DISEASE AND DISASTER

FARAZ MAHMOOD AYYAZ
(feedback@pgeconomist.com)

Jan 17 - 23, 2011

I have always thought of mosquitoes as God's wrath upon humanity. They are small, fast, deadly and they spread like forest fire. However, the most infuriatingly disastrous aspect of mosquitoes is their ability to act as vectors for some of the most fatal diseases known to man.

Recently, the mosquito's new take on destroying humanity involves a certain strain of virus known as the dengue virus. Over 3000 cases of patients with dengue fever have been reported in Pakistan. Over 25 deaths have occurred. More may yet be pending.

The dengue fever is not very characteristic in its nature but it can be easily identified within the span of a few days. It is an acute illness of sudden onset that usually follows a benign course with a combination of symptoms for example, headache, fever, exhaustion, severe muscle and joint pain, swollen glands (lymphadenopathy), and rash. The presence (the "dengue triad") of fever, rash, and headache (and other pains) is particularly characteristic of dengue. Other signs of dengue fever include bleeding gums, severe pain behind the eyes, and red palms and soles. The patients suffering from dengue fever might also experience contortions due to the severe muscle and joint pains which is why the dengue fever is also known as the "break-bone fever".

Dengue hemorrhagic fever is a harsher form of the viral illness. Dengue hemorrhagic may materialize in forms of headaches, fever, rashes, and evidence of hemorrhages in and on the body. Small red or purple blisters under the skin, bleeding in the nose or gums, black stools, or easy bruising are all possible signs of hemorrhage. This form of dengue fever can be life-threatening and can progress to the most severe form of the illness, dengue shock syndrome.

Dengue shock syndrome is the deadliest effect of the dengue hemorrhagic fever. If at any time, during the fever, the patient should suffer a circuitry collapse, his blood pressure falls dramatically and the immediate result may be death.

Dengue is prevalent throughout the tropics and subtropics. Outbreaks have occurred in the Caribbean including Puerto Rico, the U.S. Virgin Islands, Cuba, and Central America. Cases have also been imported via tourists returning from areas with widespread dengue, including Tahiti, Singapore, the South Pacific, Southeast Asia, the West Indies, India, and the Middle East (similar in distribution to the areas of the world that harbor malaria and yellow fever).

Dengue is now the leading cause of acute febrile illness in U.S. travelers returning from the Caribbean, South America, and Asia. Pakistan, being a country lying close to the tropics can be an ideal breeding ground for the dengue mosquito.

Since statistics show that nearly 40 per cent of the world's population lives in areas, which are endemic with dengue, it is imperative that preventative measures be taken in order to prevent infection and spread of dengue virus.

Since the only major route through which dengue can be spread is by mosquitoes, the only viable option in order to prevent the illness is to break the chain of transmission. To this end, patients are kept under mosquito netting until the second bout of fever is over and they are no longer contagious.

The prevention of dengue requires control or eradication of the mosquitoes carrying the virus that causes dengue. People should be urged to empty stagnant water from old tires, trashcans, and flower pots.

Governmental initiatives to decrease mosquitoes would also help to keep the disease in check albeit having been poorly effective previously. To prevent mosquito bites, long pants and long sleeves should be worn. For personal protection, mosquito repellant sprays that contain DEET should be used when visiting places where dengue is endemic. Limiting exposure to mosquitoes by avoiding stagnant water and staying indoors two hours after sunrise and before sunset would also help. The Aedes aegyptimosquito (the vector mosquito) is a daytime biter with peak periods of biting around sunrise and sunset. It may bite at any time of the day and is often hidden inside homes or other dwellings, especially in urban areas.

Currently, there is no vaccine available for dengue fever, although scientists suggest that a vaccine may be made available by 2012 as it is undergoing clinical trials and it is still too early to tell if it will be safe or effective.

The mortality rate rendered by the dengue fever is comparatively low. And, once the patient has recovered from the disease, he develops a lifelong immunity and there is very little risk of getting infected again. Nevertheless, it is a serious condition since it leaves the patient exhausted, nauseated and unbearably pained. Since there are already several hundreds of cases of dengue patients all over Pakistan, it is advisable to stay wary and keep safe.