Health

Still no measures to control dengue spread By By Our Correspondent 9/19/2008 LAHORE PUNJAB health authorities and city district governments have failed to make necessary arrangements to control possible outbreak of dengue fever as mosquito breeding season begins. Experts say that dengue fever is expected to strike in the current season due to frequent inter-provincial movement of people. As Eid draws near, many people are expected to arrive in the province from Karachi and other parts of Sindh where several dengue fever cases have been reported. Pakistan Medical Society (PMS) chairman Dr Masood Akhter Sheikh told The News that dengue hemorrhagic, which was a more dangerous form of the disease, was expected to strike. He said that this year’s fresh cases of acute dengue fever would be confirmed as Immunoglobulin-M, whereas the previous chronic cases of dengue fever would be identified as Immunoglobulin-G. He said that it would be extremely dangerous if a patient was confirmed with dengue hemorrhagic with both Immunoglobulin-G and Immunoglobulin-M. Last year more than 250 patients were confirmed suffering form dengue fever and they lost immunity against the disease, he said. Dr Salman Kazmi, a representative of Young Doctors’ Association, said that mobile teams must be formed to conduct regular fumigation and anti-insecticide sprays to kill mosquitoes and stop breeding. He said Rafiq Khan, a 68-year-old resident of Johar Town, had been tested positive of dengue fever during initial investigation at Sir Ganga Ram Hospital and this was later confirmed by clinical reports of his blood sample at central laboratory of Institute of Public Health (IPH). He said the Punjab Health Department must set up quarantines or isolated wards to provide effective treatment to dengue fever patients besides preventing other patients from contracting the disease. “Necessary medicines and other arrangements such as clinical tests for dengue fever within hospitals or at central laboratory of Institute of Public Health must be completed,” he said. Punjab Health DG Dr Aslam Chaudhry and Lahore EDO (health) Dr Nasir Khan were not available for comments. Meanwhile, briefing local school children on prevention of mosquito borne diseases at a seminar, Dr Masood said people need not panic as dengue fever was almost 100 per cent self-limiting disease, which did not need sophisticated treatment. The seminar was held under the auspices of the Pakistan Medical Society in collaboration with Mother and Child Trust on Thursday. Dr Masood claimed that there was hardly any mortality associated with the fever. He also suggested that anti-mosquito sprays should be carried out inside houses rather than in streets. He said the mosquito spreading dengue bred in fresh water so one had to be conscious that water tanks were clean and money plants or any other discarded container were empty. He stressed that checking open vases, discarded containers or old tyres in which water could accumulate was imperative as mosquitoes thrived in them. He stressed that simple measures could prevent the spread of dengue fever such as using a mosquito repellent when mosquitoes were likely to attack and clearing water pools in and around houses. He said habitually, mosquito bit early in the morning and at sunset. He said the disease was predominantly urban as rural setting did not favour its spread, he said. This disease infected 50 million people worldwide each year as its symptoms were similar to common cold/flu. He said the disease was not confined to Pakistan alone but was endemic in more than 100 countries. He said it was scare of the disease rather than the disease itself that had created panic among citizens. Dengue fever was caused by the bite of a female mosquito of the genre Aedes Aegypti. This mosquito carried dengue virus in its active form, he said. He said dengue hemorrhagic fever (DHF) was most the dangerous of all dengue forms but its prevalence was less than one per cent of the total dengue fever cases. The Dengue Shock Syndrome (DSS) was very rare, he said. Mortality in DHF and DSS is less than 10 to 20 per cent on case to case basis out of all DHF and DSS patients, he said. If a patient afflicted with DHF or DSS was given blood or blood products in addition to fluid replacement in time, it could even reduce mortality. This morbidity and mortality is even less than that of malaria in this region, he said. Many people had exploited dengue fever and this practice could easily be stopped by community education and dispelling fears associated with the disease, he said. “Mass awareness campaign about the dengue fever can stop its reoccurrence,” he said. Dr Iram, the president of Mother and Child Trust, said neonates and children should be given extra care as they were at a higher risk than adults. She said symptoms of dengue fever were flu, coughing and fever which could be mistaken for common cold. She said human immune system was capable of fighting dengue virus and no medical attention was required to treat it in majority of cases. She said there was a possibility that a patient could be affected both with common cold and dengue fever at the same time. She said that dengue patients sometimes did not exhibit any symptom. Dr Israr Asif and Dr Fauzia also spoke at the seminar.