Health Authorities’ Readiness for the Approaching Dengue Season

Bangladesh witnessed the deadliest year of dengue outbreak in 2023 with over three lakh dengue cases and 1700 deaths. Dengue cases have already started rising with the advent of monsoon this year despite the claim by the authorities concerned that they took necessary preparations to curb spread of the mosquito-borne disease.

Families affected by dengue last year are wary about the preparedness. Shirajam Monira, a resident of Kalyanpur in the capital, said, “My close relative’s child died of dengue last year. Last year, dengue situation turned so severe that several members of a family got infected at a time. This would not have happened if necessary measures had been taken. There are fears this year as well. So, if timely measures are taken, the risk of dengue will be reduced.”

Munni Akhter’s daughter Mantasha is 10 years old. Last year, she was severely affected by dengue.
Platelets came down to 10,000 and her liver was affected. Although she somehow survived, the doctors said to be careful for the rest of his life. If she gets dengue for a second time, she may not be saved.
“We got afraid when she caught a fever. Because, last year I saw the horror of dengue,” said Munni.
This raises question as to how well preared the authorities are to tackle another possible outbreak.
Dengue cases, fatalities in last five years:

According to the Directorate General of Health Services (DGHS), the number of dengue patients was 10,148 in 2018 with fatalities reported at 26. In 2019, dengue cases increased to 1,01,354 with 179 deaths. In 2020 1,405 cases and 7 deaths were recorded. There were 28,429 cases and 105 deaths in 2021 while the cases climbed to 62,382 in 2022 with deaths 281.

In 2023, considered as the deadliest year, the number of cases soared to 321,179 with 1,705 people deaths. Until July 7 this year, DGHS recorded 3978 cases and 46 deaths, raising concern about another possible outbreak. DGHS’s preparations to cope with Dengue:
According to the DGHS, it has taken an action plan for 2024 based on the National Dengue Prevention & Control Strategy (2024-2030).

Instructions for prevention and control of dengue have been shared with all government hospitals before the start of the season and the hospitals are well prepared, it said.
It said it has strengthened surveillance by introducing Dengue Tracker for real time data collection (with actual address and avoid duplication).

Focal points for secondary and tertiary hospitals were identified and WhatsApp group was opened for quick communication and actions.
Trained doctors and paramedics are in place for proper patient management in the hospitals, it said.
Dengue test kits are available in all government hospital (12 lakh kits distributed).
Health and Family Welfare Minister Samanta Lal Sen has given necessary instructions to all government hospitals for procurement of adequate fluid.

Awareness and community engagement campaign was launched (formation of RCCE platform messages from the health minister, the state minister and the health secretary).

What officials concerned and experts say: Dhaka South City Corporation’s Chief Health Officer Fazle Shamsul Kabir said this week, “We are in a much better position this year than the previous year. In June last year, there were 1,713 dengue patients in Dhaka South City and in June ,2024, we have 97 dengue patients.

“We carry out larviciding in the morning to destroy breeding grounds and conduct fogging activities in the afternoon. It continues all the year round except on Fridays.”
Asked if the dengue cases may spike during the monsoon, he said, “Yes, it may increase. As part of preparations, we are trying to make people aware of it through miking, distributing leaflets, holding public awareness meetings in the wards. Most of the places where Aedes mosquitoes breed are in people’s homes. So people have to be aware. It is not possible for the city corporation alone to enter every person’s house. So we are working to make people aware. Besides, our mayor held meetings with government, semi-government and autonomous bodies.

He instructed them how to prevent dengue. Those who do not abide by the government instructions even after warning, we fine them through mobile courts.”
Entomologist and Researcher of Jahangirnagar University Professor Dr. Kabirul Bashar Bashar said earlier it was thought that Aedes mosquitoes do not breed in drain water but some recent studies and laboratory research say that Aedes mosquitoes also breed in stagnant gutter water.

“I didn’t agree to this study until the World Health Organization said so,” he said. However, “we spray pesticides in drains, sinks, canals and waterbodies. ‘
Dr. Kabirul Bashar said this year, dengue has not yet taken a serious turn but the cases may spike from the end of July.
“What we need to do is using pesticides to destroy Adese mosquitoes’ breeding ground in both DNCC and DSCC areas.”
Dengue is spreading to other districts including Barguna, Barisal, Pirojpur, Cox’s Bazar and so preparations should be taken at district level to prevent the disease.
Brigadier General Md Asaduzzaman, director of Dhaka Medical College Hospital, told UNB that hospitals mainly focus on treatment.

“As preparation, we have a dedicated dengue ward. We have enough saline in stock as there was a severe saline crisis last year. Mosquito nets have been provided in the dengue ward. Besides, fogging and larveciding are being done in the surrounding areas so that mosquitoes cannot breed.”
Health Minister Dr Samanta Lal Sen told parliament on June 25 that ‘Dengue Focal Person’ has been appointed in all Government Medical College Hospitals and District Headquarters Hospitals of the country, through whom stock and demand of dengue test kits, IV fluid (saline) and other logistics are being collected regularly for the treatment of dengue patients across the country.

To ensure the treatment of dengue patients, some 2,15,752 liters of IV fluid (saline), 8,87,569 saline sets, 26,135 mosquito nets and 1,01,159 dengue test kits were kept in 54 hospitals of different districts of the country.
Besides, he said that Dengue Test Kit (NS-1) of 8,51,514, Combo IgG & IgM Test kit -1600 and Dengue RNA Diagnostic Kit 1100 provided by the Chinese government were stored in CMSD.
Besides, some 55,000 bags of Ringer’s Lactate Saline were stocked at CMSD with the help of WHO. Another 20 thousand bags of 500 ml. Normal saline is available. which is stored in CMSD.
The minister said that some 2 lakh kits are stocked for dengue testing. Out of which 1,11,000 kits have been supplied to 64 districts. The remaining 88 thousand kits are in stock.