Daily News Editorial

Tackling dengue

19 November 2016

Dengue, the dreaded mosquito borne disease, has seen a dramatic rise this year with more than 45,000 cases reported so far this year, including 14,000 from Colombo District alone. This is in sharp contrast to the 29,000 cases reported last year. More than 60 deaths have been reported. This is an alarming situation by any yardstick.

While the present rainy weather is generally conducive to mosquito breeding, it is still possible to eliminate breeding grounds if several simple guidelines are followed. Prevention is always better than cure. Unfortunately, many Government institutions including schools and hospitals and local bodies themselves have been found wanting in that department. Health authorities who inspected 120 schools during the recently completed two day intensive dengue control programme found 48 schools in the Colombo district alone with mosquito larvae. Health authorities also found 48 state institutions out of 134, with mosquito larvae. At the end of the programme the inspectors searched 12,058 premises and took legal action against 316 premises.

This is a black mark on a country that recently became only the second in South Asia after the Maldives to have eliminated malaria, which still claims millions of lives worldwide. Sri Lanka has been described as a role model for all other developing nations in this regard – dengue infects more than 350 million people and kills 25,000 across the globe each year. However, the rapid spread of dengue throughout the island could negate these achievements unless urgent preventive measures are taken. This is a task that the Government alone cannot accomplish, without the fullest public support.

All households should strive to keep their homes and compounds free of any possible breeding grounds for mosquitoes that are vectors for many other diseases such as filaria, chikungunya and Zika. This does not cost any money and only a little time is needed to spruce up one’s home and garden. For example, residents should make sure that water is not stagnating in surrounding areas or in unused tyres, water containers, potted plants, AC trays, pot holes, flower vases or water tanks. Some of the preventive steps, such as getting a mosquito net, does cost some money but is a worthwhile investment in the long run. Be aware that some mosquito repellants such as coils could have other health implications, so look for natural repellants. Doctors also say that wearing light coloured, fully sleeved clothing also helps keeps the mosquitoes at bay.

Another major impediment to controlling dengue is that many persons who contract dengue do not seek medical advice and treatment fast enough, until it is too late. Doctors advise that persons who suffer from any kind of fever for more than two days should seek immediate medical treatment from a qualified doctor or a State hospital. This gives doctors ample time to set the patient on the path to recovery if it is indeed dengue. If it is not dengue, the patient can be treated for whatever disease associated with his or her symptoms. In the initial stages of the fever before any diagnosis, it is important not to take any medication for fever except paracetamol. Other medications can lead to serious complications which can have fatal consequences. As with most other diseases, timely diagnosis and early treatment can save lives that would otherwise be consumed by dengue.

Scientists are also racing to test a new dengue vaccine, which has the potential to save a lot of lives in our region. Dengvaxia, the world’s first dengue vaccine (manufactured by Sonafi Pasteur) was rolled out recently, though several other competing vaccines are on the horizon. The Philippines and Brazil have already introduced public vaccination programmes in specific areas or populations. The vaccine is designed to induce an immune response against each of the four dengue viruses, but not to cause the disease itself. The immune response results in antibodies capable of fighting dengue infections. Sri Lankan Aravinda de Silva, professor of microbiology and immunology at the University of North Carolina (UNC) School of Medicine, is leading efforts to develop a nanoparticle based dengue vaccine which will work somewhat differently.

Sri Lanka is often cited as a “vaccination success story” where most childhood diseases have been eliminated or minimized as a result of an islandwide vaccination programme. These vaccination campaigns continued even during the height of the conflict. Sri Lankans have a generally optimistic attitude towards vaccination and a dengue vaccine will no doubt be readily accepted here. The authorities should work with the relevant parties including the World Health Organisation (WHO) to launch this vaccine here in due course.

However, even if a vaccine is introduced we cannot be complacent. It is only a part of the prevention chain. It would be suicidal to abandon the other preventive measures such as keeping our premises clean, thinking that a vaccine would end the problem. Addressing dengue must remain a collective responsibility of the whole society.