Dengue Fever Issue---a cause for concern

Dengue not just a health issue: official
By Nasir Iqbal, DAWN

ISLAMABAD, Oct 24: Feeling the heat of dengue fever, the health ministry on Tuesday said vector control was the only solution to check the outbreak of dengue fever in some parts of the country for which the role of municipal administrations became pivotal.

“Dengue fever is not a health issue alone and also related to our environment,” federal secretary, health, Anwar Mehmood told reporters at the health ministry.

The role of municipal administration becomes all the more important since fumigation, fogging and removal of solid waste from the cities was their job, the secretary said.

World Health Organisation (WHO) representative Dr Khalif Bile also endorsed the health secretary’s point of view saying proper case management, vector control by involving municipal administrations, social mobilisation and education among the people could create a big difference in controlling the disease.

WHO, he said, was closely working with the ministry for effective case management of the dengue fever and to develop human resource for containing the disease.

“We expect that all the municipal departments would play a proactive role in helping us by doing proper garbage disposal and giving proper treatment to water storage tanks,” the secretary said.

The secretary also denied that a dengue patient had died in a Rawalpindi hospital on Monday, saying the mosquito-borne viral infection was not the cause of the 14-year-old girl’s death.

Dr Nilofer Ansari, Acting Medical Superintendent of the Cantonment General Hospital (DGH) said Mehreen was brought to the hospital from Pindi Gheb with ‘Septic Shock’ (a different kind of infection) and not with dengue.

About the growing number of suspected cases, Anwar Mehmood said, the people were coming in a large number in the hospitals because of better awareness created by the media.

“The current spike, though much severe, is the continuation of the November last year’s outbreak of dengue fever in Karachi. However, the fatality rate remained contained around a little over 2 per cent which is also dropping to 1.86 per cent due to better case management by hospitals”, he said. It will subside as the winter sets in, he added. During the first spike in 2005, the fatality rate was seven per cent.

Out of a total of 81 blood samples in Rawalpindi and Islamabad over the last three weeks, 34 samples, including three of the Shifa International Hospital, have been confirmed.

As regards to Karachi, a total of 1,392 patients with symptoms of dengue disease were admitted to different hospitals in Karachi since October 2. Of these 455 were found to be positive for the virus. 25 deaths have been reported so far from the infection in Karachi.

In addition three cases have also been confirmed in Khushab and Chakwal each, four in Kotli (Azad Kashmir) and one in Peshawar.END


Steps taken to check dengue fever: Aziz
DAWN report

ISLAMABAD, Oct 24: Prime Minister Shaukat Aziz said on Tuesday the government would check the spread of dengue fever and there was no shortage of testing kits or other required facilities to deal with the situation.

“Special treatment units have been established at all the hospitals across the country, with hospitals in major cities put on high alert and there is no problem of medical or paramedical staff despite Eid holidays,” the prime minister told journalists during a visit to Pakistan Institute of Medical Sciences (Pims).

The prime minister inquired after Dengue patients as well as the under-treatment children and distributed Eid gifts among them.

He said there were four dengue patients being treated at Pims, adding that some others had been discharged after effective treatment.

The government, he said, had ensured the availability of testing kits in Karachi, Lahore, Rawalpindi, Islamabad and other major cities.

Answering a question, Mr Aziz said the government was taking all out measures, including the use of anti-mosquito sprays, to contain the disease.—APP

KARACHI: Number of VHF cases on the rise
By Mukhtar Alam, DAWN

KARACHI, Oct 24: With more than 50 cases of the viral haemorrhagic fever (VHF) reporting every day at a few major hospitals of the city alone every day, the disease is taking the shape of an epidemic that has struck both slums and posh areas equally.

The number of such cases reporting at big public and private hospitals, as well as small clinics and other health care centres, is on the increase. The Sindh health department’s Dengue Fever Cell recorded arrival of 55 fresh cases at nine government and private hospitals during the past 24 hours ending at 2pm Tuesday.

Of the 1,392 suspected VHF patients admitted to various hospitals since June 2006, 431 have already been declared dengue-positive cases, bringing the percentage of these patients from among the total VHF patients to 30.96 by Tuesday.

This percentage is on a higher side at the private hospitals where normally a patient from a well-off family is admitted. The Aga Khan University Hospital said that it had 21 in-house VHF/dengue patients, 11 of them having been tested dengue positive and the remaining ones negative.

According to the Dengue Information and Surveillance Cell, of the 353 patients admitted to the AKUH over a period of four months, 100 have been tested dengue positive. At another private facility, the Liaquat National Hospital, the tally of dengue positive cases has reached 130. The Ziauddin Hospital has 52 and the Bismillah Taqi Hospital 45 dengue positive cases at present.

