Dengue patients tally may surge from 63,500 without public help
The most affected is the Western province, which accounts for almost half of all cases at 30,818 (48.5%).
Consultant community physician of the NDCU Dr. Nimalka Pannila said that up until September, there have been 63,540 dengue patients and 38 reported deaths throughout the country. She stressed that more than 1,000 cases were recorded in 20 days of September alone.
The highest number of dengue cases in the Western Province is in the Colombo district, at 13,422 (21.2%). Besides, 13,262 (20.9%) cases were reported in the Gampaha district and 4,134 (6.5%) from the Kalutara district.
The NDCU has also drawn attention to the lack of proper prevention measures that has enabled the dengue-carrying Aedes aegypti mosquito to spread across almost all of the Central province (10.7%), Northwestern province (8.3%), and Sabaragamuwa province (8.3%).
NDCU's Director General Dr. Nalin Ariyarathna told the Sunday Times this opened the risk of more infections occurring in September. Dengue is common during the JuneSeptember monsoon season.
Dr. Ariyarathna explained how the rising temperature provides ideal breeding settings for mosquitoes. The rise in dengue has been closely connected to variations in climate. “When taking a look at this year, no such cyclic change has been followed,” he said.
Increased rainfall during monsoons increases vector habitat availability.
Many other factors including population growth, unplanned urbanisation, waste management are determining factors that could enable the rapid spread of dengue.
He said the connection between dengue incidence and climate
change has been broadly studied, but limitted attention is given to the fallout on the borderline of climate on dengue vector indicators.
On Wednesday, the NDCU as the national policymaker for dengue prevention held a workshop titled, ‘Sustainable Prevention and Control of Dengue in Sri Lanka’.
In view of the situation, enforcing zoning regulations to prevent the establishment of high-risk breeding sites in urban areas and incorporating green spaces and vegetation in urban design to provide natural buffers in the face of mosquito proliferation would be a game changer.
“This points at involving urban planners, architects and communities in dengue prevention through urban design,” said Dr. Janaka Wijesundara, Head of Department of Architecture of University of Moratuwa.
The Central Environment Authority (CEA) encourages the public to ensure regular waste collection and disposal to prevent the accumulation of discarded containers and tyres, and also promotes recycling.
Professor Emeritus of Sociology of University of Colombo, Siri Hettige stressed the need to address socioeconomic factors that contribute to dengue vulnerability, such as
poverty and inadequate housing to secure access to healthcare and education about dengue prevention for all socioeconomic groups.
Consultant Community Physician (Epidemiology) – Kalutara District Dr. Charith Hettiarachchi pointed to the need for establishing and enforcing regulations and penalties against individuals and businesses that do not comply with dengue prevention measures.
Adequate resources, including trained healthcare personnel and medical supplies for dengue treatment are needed, along with facilitating coordination among healthcare agencies, local government, and community organisations to streamline dengue prevention efforts.
The NDCU added extra weight on developing a robust disease surveillance system to monitor dengue cases and trends, and maintaining rapid response teams to manage outbreaks.
The move further attached greater importance to the role of non-health stakeholders being vital in sustainable prevention and control of dengue as many mosquito oviposition sites are found at public places more than at private residences.
All in all, the NDCU stressed that a more constructive and focused framework is yet to be developed to identify roles and responsibilities and to ensure every citizen has done their role as a continuous independent task-oriented manner to control the disease transmission.
The high case numbers in recent weeks have been controlled following continuous dengue vector control approaches including, Public Health Inspectors (PHIs) and Medical Officers of Health (MOHs) being mobilised with guidance by the Ministry of Health to adopt largescale vector control strategies. In addition, dengue cluster areas involving schools, commercial premises, Government and private-led institutions were also encouraged to set up a health committee to minimise the menace.
Dr. Ariyarathna said: “Steered by the Ministry of Health, Grama Niladhari Divisions, and the public health agencies are all in the lead taking vigilant measures with enhanced dengue control programmes in their localities. We have also trained 1,000 teachers for health promotion activities within schools. Directives have been sent out to every sector to take up new tools that ensure sustainability of vector control approaches.
“A programme will be launched in the Northern and Eastern provinces by the end of this month as there is a clear tendency for a high rate of infection to be rotated before the onset of the North-east monsoon," he said.
Government Medical Officers Association (GMOA) media secretary Dr. Chamil Wijesinghe said that, “clean-up programmes, special larvae eradication campaigns will be set in motion collaboratively with the presidential task force, local government bodies and tri-forces in the coming days over the 10 high risk MOH areas’’.
Public Health Inspectors’ Union (PHIU) Shanaka Bopitiyage said it is in society’s interest to clear up stagnant water to prevent mosquito breeding.
He said that dengue vector control programmes have been less effective due to declining community engagement.
“Each PHI is on the lookout for 5-6 Grama Niladhari Divisions (GNDs). Fumigation is often implemented in areas harbouring a high density of mosquitoes over special inspection. We are also taking legal proceedings against owners of premises where possible mosquito breeding grounds are not wiped out after warnings have been sent out,” PHI Bopitiyage said.
Medical Officer for Vector Borne Disease Control (Western Province) Dr. Yudhisteera Wedisinghe said that drone-led dengue prevention involving Sri Lanka Air Force, Environmental Police, and Governor of the Western Province, Marshal of the Air Force Roshan Goonethilake has been useful.
“Surveillance is a critical part of any vector borne pathogen prevention programme. Not long ago, it was carried out using time-consuming and labour-intensive ground techniques. With these unmanned aerial vehicles, we can cover the exact areas of special concern within 2-3 hours which is quite time efficient all the same, cost-effective,” said Dr. Wedisinghe.
He also pointed that a 24-hour special operations unit is serving the Western Province for dengue prevention. The public can call: 011-2092720.