Although outbreak of dengue fever has triggered national concern in India and two Southeast Asian countries, Bangladesh has developed, in view of its bitter experience in 2000, a disaster management system to tackle it.
Dengue fever may develop in Dhaka city and elsewhere anytime in the current or next month. But experts, however, think that it will not take a serious turn as it did in the previous year.
At least 225 people have so far been identified with dengue fever this year and two patients died in Dhaka city as of last month, according to official sources.
Last year, 93 persons died of dengue and 5,551 persons were identified with the disease, according to the Directorate of Health Services (DHS). But unofficial sources say dengue claimed more than 150 lives last year.
Experts think that the people and the government are much more conscious about the dengue menace this year, and also feel the present environment is also not now favourable for Aedes mosquitoes, the carriers.
However, the risk of an outbreak of dengue will remain till the end of the rainy season, and may be prolonged until September, according to experts.
The Dhaka City Corp (DCC) medical officer, Dr Shahidur Rahman, who is in charge of mosquito control, said the country is facing risk of a dengue outbreak this year also as in neighbouring countries like India, Thailand and Singapore are witnessing epidemics that are 20% more severe this year than in the previous year.
Some 108 people have already died of dengue and over 50,000 have been afflicted by the disease in those countries, he mentioned, and added that the situation in Dhaka is still good as the weather is not in favour of the Aedes mosquitoes and because the DCC has taken extensive measures to check the mosquito population.
The almost daily rainfall in Dhaka city is not allowing the mosquito larvae enough time to mature. Larvae need five to six days to develop into mosquitoes, Dr Shahid said, adding that rain without adequate interruption was destroying the larvae.
Moreover, the DCC has undertaken a dengue surveillance project and formed a task force and a rapid action force. It is also conducting anti-Aedes drives in different parts of the city with the co-operation of different voluntary organisations.
Dr Shahid said the population density of mosquito larvae has decreased in different parts of the city in the last few days.
Dr Nurul Islam, in-charge of the control room of the Directorate of Health Services, said a severe outbreak of dengue might not occur this year, as the disease is unlikely to take an epidemic form in two consecutive years.
“Those who are found with the fever develop anti-bodies to resist the disease for at least one year.”
Moreover, the Bangladeshis are now conscious about dengue, he added.
However, he did not rule out the possibility of an outbreak of the disease by the end of the current monsoon.
Dr A S M Alamgir, medical officer of the Institute of Epidemiology, Disease Control and Research (IEDCR), said the possibility of a dengue outbreak in Dhaka city would persist until the advent of winter.
He said that those who were attacked by any of the four types of dengue virus — Den-1, Den-2, Den-3 and Den-4 — may be afflicted by one of the remaining three types, though not by the previous one. In that case, the patient would suffer from dengue haemorrhagic fever, the worst form of the disease.
The other form of the disease, known as classical dengue, is almost like normal fever and is often curable without any major treatment.
Dr. Alamgir said only three to four suspected dengue patients are coming to the IEDCR for blood tests each day. Dengue germs have been detected this year in the blood of 40% of these few daily patients following tests at the laboratory of the Institute of Epidemiology, Disease Control and Research (IEDCR) at Mohakhali, he said.
The IEDCR, supported by the World Health Organisation (WHO), tests the blood of suspected dengue patients free of cost.
Dr Alamgir said that the IEDCR would be able to test the blood of many more patients and is ready to tackle the situation in case dengue breaks out in epidemic proportions this year.
He said the blood test for dengue fever is expensive. Private laboratories usually take about 800 taka for each test. He suggested that dengue patients should avail themselves of free blood tests at the IEDRC.
Last year, the healthcare authorities of the Bangladesh government did very little to control dengue. The government has, however, mobilised resources and some manpower to deal with dengue cases this year.
Sources in the Communicable Diseases Control (CDC) of the Directorate of Health Services said the directorate gained some valuable experience in dealing with dengue last year and it will not be very difficult to deal with the disease if it breaks out this year.
The Bangladesh government has imparted training on dengue case management to 134 doctors and 45 professors of 13 government medical colleges, the Bangabandhu Sheikh Mujib Medical University and the Dhaka Shishu Hospital. Doctors at district level were also trained.
Within the first week of the report of the dengue outbreak in 2000, the Disease Control Directorate initially arranged the imposition of WHO guidelines for case management and test-kits for dengue serology and established reporting portals and a set-up for the documentation of cases.
This effort was followed by training of doctors and orientation of specialists on dengue case management, formulation of national guidelines for Clinical Management of dengue syndrome by customisation of WHO guidelines and attaining a general consensus, entomological survey and initiation of clinical and virological documentations.