Dengue claims 87 lives across India

Angel · **Dengue claims 87 lives across India -** 04-10-2006, 09:49 PM

Outbreaks of mosquito-borne diseases hit southern and northern India; at least 87 dead

NEW DELHI (AP) - Health officials struggled Wednesday to cope with outbreaks of mosquito-borne diseases in northern and southern India that have killed at least 87 people and overwhelmed hospitals and clinics.

At New Delhi's All India Institute of Medical Sciences, India's premier state-run hospital, a makeshift ward was set up in a hallway to deal with hundreds of dengue fever patients, some of whom were forced to hold intravenous drip bags above their heads because of a lack of equipment.

The dengue outbreak began in late August, and the death toll in New Delhi and surrounding areas of northern India rose to 16 on Wednesday when a patient at the institute died.

The situation was even worse in the southern state of Kerala, where 71 people have died in the past month from another mosquito-borne disease, a rare viral fever known as chikungunya, said the state's health minister P. K. Sreemathi.

In the hardest-hit district of the state, Alappuzha, some 40,000 people were showing symptoms of the disease - such as high fevers and severe joint pain - and thousands had been hospitalized, said the area's chief medical officer, K. Velayudhan.

Across the state, local authorities were overwhelmed by the outbreak, and Sreemathi said a World Health Organization team made up of experts from India's National Institutes of Communicable Diseases was to arrive Thursday.

"The expert heath team from WHO needs to make an on-the-spot assessment to tackle the situation,'' she told The Associated Press from Alappuzha.

The outbreaks of dengue in the north and chikungunya in the south come as the annual monsoon tapers off across much of the subcontinent, leaving behind countless small pools and puddles of dirty, stagnant water where infectious mosquitoes breed. Open sewers that are features of many Indian towns and cities provide even more breeding grounds.

While a dengue outbreak is an annual post-monsoon occurrence in parts of northern India, this year's has been particularly widespread, with more than 400 cases compared to last year's 217 infections.

India's health minister, Anbumani Ramadoss, blamed the spike in cases this year on a construction boom in New Delhi, where scores of new malls, high-rise apartment towers and office blocks are going up and a new subway system is being built.

The result of the largely unregulated building boom is a city filled with poorly maintained construction sites where water collects in pits, adding to the already ample mosquito breeding grounds, Ramadoss told reporters.

"There is a lot of stagnant water collecting in places due to construction activity. We are aware of the health risks posed by this and have begun a concerted campaign to make people aware of the need for sanitation,'' Ramadoss said.

Female Aedes mosquitoes transmit the disease, and symptoms include high fever, joint pain, headache and vomiting. It is fatal in rare cases. India's annual outbreak normally dies off with the end of the mosquito breeding period in November.

Authorities in New Delhi were pressing home and business owners to spray their properties with insecticides, and teams of municipal workers sprayed some construction sites, office buildings and residential neighborhoods. Fogging machines were also used to spread clouds of insecticides in densely populated areas of the city.

But such efforts have only begun in recent days and it remained unclear what, if any, impact was being made.

Further complicating matters was a shortage of staff at the All India Institute of Medical Sciences, where one doctor has died from dengue and 19 other physicians and medical students had fallen ill with the disease.

Authorities in the capital were, however, urging residents to remain clam.

"We don't want to create any panic. The efforts of the past few days should kick in and the number of dengue cases should taper off shortly,'' Ramadoss said.-AP

Angel · **About Dengue -** 04-10-2006, 09:50 PM

Dengue (DF) and dengue hemorrhagic fever (DHF) are caused by one of four closely related, but antigenically distinct, virus serotypes (DEN-1, DEN-2, DEN-3, and DEN-4), of the genus Flavivirus.

The global prevalence of dengue has grown dramatically in recent decades. The disease is now endemic in more than 100 countries in Africa, the Americas, the Eastern Mediterranean, South-east Asia and the Western Pacific. South-east Asia and the Western Pacific are most seriously affected. Before 1970 only nine countries had experienced DHF epidemics, a number that had increased more than four-fold by 1995.

Dengue fever is found mostly during and shortly after the rainy season in tropical and subtropical areas of:-

Africa
Southeast Asia and China
India
Middle East
Caribbean and Central and South America
Australia and the South and Central Pacific

Some 2500 million people -- two fifths of the world's population -- are now at risk from dengue. WHO currently estimates there may be 50 million cases of dengue infection worldwide every year.

Several factors are contributing to the resurgence of dengue fever:

No effective mosquito control efforts are underway in most countries with dengue.
Public health systems to detect and control epidemics are deteriorating around the world.
Rapid growth of cities in tropical countries has led to overcrowding, urban decay, and substandard sanitation, allowing more mosquitoes to live closer to more people.
The increase in non-biodegradable plastic packaging and discarded tires is creating new breeding sites for mosquitoes.
Increased jet air travel is helping people infected with dengue viruses to move easily from city to city.

The time between the bite of a mosquito carrying dengue virus and the start of symptoms averages 4 to 6 days, with a range of 3 to 14 days. An infected person cannot spread the infection to other persons but can be a source of dengue virus for mosquitoes for about 6 days.

Symptoms of typical uncomplicated (classic) dengue usually start with fever within 5 to 6 days after you have been bitten by an infected mosquito and include

High fever, up to 105 degrees Fahrenheit
Severe headache
Retro-orbital (behind the eye) pain
Severe joint and muscle pain
Nausea and vomiting
Rash

Diagnosis of the Dengue Fever is done by two blood tests, 2 to 3 weeks apart. The tests can show whether a sample of the blood contains antibodies to the virus or not. In epidemics, a health care provider often can diagnose dengue by typical signs and symptoms.

There is no specific treatment for classic dengue fever, and like most people patient will recover completely within 2 weeks. To help with recovery, health care experts recommend

Getting plenty of bed rest
Drinking lots of fluids
Taking medicine to reduce fever

There is no vaccine to prevent dengue. The best way to prevent this disease is avoid mosquito bites when traveling or in tropical or endemic areas:

Use mosquito repellents on skin and clothing.
When outdoors during times that mosquitoes are biting, wear long-sleeved shirts and long pants tucked into socks.
Avoid heavily populated residential areas.
When indoors, stay in air-conditioned or screened areas. Use bednets if sleeping areas are not screened or air-conditioned.
If you have symptoms of dengue, report your travel history to your doctor.

Eliminate mosquito breeding sites in areas where dengue might occur:

Eliminate mosquito breeding sites around homes. Discard items that can collect rain or run-off water, especially old tires.
Regularly change the water in outdoor bird baths and pet and animal water containers.

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