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Dengue, Chikungunya Are Preventable – Stop Pretending They Aren’t

Dengue and chikungunya claim countless lives in India every year. This year is bound to be the worst yet. 

Updated
Health News
5 min read
From sporadic cases of dengue in 1960s to widespread outbreak now – the scale of mosquito-borne diseases appears to be growing every year. (Photo: <b>The Quint</b>)

Whether you’re outdoors, or travelling in a metro, or even watching TV in the comfort of your home, you’ll never be alone in the summer. Mosquitoes are always by your side, sucking your blood, leaving you with itchy red bumps, and spreading diseases.

Mosquito-borne diseases typically peak in the monsoon season. It may not be mosquito season yet, but the winged insects are already wreaking havoc in the country. As of the first week of April this year, Delhi has already reported 79 chikungunya, 24 dengue and 13 malaria cases. To put this into context, a total of four chikungunya cases were reported in the capital during the same time period in the last five years combined.

From sporadic cases of dengue in the 1960s to widespread outbreak now – the scale of mosquito-borne diseases appears to be growing every year. This should not come as a surprise considering how little attention we pay to public health in the country.

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Not Long Before It Becomes a Year-Long Issue

How is it that so many of these cases have been reported outside the ‘season’ – typically early August to November-end?

Speaking to The Quint, Dr Atul Gogia, infectious diseases specialist from Sir Ganga Ram Hospital, explains that all it takes for an outbreak is for aedes aegypti mosquitoes and the virus to be present together.

The moment there are mosquitoes, the diseases will spread. These viruses are perpetually there in the environment now. The mosquitoes just need warm, humid weather and clean, stagnant water to breed.
Dr Atul Gogia, Sir Ganga Ram Hospital

“It’s not about rainwater, they can breed anywhere there’s clean and open water like in overhead tanks in localities,” Dr Ramanan Laxminarayan, Director, Centre for Disease Dynamics, Economics & Policy (CDDEP) told The Quint.

This may soon turn into a year-long issue. Earlier, dengue and chikungunya were around for a month around September. Then it became a six-month problem and it won’t be long before it becomes a nearly year-round problem.
Dr Ramanan Laxminarayan
File photo of people suffering from dengue and chikungunya being treated at a Delhi hospital. (Photo: IANS)
File photo of people suffering from dengue and chikungunya being treated at a Delhi hospital. (Photo: IANS)

This is a “climate change issue” and a menace to public health, said Dr Indira Behara, from Global Health Strategies, when asked about the dangers of these diseases turning into a year-long issue.

The Big Picture: A Poor Public Health System

While the early onset of mosquito-borne diseases is worrying, it is important to question why nothing has been done to prevent the epidemic. Why have no preemptive measures been taken despite the fact that these diseases wreak havoc year after year?

It’s tough to avoid the politics of it, but the governments seem to have no interest in dealing with the public health issue. Every year they approach dengue as if it’s a new problem.
Dr Ramanan Laxminarayan, Director, CDDEP

“There are guidelines to follow and a lot more to be done by the civic authorities,” said Dr Indira Behara of Global Health Strategies. There are simple ways to prevent, or at least control, an outbreak. These include spreading awareness, keeping a check on open contained water, covering overhead tanks, using insecticides, and keeping water from collecting in stagnant pools.

There is no real clamping down on the issue.
Dr Indira Behara, Global Health Strategies

The crippling lack of adequate medical infrastructure was glaringly evident last year, with hospitals across the country reporting a severe shortage of beds and doctors. Last year, Delhi alone recorded 7,760 chikungunya and 4,431 dengue cases.

There is little proof that things will improve this year, even if the health minister claims otherwise.

Our medical infrastructure isn’t tuned to the kind of population we have. If an outbreak occurs, we’ll see shortage of beds and doctors again. Nothing has changed.
Dr Atul Gogia, Sir Ganga Ram Hospital
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The Threat of Zika Looms

India’s level of public health preparedness is “inadequate”, and the country is “vulnerable” to emerging diseases like Zika and Ebola, an 11 April report in the British Medical Journal (BMJ) said.

It added that inadequate surveillance and an uneven health system capacity may accelerate the spread of the emerging infectious diseases in the country.

If Zika comes to India, it’s going to be a disaster. Aedes aegypti is also a vector for Zika. And we have created the perfect condition for it, with the vector and the population ready to be targeted. 
Dr Ramanan Laxminarayan, Director, CDDEP

The report also highlights that surveillance is weak and many cases go unreported. “If there are 70 cases reported, then there may be 700. I’m willing to bet there are at least 5,000 cases of dengue right now,” Dr Laxminarayan said.

What Is Being Done to Prevent Another Outbreak?

The Quint asked the South Delhi Municipal Corporation (SDMC) about the measures being taken to prevent an epidemic this year.

Most of the cases that have been reported have come from outside the city. They haven’t occurred in the DMC area.
Mukesh Yadav, PRO, SDMC

The CAG’s performance audit report – covering January 2013 to December 2015 – dubs the efforts of government agencies and municipal corporations as being below par.

The countless meetings appear to be doing nothing to change the situation. The CAG report found that funds were being spent without following guidelines, or even assessing the effectiveness of the methods being used. Every year, the government initiated public awareness programmes only after the outbreak began to spread panic.

Awareness programmes must be held way before mosquito season, in order to equip the public with knowledge of preventive measures.

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The Blame Game

Parties in Delhi appear to have no time to deal with preventing an epidemic this year. Instead, parties are occupied with the upcoming MCD elections and are caught in a slugfest. The AAP-led Delhi government blames the BJP-ruled MCD for inaction, and vice-versa.

What will it take? Will it take a senior politician to get dengue for the governments to realise the magnitude and impact of these diseases?
Dr Ramanan Laxminarayan, Director, CDDEP

Both the public and the government appear to have turned a blind eye to what is essentially a preventable epidemic. Pointing fingers is not the solution. All stakeholders involved need to make collective efforts to address the urgency of the situation. The public needs to outrage in order to get its share of attention, Dr Laxminarayan says.

Last year, our equally hot and humid neighbour Sri Lanka eradicated malaria – evidence that these diseases are indeed, preventable. What is India waiting for?

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