A total of 22 people have died from the VHF since its outbreak. The diseases, including dengue, have claimed three lives in the interior of Sindh whereas four patients with the symptoms linked to the dengue fever are admitted to two hospitals, one in Sukkur and the other in Larkana. Three patients have been tested dengue positive, said an official of the Cell.

Meanwhile, patients with suspected VHF were brought to various hospitals from Defence, Clifton, PECHS, Bahadurabad, Liaquatabad, F B Area, Korangi, Landhi, North Karachi, New Karachi, North Nazimabad, Orangi, Nazimabad, Baldia, Golimar, Gulistan-i-Jauhar, Garden, Saddar, Gulshan-i-Iqbal, Shah Faisal and Malir.

According to the Dengue Fever Cell, 160 patients are under treatment at 12 hospitals while 47 have since been discharged during the past 24 hours.

The number of in-house patient as of Tuesday was as follows: AKUH: 21 (12 new), LNH: 38 (11 new), CHK: seven (two new), Ziauddin Hospital: 28 (10 new), JPMC: 30(eight new), Bismillah Taqi Hospital: five (four new), Hamid Hospital: one (no new), NICH: seven (four new), Abbasi Shaheed Hospital: 14 (two new), Baqai Hospital: five(two new), Star Gate Hospital Malir: three (no new) and Afroze Medical Centre: one (no new).

Experts have once again urged the government to scan all those areas which have been providing breeding grounds to the Aedes Aegypti, the mosquito class responsible for the dengue infliction and spread.

In another development, the Ziauddin University Hospital has decided to perform dengue IGM test at its North Nazimabad, Clifton and Keamari campuses at a reduced rate of Rs600 in line with the directive by Sindh Governor Dr Ishratul Ibad and Minister for Health Syed Sardar Ahmed, said a press release of the hospital.END

Dengue Fever Kills 23 in Pakistan
Yahoo News Story

Twenty-three people have died and more than 1,000 been infected in a month-long outbreak of dengue fever, Pakistan health chiefs have said.

The latest casualties were an 11-year-old boy and a girl of eight who died of the mosquito-borne virus in a children's hospital in the southern port city of Karachi earlier this week, the government of Sindh province said Thursday.

"The death toll is now 23, with 20 in Karachi, while over 1,000 cases have been reported so far in Sindh province this a month," provincial spokesman Salahuddin Haider told AFP.

"It's deadly and has hit Karachi badly with hospitals full of dengue fever patients, but the government has provided machines to carry out a massive spray in the city," Haider said.

Authorities in the capital Islamabad and nearby Rawalpindi have also issued public advice for preventing the spread of the female Aedes mosquitos that carry the virus.

In neighbouring India, the death toll from a dengue outbreak rose to 107 on Wednesday. END

Dengue Deaths Put Pakistanis on Alert
by Reuters by way of the New York Times

KARACHI, Pakistan, Oct. 14 (Reuters) — Dengue fever has killed at least 17 people in Pakistan’s biggest city, Karachi, in the past four months, five of them since the beginning of October, health officials said Saturday.

A high alert has been declared in the city’s hospitals after about 250 people tested positive for the disease, they said.

“We have had 17 reported deaths from the virus in various hospitals,” said Abdul Majid, a health official in the southern province of Sindh, which includes Karachi.

“It is not a panic-like situation, but yes, in the last few weeks cases have been increasing on a daily basis,” he said.

Indian health authorities have been battling dengue too, reporting nearly 4,900 cases, including 94 deaths, in recent weeks.

But Saturday’s announcement in Pakistan was the first that dengue was raging there as well. Opposition politicians, some aid workers and the news media have criticized the city government for not anticipating the disease after the rainy season and for not carrying out proper fumigation drives.

Dengue is a disease of the tropics and is carried by the Aedes mosquito, which bites during the day. The mosquitoes usually breed in trapped rainwater. END

About Dengue Courtesy of the CDC

Dengue (DF) and dengue hemorrhagic fever (DHF) are caused by one of four closely related, but antigenically distinct, virus serotypes (DEN-1, DEN-2, DEN-3, and DEN-4), of the genus Flavivirus. Infection with one of these serotypes provides immunity to only that serotype for life, so persons living in a dengue-endemic area can have more than one dengue infection during their lifetime. DF and DHF are primarily diseases of tropical and sub tropical areas, and the four different dengue serotypes are maintained in a cycle that involves humans and the Aedes mosquito. However, Aedes aegypti, a domestic, day-biting mosquito that prefers to feed on humans, is the most common Aedes species. Infections produce a spectrum of clinical illness ranging from a nonspecific viral syndrome to severe and fatal hemorrhagic disease. Important risk factors for DHF include the strain of the infecting virus, as well as the age, and especially the prior dengue infection history of the patient. click to learn more

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