As monsoon season looms, hospitals prepare for dengue cases

With the summer upon us, India’s monsoon season is looming and, with it, the prospect of outbreaks of mosquito-borne infectious diseases such as dengue fever. In preparation, the Union Health Ministry is calling on government-run hospitals to set up dedicated centres on their grounds for the treatment of dengue cases.

“As rising temperatures and natural disasters such as the Kerala floods change the breeding patterns of mosquitoes, outbreaks of dengue cases could be more unpredictable and difficult to prepare for in the years to come.”

Dengue fever is considered the world’s fastest-growing mosquito-borne disease. It is endemic across all of India’s states and union territories and 2017 saw the highest number of dengue cases in a decade, with a 300 percent rise in cases compared to 2009. In Delhi alone, cases of dengue almost doubled between 2013 and 2017 while states such as Mizoram, Sikkim, and Tripura saw increases of between 1,500 and 1,700 percent.

Worryingly, the situation could be worse than we realise. Doctors at the All India Institute of Medical Sciences (AIIMS) in Delhi detected last year a number of asymptomatic dengue cases, sparking fears that cases could be going under the radar. This carries the potential for individuals harbouring the disease without symptoms to subsequently spread it unknowingly. Meanwhile, as rising temperatures and natural disasters such as the Kerala floods change the breeding patterns of mosquitoes, outbreaks of dengue cases could be more unpredictable and difficult to prepare for in the years to come.

““The aim of setting up these dengue corners is to provide seamless and efficient healthcare service to the patients””

With this in mind, extra vigilance will be needed this year to curb dengue’s spread after the monsoon rains. The Union Health Ministry’s guidelines – in line with the National Vector Borne Disease Control Guidelines – could be one step to ensuring that the response to the likely influx of dengue cases is efficient and effective.

Doctors at AIIMS are optimistic about the policy, which will see designated staff staffing the so-called ‘dengue corners’ to support patients. “The aim of setting up these dengue corners is to provide seamless and efficient healthcare service to the patients,” said Dr Ashutosh Biswas, a professor of medicine at AIIMS. The objective, according to the hospital’s director Randeep Guleria, is ensuring timely diagnosis and treatment.

“Just four states accounted for forty percent of dengue cases in India in 2017”

According to reports, the burden of dengue is higher at AIIMS Delhi than anywhere else in India. Dr Biswas has said that the hospital has registered 4,000 cases of dengue this year. Many facilities refer dengue patients to AIIMS when their condition begins to deteriorate.  Given the hospital’s high burden of the disease, the mortality rate of dengue is higher there, standing at seven percent compared to the national average of less than two percent.

AIIMS has responded to this, providing dengue management training to its staff and adopting the guidelines issued by the Union Health Ministry. It is necessary for other facilities across India to do the same, particularly those in states with a high dengue burden. As highlighted by Down to Earth, just four states accounted for forty percent of dengue cases in India in 2017.

It cannot be overlooked either that the disease is endemic in every state and UT, meaning vigilance is needed not only in a handful of regions but at the national level. Steps need to be taken to ensure treatment is timely and effective, while sanitation must also be of a high standard to prevent healthcare facilities themselves becoming breeding grounds for mosquito populations.