Down to Earth - - COVER STORY -

Ku­mar, a labourHEN NAREN­DRA er who lives in a slum in Delhi’s Badarpur lo­cal­ity, re­turned home from work on Septem­ber 13,he found his mother burn­ing with fever. He took Renu Devi, 63, to a nearby doc­tor but her con­di­tion kept de­te­ri­o­rat­ing. He then shifted her to a nurs­ing home, where he was ad­vised to take her to Saf­dar­jang Hos­pi­tal. At Saf­dar­jang,she was di­ag­nosed with dengue.

Ku­mar says he spent on treat­ment in the three days be­fore he came to Saf­dar­jang.He had saved this money to visit his vil­lage in Bi­har dur­ing the fes­ti­val sea­son. It will not be pos­si­ble for him to make the trip now.He is,how­ever,re­lieved about his mother’s health be­cause the doc­tors have told him not to panic and the treat­ment is free.

Sim­i­lar is the case of Bal­want Ram,a Gur­gaon res­i­dent. His wife, Vi­mal Devi, 40, was treated for four days in the city’s Metro Life Line Hos­pi­tal at an ex­pense of But her con­di­tion con­tin­ued to de­te­ri­o­rate till she was taken to the All In­dia In­sti­tute of Med­i­cal Sci­ences (aiims),New Delhi.

Th­ese pa­tients were still for­tu­nate to have re­ceived timely treat­ment, which is not al­ways the case. Till Septem­ber 21, a to­tal of 22 pa­tients, mostly chil­dren, had died of dengue in Delhi. In fact,the me­dia took note of dengue in Delhi only af­ter two chil­dren, Av­inash and Aman, were de­nied ad­mis­sion by Saf­dar­jang and Moolc­hand hos­pi­tals and died on Septem­ber 8 and Septem­ber 12 re­spec­tively.The city has wit­nessed over 3,194 cases till Septem­ber 21,with nearly 1,000 cases re­ported be­tween Septem­ber 5 and Septem­ber 15.This is the worst out­break in the last six years. Caught un­pre­pared, the health in­fra­struc­ture in Delhi was un­able to cope with the del­uge of dengue pa­tients. De­spite hav­ing wit­nessed the first case in Jan­uary—a time when dengue cases are not usu­ally re­ported—the gov­ern­ments did not take ad­e­quate mea­sures to deal with the prob­lem.The dengue cases in Jan­uary were a re­sult of unsea­sonal rain­fall, fol­lowed by dry spell that cre­ated hu­mid con­di­tions and al­lowed the dengue-car­ry­ing mos­quito, Aedes ae­gypti, to breed.

The help­less­ness of the Delhi gov­ern­ment in deal­ing with dengue was mir­rored by other states too.Ac­cord­ing to the Union Min­istry of Health and Fam­ily Wel­fare, all the states of the coun­try have re­ported dengue cases this year. There have been over 22,100 cases of dengue in In­dia this year, and more than 50 deaths.Delhi and Kar­nataka have been the worst af­fected states. South In­dia in par­tic­u­lar has re­ported a large num­ber of cases this time (see map), with states like Ker­ala, Te­lan­gana, Andhra Pradesh and Ma­ha­rash­tra bear­ing the brunt of the dengue at­tack.Ker­ala has had the high­est num­ber of deaths (19) in the coun­try.Even states like Arunachal Pradesh, which had no dengue cases two years ago, have been hit by the dis­ease this time.

So, is this year’s dengue virus more vir­u­lent? “No,” says Ra­jeeva Moger, se­nior con­sul­tant, In­ter­nal Medicine, Apollo Hos­pi­tals, Ben­galuru. “In fact, the over­all symp­toms are eas­ier to cure this year as com­pared to last year,” he says. But a few pa­tients have shown “sud­den”wors­en­ing of symp­toms lead­ing to death, he adds. Savio Pereira, as­so­ciate med­i­cal su­per­in­ten­dent at St John’s Hos­pi­tal, Ben­galuru, too sees no in­crease in vir­u­lence in this year’s strain.

Apollo Hos­pi­tals and the Na­tional In­sti­tute of Men­tal Health and Neu­ro­sciences (nimhans) are jointly do­ing a study to iden­tify the strain of dengue virus in cir­cu­la­tion in Kar­nataka this year. Blood sam­ples are be­ing col­lected and tests will be done in Novem­ber, when the peak dengue sea­son is over. More in­for­ma­tion on this year’s strain is ex­pected by De­cem­ber.The same team worked on last year’s dengue virus and found it to be the “serotype 2”, says Jayas­ree Shivadasan, con­sul­tant mi­cro­bi­ol­o­gist, Apollo Hos­pi­tals, Ben­galuru.

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