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Vector-borne diseases: prevention and management

Dengue and chikungunya, the most common vector-borne diseases, are mosquito-borne viral infections common in warm, tropical climates.

A long spell of unrelenting rain flooding parts of India in late September may signal the retreat of the four-month southwest monsoon, but it also raises concerns as standing water becomes fertile ground for mosquitoes causing various vector-borne diseases.

With 50 million people affected by dengue every year, causing about 4% of deaths, according to estimates by the World Health Organization (WHO), she calls for action to minimize disease and death from dengue.

Dengue and chikungunya, the most common vector-borne diseases, are mosquito-borne viral infections common in warm, tropical climates. The infection is caused by one of four closely related dengue viruses (called serotypes) and these can cause a wide range of symptoms, some ranging from extremely mild (unnoticeable) to those that may require medical intervention and hospitalization. In severe cases, death can occur.

However, there is no cure for the infection, but the symptoms a patient experiences can be managed.

To fight the infection, here are some of the precautionary measures shared by hospital doctors that you should know.

Dr. Rajiv Dang, Senior Director and HOD – Internal Medicine and Medical Director, Max Hospital, Gurugram

Dengue fever cases are on the increase, which is probably due to the accumulation of water in certain places and the growth of Aedes mosquitoes.

Most of the cases we receive show high fever on day 1 or day 2 and most of them turn out to be dengue fever.

The first signs of dengue begin four to ten days after a mosquito bite and persist for three to seven days.

There are four dengue virus serotypes (DENV-1, DENV-2, DENV-3 and DENV-4)

The dengue virus can trigger an acute flu-like illness, but the majority of infections cause only mild illness. This can sometimes progress to severe dengue, which is attributed to the DENV-2 strain. The DENV-2 strain is considered the worst. It can cause two or more typical dengue symptoms in addition to fever and be fatal.

Although there is no cure for dengue, as a precaution, you can make changes to your home and lifestyle.

Apply mosquito repellent, even at home, wear long-sleeved shirts and pants outside, and get rid of standing water at home.

Dr Ajay Agarwal, Director and HOD, Internal Medicine, Fortis Hospital Noida

Every year during the monsoons, there is a rapid increase in dengue fever cases. There are mainly four strains of dengue virus. In Delhi, DENV 2 serotype prevailed this year.

Over the years, the case fatality rate attributed to dengue fever has dropped significantly. However, we must keep our guard against disease.

About 1 in 20 people who get sick with dengue will develop severe dengue. If you have had dengue fever in the past, you are more likely to develop severe disease.

Since the transmission vector (Aedes) lives only 15 days and can fly a limited distance of about 400 m, the distribution of the disease is closely related to the reproduction and distribution of the mosquito.

The mosquito lays its eggs on moist surfaces just above the waterline. It breeds in water collected in container, coconut shells, flower pots, water coolers, etc. Thus, people should try to avoid even a small amount of standing water in their immediate vicinity. Using insect repellent outdoors and wearing long-sleeved clothing can be additional ways to prevent a mosquito bite.

Dengue fever symptoms include high fever, headache, rash, and muscle and joint pain.

Dr. Niranjan Patil, AVP Scientific Business Head – Infectious Diseases, Microbiology; Molecular Biology – Biosafety Manager, Metropolis Healthcare

Dengue fever is known to be caused by 4 distinct types of dengue virus – Den 1, Den 2, Den 3 and Den 4.

Currently, it is caused by the co-circulation of the 4 types of dengue virus. But increased severity is usually seen with the Den-2 type strain. Besides increased virulence, Den 2 can also manifest as high fever, joint pain, vomiting, sensory impairment, and bleeding complications leading to circulatory shock and death in a few cases.

Irregular weather conditions such as increase in ambient temperature as part of global warming, increased rainfall and seasonal changes contribute to an increase in mosquito population.

The practice of storing fresh water should be followed; construction sites are also important breeding sites for mosquitoes.

Most dengue cases are underreported and more than 80% of cases are asymptomatic.

However, prevention is better than cure, and we should start eliminating mosquito breeding sites such as fresh water accumulated in any form, such as lakes, ponds, water reservoirs, pots of mud, buckets, flower pots, cisterns, discarded tires or containers, water from above. tanks, etc. These must be emptied periodically.

Since dengue mosquitoes are daytime biters, it is advisable to wear protective clothing with long sleeves when outdoors. Using mosquito repellent and bed nets will help when you are indoors.

Nowadays even dengue fever vaccine is also available in India and can be used in selected people who have already been infected with dengue fever at least once. You can consult your doctor for more information about the vaccine.

Dr Neeti Pravesh, Consultant – Internal Medicine, Max Super Specialty Hospital, Shalimar Bagh, New Delhi

This year the monsoon has brought about the ‘Dengue fever health crisis’ attributed to the ‘virulent DENV-2’ strain in states like Delhi, UP, Bihar, Tamil Nadu and Maharashtra are witnessing an outbreak of dengue fever

The most prevalent DENV-2 strain this year is characterized by the early onset of severe symptoms.

For prevention, get children vaccinated between the ages of 9 and 16 with lab-confirmed cases of preventive dengue infection in areas where dengue is endemic, wear covered clothing, use insect repellent and mosquito nets, and eliminate standing water

Also, as part of the treatment, stay hydrated, get plenty of rest and take painkillers such as paracetamol, non-steroidal anti-inflammatory drugs should be avoided, they may increase the risk of internal bleeding.

Dr. Amol Jaybhaye, Consultant (Pediatric Infectious Diseases and Immunology) SRCC Children’s Hospital, managed by Narayana Health

Dengue fever is caused by a virus from the Flaviviridae family and there are four distinct ones. The fifth DENV-5 variant was isolated in October 2013. This serotype follows the sylvatic cycle while the other four serotypes follow the human cycle. Genetic recombination, natural selection and genetic bottleneck are some of the causes for the emergence of the new serotype. Currently, in India, there is no indication of the presence of DENV-5.

Prevent mosquitoes from accessing nesting habitats through environmental management by removing artificial man-made habitats that may retain water;

Use protective measures, such as mosquito nets and repellents.

Dr Santosh Kumar Agrawal Senior Consultant Internal Medicine Marengo QRG Hospital Faridabad

In the case of dengue, there are a few aspects of prevention.

The first is source reduction, which means finding potential mosquito breeding sites like outdoor or indoor water storage tanks.

In these storage containers, fresh water should be refilled at least once a week after cleaning the interior.

The second is the outdoor and indoor use of insecticidal sprays. The next preventive aspect is the use of mosquito repellent creams or sprays.

During outdoor activities, wear shoes, a long-sleeved shirt, and full pants/trousers

Dr Trupti Gilada, Infectious Disease Specialist, Masina Hospital

Dengue has four strains and there is no evidence of a new dengue strain emerging since the last strain we saw in the past two years.

The prevention protocols for all malaria and all mosquito-borne diseases remain at different levels, which include the government level and the policy level, which includes the prevention of mosquito breeding areas.

This is the hardest to tackle. So on an individual level, it is important to take care to prevent mosquito breeding areas in and around the house. Keep your windows closed at dusk and dawn to prevent mosquitoes from entering the house, by wearing long clothes, especially when children are playing in the evening and the use of mosquito repellents is key.