Eliminating mosquito breeding sites key to prevent dengue: Expert
Being aware of dengue alone won't do, a change in behaviour is needed, stresses Consultant Community Physician Dr Shilanthi Seneviratne as dengue cases increase around the country
Dengue is on the rise with a total of 1768 cases reported as at January 7, Health Ministry statistics revealed.
Last year 35,924 cases were reported with 26 confirmed deaths. December 2021 alone saw 8966 cases, reporting the highest dengue patients for the year.
The National Dengue Control Unit's Consultant Community Physician Dr Shilanthi Seneviratne told the Sunday Times that Colombo, Gampaha, Kalutara, Kandy, Jaffna, Mannar, Trincomalee, Batticaloa, Galle, Matara, Kurunegala, Puttalam, Badulla, Ratnapura and Kegalle have been identified as the 15 high risk districts.
She said due to the monsoon season the frequency in which water collecting areas are created rises. Especially with intermittent rain, water gets pooled and creates breeding sites for mosquitoes. According to Dr Shilanthi, the strategy to prevent the spread of dengue is source reduction--the removal of water collecting sources. These include coconut shells, tyres, yogurt cups and also water storage tanks, barrels and even the water collected on concrete slabs. She said although it is a difficult task to detect all water collecting sources and destroy them, it is a key strategy in controlling mosquito breeding. People must look for mosquito breeding sites at least twice a week in their homes, working places, schools, etc. Dr Seneviratne emphasised. She said in places like discarded vehicle yards where it is hard to destroy such sources, larvicides have to be used. “The mosquitoes are the vectors that transmit the virus, it is crucial to break that cycle.”
In addition, using mosquito repellents like citronella and using mosquito nets will further assist in keeping oneself safe.
She emphasised that during the initial stages of the infection it is difficult in identifying whether it is COVID – 19 or dengue as they share similar symptoms. Headaches, fever, aches and pains in the body and nausea are some common symptoms while the headache mainly includes pain behind the eyes. Dr Seneviratne commented that symptoms in small children are not very specific as virus types are changing. “If a child gets diarrhea, it could be dengue.” People have been advised to seek medical advice if they have fever for more than 24 hours. Dr Seneviratne said it was crucial to “seek medical advice to identify which disease you have.” It can only be detected through conducting the relevant tests; a Full Blood Count test (FBC) and a NS1 Antigen test. Failure to seek medical advice could result in dengue haemorrhagic fever, dengue shock and even death. Fluid leakage from blood vessels can result in hypovolemic shock which leads to the fatal form of the infection. Although there is no specific treatment for dengue, deaths can be prevented.
In response to how hospitals are managing both COVID-19 and dengue, she said that while it is challenging for the health system to tackle other diseases in the midst of a global pandemic, the Sri Lankan health system is presently managing well with hospitals well equipped with resources to treat infections. However, she warned that if dengue infections increase on par with Covid cases it will be very difficult for the health system to cope.
In 2017 there was a massive dengue outbreak but the present increase does not reflect an outbreak as such. However, it has the potential to become an epidemic if necessary measures are not taken, warned Dr Seneviratne. The Dengue Control Unit has started conducting special mosquito control programmes with the collaboration of the tri – forces, environmental police and officials from the health sector. Routine site visits to detect mosquito breeding areas and awareness programmes have been stepped up, she said.
“People talk about dengue on various forms of social media, but what needs to change is the behaviour.” Dr Seneviratne said that although many people are aware of dengue, they need to act while adding that sometimes people know there are mosquito breeding sites but take little or no effort to destroy it or to prevent water from accumulating in the same place again. “This should be a culture,” she highlighted.
On December 13, the Cabinet decided to strengthen the multilateral approach to prevent and control Dengue. The nomination of a permanent officer within each ministry for the prevention and control of dengue, requiring district and divisional coordinating committees to take necessary action, entrusting provincial governors with the responsibility of provincial, district, divisional and grassroot level dengue control, updating present laws applicable for the prevention of dengue and entrusting the sole responsibility of coordinating all dengue control activities to the National Dengue Control unit were the resolutions approved by the Cabinet.