Sri Lanka records over 6,000 dengue cases in first three weeks of January
ECONOMYNEXT – Sri Lanka recorded over than 6,000 dengue cases in the first three weeks of January 2023 after a spell of heavy monsoon rain though a drop in cases is likely from February, officials said.
Health officials identified 6,204 dengue patients by January 22, up from 5,793 recorded in the corresponding period last year.
“A rise in cases can be observed in the November-January period with the heavy rain due to the northeast monsoon,” an official from the National Dengue Control Unit told EconomyNext.
Of all reported cases, 46.3 percent were from the Western Province, official reports showed.
Akuressa, Batticaloa, Eravur, Trincomalee, Madampe, Badulla, Eheliyagoda, Kegalle, Kalmunai North and Alayadivembu MOH areas were identified as high-risk areas for dengue during the third week of January by the health officials.
“We are expecting a decline in dengue cases soon. The Western province is always in the top position with the highest number of dengue cases. Apart from that, we are seeing a higher number of cases during this period in areas like Puttalam, Jaffna districts. A certain number of cases have also been recorded in the Kandy district,” the official said.
“Usually the cases peak in December, but they decline by February. This year, too, we are facing this scenario. There is an increase of dengue during the months of November, December and January”.
Due to the economic situation in the country, the Public Health Inspectors (PHIs) in an earlier report said, diesel and pesticides are not being provided by the ministry.
However, rejecting the allegation, the official from the NDCU said the government has provided enough funds for get the necessary pesticides but it is being used according to a scientific method to avoid building a resistance in the dengue mosquito.
“The recommendation is to do the fogging if there is a dengue outbreak or if there are few patients reported from the same locality.
“If you use this pesticide haphazardly, the mosquitos will develop resistance against it,” the official said, adding that there are adequate stocks of the chemical available. (Colombo/ Jan 31/2023)
Source:https://economynext.com
Dengue Fever Symptoms
According to data from epidemiology unit of Sri Lanka, the number of total cases recorded for year 2009 is 32713. Most affected district was Kandy. Colombo, Gampaha and Kaluthara districts which have been susceptible in the past have also recorded a high rate of infection and deaths.
- Incubation period is 2-7 days.
- All haemorrhagic fever syndromes begin with abrupt onset of fever (39.5–41ºC) and myalgia.
- Fever is often biphasic with two peaks.
- Fever is associated with frontal or retro-orbital headache lasting 1–7 days, accompanied by generalised macular, blanching rash.
- Initial rash usually fades after 1–2 days.
- Symptoms regress for a day or two then rash reappears in maculopapular, morbilliform pattern, sparing palms and soles of feet. Fever recurs but not as high. There may be desquamation.
- DF cases experience severe bony and myalgic pain in legs, joints and lower back which may last for weeks (hence breakbone fever).
- Nausea, vomiting, cutaneous hyperaesthesia, taste disturbance and anorexia are common.
- Abdominal pain may occur and if severe suggests DHF pattern.The signs of dengue fever/ Dengue haemorrhagic fever are- High fever, rash, hypotension and narrow pulse pressure, poor capillary refill.
- There may be hepatomegaly and lymphadenopathy.
- A tourniquet placed on an arm may induce petechiae in early DHF cases. DHF sufferers exhibit a bleeding tendency as evidenced by petechiae, purpura, epistaxis, gum bleeding, GI haemorrhage and menorrhagia. There may be pleural effusion, ascites and pericarditis due to plasma leakage.
- Petechiae are best visualised in the axillae.
- Flushing of head and neck.
- Tender muscles on palpation.
- Periorbital oedema and proteinuria may be present.
- Maculopathy and retinal haemorrhages may also occur.
- DSS pattern cases progress through DHF until profound shock due to severe hypotension is present.
- CNS involvement e.g. encephalopathy, coma, convulsions.
- Hepatic failure: Means failure of the liver
- Encephalopathy: Means damage to the brain causing fits, loss of consciousness and confusion- Myocarditis – Inflamation of heart muscles
- Disseminated intravascular coagulation - Damage to blood vessels and blood cells causing problematic bleeding and clottingDengue can cause death
- Infection may be confirmed by isolation of virus in serum and detection of IgM and IgG antibodies for Dengue by ELISA, monoclonal antibody or haemagglutination
- Molecular diagnostic methods such as reverse-transcriptase-PCR are increasingly being used.
- Chest X-ray may show pleural effusion.
- Nutritious diet and lot of liquids, But avoid red and brown foods and drinks like coffee, chocolate, grapes etc as it may misinterpret vomiting as blood stained vomitus.
- Fever control with paracetamol, tepid sponging and fans. Aspirin should be avoided.
- Need to seek advice from a qualified medical practitioner if fever lasts for more than 2 days
- Hospital managemnt includes intravenous fluid resuscitation with close monitoring. Haemorrhage and shock will require Fresh Frozen Plasma, platelets and blood. Intensive management with inotropes of the shock syndrome may be required in severe DHF/DSS cases.
- Anti-mosquito public health measures such as reducing breeding sites ( flower pots, fish tanks,tires, coconut shells, tins, water collecting plants, gutters which can collect water) and good sewage management
- Insecticides to destroy the larvae
- Mosquito nets can be used during day time as the Aedes mosquitoes is day-biting.
- Mosquita repellents
- There is a bacteria called Bacillus thuringiensis which destroy the mosquito larvea