Strike before being struck
To stop frequent outbreaks of diseases we need better preventive measures and social awareness campaigns
Mystery viruses strike and kill at random each year before microbiologists can put their slides together. Often, viruses go on a rampage, confusing microbiologists by presenting them with different sets of DNAs and RNAs. By the time experts respond to an outbreak, hundreds are stricken and dozens are dead. And then there is the threat of the wider geographical spread of identified diseases. Few people in northern India had heard of chikungunya a decade ago, but regular outbreaks have made the mosquito-borne diseases synonymous with the monsoons. Adding to the disease cauldron are the frequent outbreaks of other infections such as malaria and H1N1.
All sorts of disease-causing pathogens found in the faeces of the infected, for example, spread to other people through contaminated soil and water, food and surfaces touched by infected people. Add to that mosquitoes breeding in stagnant water, algae and fungi in neglected surroundings, lack of safe running water and missing toilets and sewerage — we are juggling several triggers of outbreaks waiting to happen. Apart from the fever and malaise, what these diseases have in common is that they are all under-reported. Blood samples taken from more than a thousand people across 50 Chennai neighbourhoods revealed that nearly all had been exposed to the dengue virus and 44% to chikungunya. Yet almost none of the people had reported having been infected. Complicating containment is the systematic knee-jerk reaction of the health department and civic authorities to each outbreak. They begin by publicly accusing each other of mismanagement, add beds in hospitals and start cleanliness drives, and stop everything once infections begin to fall because of unfavourable weather conditions. There is no sustained planning for the year ahead.
Clearing neighbourhoods of garbage and filling up uneven surfaces where rainwater collects and becomes a breeding ground for mosquitoes is a start, as is building toilets and encouraging people to use them through sustained social campaigns. These outbreaks are back with frightening regularity because we strike at the disease after it’s struck us down. Prevention is better than cure is a public health adage civic and health authorities must treat as a truism that can be ignored only at their peril.