‘Surgical strike’ needed on dengue, chikungunya (Comment: Speccial to IANS)
The “surgical strike” on the terror launch pads across the Line of Control in Jammu and Kashmir has been considered a mature and unrivalled move by the Indian Army. For a country that is able to handle terrorists brilliantly, shouldn’t handling mosquitoes be only child’s play?
What is quite evident in the current scenario in which there is an outbreak of chikungunya and dengue in Delhi is the need to control the virulent spread of vector-borne diseases. chikungunya, which is derived from Swahili and means “that which contorts or bends up” calls for immediate deliberation by the government machinery to set things straight.
The potency with which the virus is being transmitted vividly indicates the apathy and inefficiency of the state in containing the breeding of the Aedes aegypti mosquito. Aedes aegypti most likely originated in Africa; since then, the mosquito has been transported throughout the tropical, sub-tropical and parts of the temperate world through global trade and shipping activities.
This mosquito has also been associated with yellow fever, dengue and zika. In fact, the symptoms of chikungunya are almost similar to those of dengue and zika.
A national newspaper recently reported that 12,255 cases of chikungunya have been reported in the country until August 31, 2016, — a little less than half of what was reported in all of 2015. There have been 27,879 cases of dengue and 60 deaths because of dengue haemorrhagic fever. The year 2015 had seen 99,913 dengue cases with 220 deaths.
Health Secretary C.K. Mishra had, in a statement, noted that the chikungunya situation may be at the peak of a seven-to-eight-year cycle, but the disease causes less casualties than dengue and there is a dire need to focus on symptomatic treatment and prevention. It is essential for the community to come together to represent to the healthcare provider to visit the areas where chikungunya is rampant so as to carry out fogging measures.
If one transmits the disease following recent travel, it is important to keep the health officials informed so that they could engage in preventing its spread. It is not just about tackling the disease, it is also important to prevent it.
The health department should necessarily be on double-duty working to suppress the mosquito population. There is research that indicates that no method has yet been found that will eradicate mosquitoes beyond the short term of a few days. Despite the fact that some products promise to work, preventing the breeding of mosquitoes is a continuous process.
As in the West, it is important for the health officials to conduct surveillance to understand local populations of mosquitoes and begin control efforts. The prevention or reduction of transmission is completely dependent on the control of mosquito vectors and limiting person-mosquito contact. Though both dengue and chikungunya are national notifiable conditions, there is very little liaisoning between healthcare providers, local and state public health departments and vector-control specialists.
There is a need to organise area/community clean-up campaigns targeting disposable containers for source-reduction, including large objects that accumulate water (broken washing machines, refrigerators, toilets, flower pots, tyres, buckets) in houses, buildings and public areas. Female mosquitoes lay several hundred eggs on the walls of water-filled containers. Eggs stick to containers like glue and remain attached until they are scrubbed off. When water covers the eggs, they hatch and become adults in about a week.
So, once a week, empty and scrub, turn over, cover, or throw out items that hold water. Tightly cover water storage containers so that mosquitoes cannot get inside to lay eggs. As for homes, it is better to use screens on windows and doors; repair holes in screens and use air conditioning when available.
During a chikungunya or dengue virus outbreak, aggressive vector management and personal protection activities are required to effectively reduce mosquito density and prevent mosquitoes from feeding on infected people. This will help break the transmission cycle. So certainly, a partnership between the city and citizens will keep the numbers down as we head into cooler weather in the fall.
(Dr. Rajat Arora is an Interventional Cardiologist and Medical Director at Yashoda Hospitals in Delhi. The views expressed are personal. He can be contacted at firstname.lastname@example.org)