INTRODUCTION ( 2019-08-28)
Dengue is a mosquito- borne viral infection disease that causes flu- like illness and occasionally develops into a potentially lethal complication called severe dengue. There are 4 distinct serotypes of dengue virus of Flaviviridea family that are Den-1, Den-2, Den-3 and Den-4. It is generally found in tropical and sub- tropical climates worldwide, mostly in unplanned urban and sub- urban areas. It is mostly transmitted by female mosquitoes mainly of the species Aedes Aegypti and also Aedes Albopictus, secondary dengue vector in Asia. These species of mosquitoes are also responsible for transmitting Chikungunya, yellow fever and Zika infection. Aedes Aegypti is a day – time feeder and its peak biting periods are early in the morning and in the evening before dusk. Its eggs can remain dry for over a year in their breeding habitat and become active again when in contact with water.
Dengue has grown dramatically in recent decades and about half of the world population is now at risk. Severe dengue is a prime cause of serious illness and mortality among children in some Asian and Latin American countries. It was initially discovered in 1950s during dengue epidemics in Philippines and Thailand. According to a report, there are internationally 390 millions dengue infections per year. Emigration is considered as the lead reason of transportation of dengue virus.
DENGUE IN NEPAL
Dengue cases have been identified in Nepal recently and have been mainly reported from Makwanpur, Tanahun, Dailekh, Achlam and Kalikot. All 4 types of dengue virus have been confirmed throughout the country and ECDC reports that its peak transmission starts from August to November. It was detected early as in 2005 in Nepal where periodically cases continued and emerged to 2006 and 2010 outbreaks. 79 confirmed cases were reported from 15 districts during 2011 with Chitwan district holding the highest number of infection i.e. 55. In one Dharan district’s case, 7 people from a single family were verified of infection. Migration between Nepal and India was regarded as major factor however indigenous cases were reported lately. During 2010 outbreak, ‘Highlands of Nepal’ was reported of dengue incidence for the first time. Kathmandu is highly inclined to dengue infections with its high temperature and humidity favoring as a fecund land for mosquitoes. The capital city is in danger of dengue outbreak as it is transit point of migration in Nepal and people from dengue affected areas can immigrate in a brief period. One survey states that most of the residents were aware of the disease and its preventive methods but didn’t practically implement the knowledge. Since there is no medicine to cure the disease, persecuting and executing fresh eggs of the mosquitoes is the only feasible possibility to restrain the dengue outbreak.
- The first symptom of dengue infection is 1040F fever occurring after incubation period of 4- 10 days after the bite from infected mosquito which follows with either of the two signs from below:
- Severe headache
- Pain behind the eyes, muscle and joint areas
- Swollen glands or rash
- First symptoms last for 2-7 days and caution signs arise after 3-7 days of first symptoms and other signs co-occurs with decrease in temperature i.e. below 1000F which are:
- Severe abdominal pain
- Persistent vomiting
- Rapid breathing
- Bleeding gums
- Blood in vomit
- This stage is critical and medical attention is required in the next 24- 28 hours to circumvent any unfavorable risks in near future.
DENGUE PREVENTION AND CONTROL
- Keeping the environment clean and preventing mosquitoes from habituating nearby.
- Disposing solid wastes properly.
- Cleaning water storage and residential areas in a timely manner
- Immediate pest control action must be taken for effective prevention.
Dengue prevention and control relies on effective and systematic control measures. There is no particular treatment for dengue but early medical care can lower the maximum risks.
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