Killer dengue, with more infectious and more fatal strains, is creeping along snuffing out unsuspecting lives while the Government is hopelessly staring in the face of 100,000-plus infections, although the Health Ministry reported 90,865 cases. The next peak season, from October onwards, is also fast approaching. News about the dengue crisis is also spreading in [...]


No deadly blow in sight against ravages of killer dengue

Says Colombo garbage cleaning up op now going smoothly; but public support needed for recycling efforts

Killer dengue, with more infectious and more fatal strains, is creeping along snuffing out unsuspecting lives while the Government is hopelessly staring in the face of 100,000-plus infections, although the Health Ministry reported 90,865 cases.
The next peak season, from October onwards, is also fast approaching.

News about the dengue crisis is also spreading in world capitals including London, where travellers are being warned. The UK Foreign Office posted its latest update on July 6. Australia warns it citizens of outbreaks in all regions of Sri Lanka.
Hong Kong, the city closest to the biggest source of Sri Lanka’s tourists, China, has reported the dangers in prime time local news bulletins. This came as Sri Lankan Airlines began non-stop Hong Kong-Colombo flights on Saturday.
Locally, health officials now say containers that collect water are potential breeding sites for the dengue mosquito. Various factors have been blamed.

Vatican Radio reports that Cardinal Malcolm Ranjith has asked Catholics to pray and fast from Saturday to July 23. He has asked Catholics to hold a novena dedicated to Saint Sebastian, protector against the plague.

The regional director of health services in Jaffna, Dr Nanthakumar told the Sunday Times that until yesterday there were 104 cases and this year there have been 2,800 confirmed dengue cases. Teaching hospitals report at least 10 dengue cases per day and base hospitals report only one to two patients a day.

He said only a third of the cases are from Jaffna. The remainder is from other districts. Vigilance is necessary in Jaffna where there is a drought. Rain expected the next few months could trigger an outbreak of dengue.

“It is not necessary to conclude that dengue only occurs during the rainy season. Houses are still able to create dengue breeding places through improper disposal of water retention containers,’’ he said.

Meanwhile, the regional epidemiologist of the RDHS Batticaloa, Dr Dharshini Murugupillai, said outbreaks have not been reported in the area and for the past three weeks and fewer than 50 cases a week were recorded. Teaching Hospitals report three to five patients a day and the base hospital reports one case a day and just one sometimes.

The Batticaloa District faced a severe outbreak in March and April. “In the Eastern Province, generally 50% of the dengue cases are caused by containers that retain water and the remaining 50% is caused by unprotected wells. However, 90% of the wells and tanks are now protected and the only issue at present are the containers that are potential breeding grounds for dengue mosquitoes,’’ she said.

Dr Murugupillai said there had been intermittent showers in Batticaloa, when usually this is a period of drought. She suspects the rain is a contributing factor in the dengue spread.

“Cases tend to rise in October and November with the rain. So if we regularly collect containers and protect the wells, there is a possibility of reducing the number of cases,’’ she said. There are breeding sites in the area, she added.

The Kurunegala District has reported 5,592 dengue cases this year and there have been six deaths, said the regional director of health services in Kurunegala, Dr Champa Aluthweera.

She told the Sunday Times that hospitals are overcrowded.

There is a mandatory cleaning program every Friday.

Dr Aluthweera said there are some high risk areas and cases are still on the rise.

The spokesperson of the provincial director of health services of Sabaragamuwa emphasised that cases in Ratnapura are sill rising and cleaning activities are continuing regardless of the lack of labor.

“Now we are getting the support of local governments. They have started addressing issues and providing solutions,’’ he added.

He said that under the Breteau Index, a number of containers with mosquito larvae per 100 houses has to be below 5% which is indicated as a safe limit. “However out of the 275 houses inspected in Kuruwita, half of the houses were 25% positive according to the Breteau index.’’

The Breteau Index is one of many tools used to track the dengue carrying mosquito.

He said 70% of the dengue cases are caused by water retention containers.

Dr U I Ratnayake the regional director of health services of Kalutara said there were 4,107 dengue cases so far. Panadura reported 1,442 and Horana reported 505 cases.

“There are many prevention programmes in the district. Houses, institutions and schools are inspected,’’ he said.
Based on surveillance reports, the Medical officer of Health visits houses and conducts fogging covering an area of 10 metres from the site, he said.

Also, a waste management campaign, ’Parisara Pola’ by the Divisional Secretariat and the local government authority in the Kalutara District, draws recyclers. People can sell recyclable materials at this market held once in two weeks.
Dr G Wijesuriya, the provincial director of health services of the south, said dengue in the old Hambantota and the Galle town areas is under control.

However, dengue is increasing in Balapitiya, Ambalangoda, Hikkaduwa, Matara town, Dewundara, and Dikwella. This year 2,600 cases and 12 deaths were reported in the Galle District, 1,600 cases and six deaths were reported in Matara and 800 cases were reported in Hambantota which reported two deaths so far.

Dr Wijesuriya said cleaning was carried out in high risk areas every day.

WHO’s dengue report recommends vector control programmes as priority


The World Health Organisation (WHO) has handed over to the Health Ministry a report compiled with the aim of providing technical assistance to the Government to address the dengue outbreak.

The report was compiled following the feedback from two dengue experts from Thailand who trained clinicians here on case management. The WHO South-East Asia Regional Office also sent an epidemiologist and an entomologist to Sri Lanka.
The report recommends that vector control programmes should be given priority to reduce potential mosquito breeding places in areas affected by dengue, while it notes the meassures taken by the Health Ministry to cope with the rising number of cases.

“The Health Ministry has placed the triage protocol in place that was updated in June to cope with the outbreak. And temporary wards have been put up in hospitals to cope with the crowd and manage the distribution of patients,” the report says.

(Triage is the process of determining the priority of patients’ treatments based on the severity of their condition. This rations patient treatment efficiently when resources are insufficient for all to be treated immediately.)
According to the report, some 600,000 people have been affected in 15 districts by the latest dengue outbreak to hit Sri Lanka following the recent heavy rains, flooding and landslides.

After heavy rains, more dengue cases are reported from urban and suburban areas than from rural areas, the report notes, identifying standing water and uncleared waste dumps, among others, as potential breeding grounds for mosquito larvae.
The WHO has also handed over 50 fogging machines to the Government.



The director of the National Dengue Control Unit, Dr Hasitha Tissera, told the media on Friday that the bacillus thuringiensis israelensis bacteria would be a temporary measure to try to eradicate mosquito larvae. And he said it was not practical to introduce the bacteria to every house, institution or school, without inspecting breeding places.

“But the bacteria can be used in places places like construction sites and gutters in houses,’’ he said. Dr Tissera pointed out that the lifecycle of the dengue vector, the Aedes Aegypti mosquito is completed within a week whereas the mosquito with the wolbachia bacteria takes 90 days to complete its lifecycle. For this reason, the elimination of mosquito breeding sites is being encouraged.

Dr. Tissera urged the people to use mosquito repellents like Citronella Oil to prevent mosquito bites. He said it was recommended to use natural forms of repellents on children in the 2-5 age group.

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