With cases rising in Lahore, strict preventive measures need to be taken
engue cases continue to rise in Lahore’
‘29 dengue cases reported in Lahore’
Such headlines and TV tickers have ruined the tradition in Ali Abbas’s family of spending weekend evenings at Racecourse Park on Jail Road.
Ali Abbas, an officer in the Education Department, loves to spend Saturday evenings with his family at the park. A father of three children, he has been hanging out at the park for many years. But the rising cases of dengue fever mean Ali Abbas should not expose his family to mosquitoes.
He lost his uncle, Malik Nazar Husain, to the deadly dengue fever virus in 2011, the deadliest year when in Lahore, around 300 people died from the complications arising from dengue fever.
Ali Abbas remembers the painful days when he had a week-long vigil at the Jinnah Hospital and doctors had few options to stabilise his uncle’s falling platelet count. Within a day of admission to the hospital, his uncle suffered internal bleeding and ensuing organ failure. Doctors tried their best to save him, but there was little they could do for him.
Since then, whenever dengue fever is in the news, Ali Abbas and his family remain holed up on weekends, days off and most of the time during the day.
Though this severe mosquito-borne disease merits utmost care, Dr Faisal Malik, chief executive officer of the District Health Authority, suggests that people can visit their favourite hangouts whenever they feel like it, even at the peak of a dengue fever breakout.
“What we need to do is take appropriate protective measures,” he says.
“Yes, just dump your half-sleeve shirts and shorts for a while. Whenever you’re in an open place, use repellents to avoid mosquito bites. Don’t let water stand near your house and keep on a look out for the places where you find standing water. Dump it.”
Now is the peak season for dengue fever in Lahore and some other parts of the country. This brings frantic activities in the government quarters to find and visit mosquito larva hot spots, and destroy larva and adult mosquitoes.
“In Lahore alone, there are more than 35,000 hot spots of dengue larvae,” says Dr Malik.
The task of surveillance and destruction of larvae and adult bugs is carried out by the staff of 63 departments, Dr Malik says.
Dengue fever became a household name in 2011 when the then Punjab government decided to fight the virus by deploying all available resources as the disease became an epidemic. The interventions helped the government reduce the illness incidence as the implementation of strategies led by national and international public health professionals proved successful. In the years to come, the disease’s spread came down. This happened on account of government departments as well as the public, taking into account the severity of dengue-related illness and mortality, followed dengue prevention and control measures.
The dengue vector surveillance, detection and control programme included the chief minister besides government servants in many departments. The top-most institutional arrangement body currently is the Central Emergency Response Committee, headed by the chief minister. Several ministers and heads of departments are its members. The body aims to review the provincial situation, policy making, implementation, defining the role of various departments and their monitoring and evaluation. There are seven such bodies, covering from provincial to tehsil, town and union council levels.
The government’s top priority is the integrated vector surveillance (IVS) of the programme.
Commissioner Ali Jan says, “We make sure that the IVS is based on real-time monitoring of the start of the vector population.”
The IVS goes on round the year, but factors like humidity and rainfall make February, pre-monsoon, monsoon and post-monsoon months more conducive for mosquito breeding.
Punjab’s dengue control programme was once cited as a case study in defeating the dengue breakout.
In fact, it is a continuous battle.
Farzana is a front-line soldier in this battle. She is part of the dengue surveillance programme as a daily wage worker in Gulberg Town. She does visual inspections and reports violations to the authorities.
Her job requires intense physical inspection of the targeted premises.
She and a co-worker visits 30 to 50 houses in the Gulberg area every day.
“We’re frequently treated as intruders. We ask the families we visit to let us inspect their kitchens, fridges, rooftops, etc,” she says.
She has been doing the job for three years.
“Most people are aware of the dengue control measures. However, they show a casual attitude to precautions like draining water.”
Allama Iqbal Zone, Bahria Town, Johar Town, Sabzazaar, Iqbal Town and Mustafa Town are extremely sensitive regions according to the commissioner’s office. The government has increased pesticide sprays in the marked areas.
Dr Malik, however, says the situation is under control. He says the disease is far from reaching the level of an epidemic in the city. He says that in the last three months, the city has reported 1,500 dengue fever cases. Currently, 25 patients are admitted to public hospitals. Three people have died from dengue fever in as many months. In recent days, dengue fever cases have been on the rise. There have been 1,133 cases reported in the last 30 days.
The rise in dengue fever cases means prompts an increase in dengue control efforts. According to a tweet by the Lahore deputy commissioner on September 19, the district administration has detected larvae at 845 indoor locations and 38 outdoor locations. In ensuing actions, 865 notices have been issued over the violators, 27 FIRs have been registered and five arrests made. The surveillance teams have also carried out inter-residual spray at homes of suspected and confirmed dengue patients.
Dr Uzair Mukhtar, a specialist in vector-borne illness, advises planning and reconnaissance before engaging in the ground, air, and water battle employing both high-tech and low-tech weapons. He warns that government departments and the public must watch out as mosquitoes – carriers of malaria, dengue fever, and other infections – proliferate during and after floodings. When coupled with increased human exposure to mosquitoes after a disaster and living in unsanitary conditions, the rise in mosquito population density can accelerate transmission and increase the risk for human disease in these delicate settings.
According to the World Health Organisation (WHO), dengue fever is spread through the bite of a female mosquito (Aedes aegypti). The mosquito becomes infected when it takes the blood of a person infected with the virus. After about one week, the mosquito can transmit the virus by biting a healthy person.
Dr Malik says the best strategy is to wage a war on dengue fever by following the interventions, that almost all of us know. During the day, dengue-carrying mosquito bites in addition to breeding in shallow standing water. The most important thing to do is to get rid of any standing water that has accumulated in trash cans, buckets, gutters, room coolers, pool covers, flower pots, and so on. Simply take a look around and dispose of any trash you see, including old tyres, bottles, pots, cans, and broken appliances.
Ensure that swimming pools are clean and properly chlorinated. When not in use, empty the plastic swimming pools.
At least once or twice a week, empty and clean the water bowls for your pets and birdbaths.
One, of the most effective things to avoid a mosquito bite, is using a repellent.
Dr Lala Rukh says insect repellents should only be used on exposed skin or on garments, not under the garments. “Certain repellents can cause allergy or skin-related diseases, so be smart while picking a repellent. The best trick is to apply repellents on a smaller body portion and watch it for 15 minutes. If there is no reaction, go ahead and apply it to other parts as well.
“No repellents for children under two months. The best protection for them is mosquito netting,” she says.
The last thing is to keep your house well screened.
“Keep an eye on doors and windows. The deadly virus carrier can be kept out of the house if doors and windows are shut.”
The writer is a media veteran interested in politics, consumer rights and entrepreneurship