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Dengue strikes again Difficult to eradicate dengue, it's endemic in Colombo
By Faraza
Farook Anjana developed fever, lost her appetite and also had other symptoms such as nausea and abdominal pain. "But I didn't think we would find dengue in Colombo," says her father Asanka Sanjeeva. Her fever fluctuated and Anjana was taken to five doctors on five consecutive days before finally being admitted to the Lady Ridgeway Hospital.
"She even went to school on those days because she seemed absolutely fine when she was given her medicines," her father said. "I was told she was suffering from viral flu and was asked to give her half a paracetamol when her fever went up." Strictly adhering to the instructions, Anjana was given half a paracetamol every time she had fever. The end result was that her liver was affected. When a blood test finally confirmed that she had dengue, she was rushed to the Lady Ridgeway Hospital (LRH). But her condition had turned serious by then. After three days in hospital, she died. The only daughter in the family, her father is sorrowful that he was unaware of the disease and its gravity. Her mother, who was away in the Middle East has now returned. She is still in hospital trying to cope with the trauma of losing her daughter. Many children today are facing the same terrible fate as Anjana. Many more cases go unreported. The vast majority of dengue cases in this country are among children less than 15 years of age and the death toll has climbed steeply in the past few weeks, causing grave concern to parents.
In Anjana's case, her life could perhaps have been saved had early treatment been sought and if her parents were aware of the symptoms of dengue, which would have alerted them right from the start. The figures of recent weeks are alarming. Despite widespread awareness and control campaigns, the number of dengue cases has risen. Already this year, the suspected dengue cases far exceed the cases reported last year for the same period. 3429 suspected cases have been recorded so far for this year as against 2452 cases reported for the same period in 2001. Last year 54 deaths were reported and this year 15 deaths have been reported so far, among them many schoolchildren. Many are still unaware of the seriousness of the disease, how it is spread or the general symptoms of dengue that can prevent unnecessary deaths. Zaynab is a 19-year-old who is recovering from dengue. If not for an early blood test, her condition could have turned serious. She suffered from fever, headache, vomiting and was told that she had the viral flu when she sought treatment from a private hospital on Monday. A blood test on Wednesday showed a drop in the platelet count, but doctors didn't confirm it was dengue until the next Sunday.
The disease strangely, is more likely to have a devastating effect on healthy children than those who are less strong. Says Epidemiology Unit Director Dr. T.A. Kulatilaka, "Children who are well nourished and have a lot of proteins when infected with dengue, due to the protein reaction are more likely to go into the haemorrhagic stage." Another factor that has led to deaths is an overdose of paracetamol that affects the liver. Patients should not be given paracetamol above the prescribed dosage and not more than four times in 24 hours, says Prof. S.L Lamabadasuriya, a paediatrician at LRH. Kapilani is yet to find out how serious her son Asantha's condition is. Having gone to a private doctor when the 11-year-old had fever, they were prescribed a strong dose of panadol. "The doctor asked me to give him two tablets four hourly and I did. In three days, I had given him 21 tablets." Asantha was
admitted to the Lady Ridgeway on June 12, four days after he first
had fever. Tests are being done to see if his liver has been affected.
Asantha is only one among the many such cases at LRH. The dengue
virus can attack the liver and an overdose of paracetamol or panadol
can prove fatal or result in worsening the illness. So what has caused this sudden increase? Health authorities blame the lack of public support or interest in maintaining a clean environment and of course, the monsoonal rains. But with dengue outbreaks being reported now for several years, the question being asked is why the many campaigns carried out by health authorities have not reduced the spread of the disease. Dr. Kulatilaka says that the intermittent rain the country has been experiencing has provided an ideal situation for the spread of the disease as there are now more breeding places for the dengue mosquito. The public should take the responsibility of keeping their environments clean, he stresses. The Public Health Department of the Colombo Municipality also attributes the problem to a lack of support from the community. Dengue is now endemic in Colombo and it will be very difficult to eradicate it, said the CMC's Chief Medical Officer Dr. Pradeep Kariyawasam. Private houses and housing schemes too are a problem. "People expect us to clean their gardens for them and also fog the areas, which is not our responsibility. We're supposed to be fogging only underground drains." He pointed out that under the Municipal Ordinance, it is the responsibility of each individual to keep his/her home and the environs clean. But, is it only a mere lack of co-ordination and support that has aggravated the dengue menace? Despite all the claims of lack of support, the Health Ministry admits that their dengue awareness and control campaigns are inadequate and calls for strengthening of social mobilisation activities. With government (hospitals) themselves not adhering to rules such as using treated nets for patients with dengue, how much co-operation can these programmes get from the public? It's high time the authorities formulated a more effective and vigorous campaign that will eradicate the menace of dengue. If Cuba and Singapore that faced similar serious epidemics could eradicate the disease completely, surely we can do the same? What
is dengue and how does it spread ? How
the infection appears: Dengue
fever - general symptoms Dengue
Haemorrhagic Fever (DHF) Dengue
Shock Syndrome If
dengue fever is suspected............ |
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