Complete Blood Count (CBC). If there are changes in hematocrit or platelet counts later, it will be necessary to compare with the initial CBC results. If four or five days have passed since the fever started, there is no need to conduct the NS1 antigen test. Instead, dengue IgG and IgM tests should be done. In recent infections, IgM remains positive for about 9-10 days and then gradually decreases. Additionally, based on necessity, the doctor may recommend further tests, such as liver SGPT tests, abdominal ultrasounds, or chest X-rays.

Do you need to go to the hospital if dengue is diagnosed? If your dengue test is positive, don't panic. First, consult a doctor. Rest at home and drink plenty of fluids and water. Isolate yourself from other family members for 4 to 6 days to prevent spreading dengue to others. However, if you are unable to eat, are experiencing vomiting and diarrhea, or have comorbidity such as high blood pressure, diabetes, kidney disease, heart disease, liver disease, cancer, or if you are pregnant, it is advisable to seek treatment in a hospital.

Prevention Measures
Due to the suitable environment created for the breeding of Aedes mosquitoes, countless people are getting infected with dengue and rushing to hospitals everyday. Many are quickly going into shock syndrome. To escape this situation, we must first focus on mosquito control. Current efforts to eradicate mosquitoes seem insufficient compared to the need. To prevent the spread of dengue fever, prioritizing mosquito control is crucial. Departments responsible for mosquito eradication should work together, involving the public in these efforts. Measures should be taken to eliminate flying mosquitoes, and emphasis should be placed on larvae control. It is essential to keep places like office yards and homes clean to prevent mosquito breeding. Identifying mosquito hotspots and conducting operations in those areas is necessary.

Based on the advice of entomologists, we must start targeted eradication efforts immediately in specific areas. All city corporations, municipalities, and unions, starting from divisional cities, should take comprehensive measures for mosquito eradication. Effective insecticides must be regularly applied through adulticiding, larviciding, and fogging.

A social movement should be created involving political leaders, various social organizations, NGOs, professionals, and volunteers for mosquito control. There should be a call to build a movement with volunteers, and punitive measures should be taken against individuals or organizations that create environments conducive to mosquito breeding.

Personal Precautions
Avoiding mosquito bites is the most effective way to prevent dengue. To protect against mosquito bites, one must be vigilant. Wearing long-sleeved shirts and pants is advisable. Mosquito nets should be hung before sleeping, whether during the day or at night. If anyone shows even mild symptoms like common fever, cold, or cough, they should promptly get tested for dengue. This will facilitate easier diagnosis and proper treatment. Preparedness must be ensured at all levels, from families to hospitals, for managing patients. However, the primary focus should be on destroying Aedes mosquito habitats, and the public must be made aware of this necessity.

The situation is worsening at the start of the monsoon season. As the monsoon season begins, the dengue situation is rapidly spiraling out of control. If immediate and prioritized actions are not taken regarding this issue, the dengue situation could become extremely dire. It could genuinely become unmanageable, with the number of infections and deaths rising abnormally.

Dr ABM Abdullah: Specialist in Medicine and Emeritus Professor, Bangabandhu Sheikh Mujib Medical University