Hit by the worst floods in recent memory, alongside a crippled economy and political instability, there is another scourge that has started making its way through the most vulnerable of our people.
Dengue fever, also known as “breakbone fever” is on the rise in Pakistan, and it does not seem like there will be any let-ups this time around. Spread by mosquitoes, the virus is rearing its head in the business capital of the country Karachi, and is projected to be worse than the 2019 dengue epidemic.
Data released by the Sindh health department showed a spike in dengue fever cases as their numbers doubled in just two days, from 201 cases on Wednesday to 403 cases on Friday. This is quite alarming, as due to record-breaking floods more than thirty million people have been displaced or rendered homeless. These people are forced to live near waterlogged areas due to flooding and provide the best breeding ground for mosquitoes and the diseases they carry.
About 3,830 cases of dengue fever have been reported by health officials in southern Sindh province, with at least nine deaths, but there are concerns this may be a conservative estimate.
“Overall the situation in Sindh is very bad, we are organizing medical camps all over the province. Most of the cases we are seeing now are of dengue patients followed closely by malaria,” Dr. Abdul Ghafoor Shoro, secretary general of the Pakistan Medical Association, told the BBC.
“The dengue burden is the same all over the province and it’s increasing daily. When we checked with the laboratories, the suspected cases are around 80% of tests being done.”
The dengue situation is nothing if not alarming in Pakistan, and post monsoon the situation is projected to spiral much more out of control unless concrete steps can be taken.
In this article, we will take a look at the origins of dengue, how it functions, its symptoms, and the current situation with regard to the disease in Pakistan in general and Sindh/Karachi in particular.
The History of Dengue Fever
The family of viruses responsible for Dengue fever originally were found among monkeys but made the jump to humans around eight hundred or so years ago. Around that time, limited trade and communication kept the disease from spreading outside of south-east Asia and Africa until the 1900s.
In 1943, Ren Kimura and Susumu Hotta first isolated the dengue virus. They were studying blood samples of patients taken during the 1943 dengue epidemic in Nagasaki, Japan. A year later, Albert B. Sabin and Walter Schlesinger independently isolated the dengue virus as well.
Flavivirus, the type of virus that Dengue is, includes the yellow fever, West Nile, Japanese encephalitis, and tick-borne encephalitis viruses. All are spread via bites of such insects and are very difficult to eradicate.
At that point, maritime routes carried Aedes aegypti (the mosquito type) across the world. This was the main vector for the disease, as it spread via mosquito bite, and that is when it began spreading where people went in the global trade network. The first recorded epidemics of “breakbone fever” as it was known at the time, occurred in the 1960s in south and south-east asia.
Currently, almost half the global population is at risk of contracting dengue fever, and it is a recurring epidemic across the globe. More than a hundred countries are at risk when it comes to Dengue fever, and close to five hundred million cases of the disease are reported annually. Of these, many become serious, with twenty five thousand people across the world dying from the illness.
The majority of those dying from this disease tend to be children-an alarming detail of an already alarming profile of a disease.
Symptoms
This is a particularly unpleasant illness, three to fourteen days after a bite by the mosquito, symptoms of Dengue fever become apparent. Vomiting, fever, and headaches are common in the initial phase, and then the virus causes muscle pains and joint-pains, giving the disease its iconic name of “breakbone fever.” If you are lucky, then the fever will become a little bad, with a skin rash and itch to boot, however the illness should pass in less than a weak.
If you are particularly unlucky, then the disease will progess, becoming something known as dengue hemorrhagic fever and then becoming dengue hemorrhagic shock, characterized by low platelet counts and plasma leakage. This is when things become dangerous and the dangerously low platelet count begins causing problems. Low blood pressure follows and recovery gets more difficult the younger the patient.
How to avoid Dengue Fever?
There is a vaccine available for the virus, but it is only recommended for people already infected with the virus or those more likely to encounter the disease before the age of nine. The more effective measure of stopping the virus is to prevent the propagation of its vector-Aedes aegypti mosquitoes. Open bodies of water near residential areas need to be cleared or emptied, with larger water bodies having larvae-eating fish released into them to reduce the chances of the mosquitoes’ breeding.
On an individual level, covering up is important, along with the use of repellants to keep mosquitoes away. The virus can only be transmitted through the mosquito, so getting rid of that vector is enough to stop its spread across a region.
Dengue and Pakistan
Pakistan is no stranger to the Dengue virus, with cases reported on an epidemic level as late as 2019 and 2021. Both years had close to fifty thousand dengue cases, it can be expected that the floods will make the problem worse. People are forced to sleep under the open sky near waterlogged areas, they lack basic supplies needed for everyday life and mosquito repellent tends to be low on that list. If the country is to avoid massive amounts of cases being reported, then a massive campaign needs to be launched to spread awareness and lend help to those affected.
