Contingency plan to tackle dengue

Nurul Islam Hasib

The government has started working on preparing the contingency plan to tackle the mosquito-borne dengue fever next year, taking lessons from this year.

Professor Sanya Tahmina, who oversees the issue from the health directorate as a Line Director of Communication Disease Control, told Bangladesh Post that she had a meeting with all relevant stakeholders in Dhaka on Saturday.

She said they stressed on training doctors and nurses from the beginning of the year and ensuring coordination with all relevant ministries including the local government.

Over 100,000 patients were hospitalised this year, a record in the history of Bangladesh. Over 100 died, according to government data. The disease spread across the country.

But there was visible lack of coordination among the different agencies of the government including the two city corporations of Dhaka.

The High Court even summoned LGRD Secretary Helal Uddin Ahmed to explain the imports of effective insecticides to kill mosquitos. It also asked the city corporations to import new agents.

Professor Tahmina said they had planned to prepare a roadmap for doctors and nurses’ training from the meeting on Saturday. “We have decided to start the training from January,” she said.

“We’ll also focus on coordination – coordination with the two city corporations in Dhaka, coordination with the local government department, and coordination with other relevant ministries,” she said.

Representatives from the Society of Medicine, Bangladesh Paediatric Association, entomologists, and disease control room attended the meeting.

Dengue causes flu-like symptoms, including piercing headaches, muscle and joint pains, fever and full body rashes. But this year it shows “atypical” symptoms affecting brain, heart, and liver.

Searching for and destroying mosquito breeding places, use of mosquito net as well as repellents, and seeking early consultation when the first signs and symptoms of the disease appear are the most effective ways to prevent and cure dengue.

Doctors suggest taking rest and plenty of fluids such as oral saline, coconut water, juices in fever. Medicines other than paracetamol are restricted without the doctor's advice.

The World Health Organisation suggests cleaning home at least once a week for one hour. 

Dengue mosquito breeds inside homes, even in 2 ml water or in a small water bottle-cap. Dengue mosquito does not sit on walls. It rests under the bed, sofa, chair, table, or behind the curtain or hanging clothes. 

Spray aerosol in those places is the key to kill them. Aerosol spray inside homes is more effective after sunrise and before sunset, according to Dr B N Nagpal, senior entomologist of WHO Southeast Asia region, who visited Dhaka in August during the outbreak.

The ‘source detection’ of the dengue mosquito breeding is the key.  Dengue mosquitoes lay eggs not directly inside the water. They lay eggs on the brim where those eggs can survive as long as one year and when flooded or when the container is fully poured, eggs hatch rapidly, according to Dr Nagpal. For larvicide, killing at the larval life stage, WHO suggests the use of Temephos 1 gram in 10 litres of water.