Fighting the Dengue war

Three weeks after the City District Government of Lahore declared a "dengue emergency," the epidemic is still raging with full force. In Lahore alone, over 3,500 cases of dengue have been reported, while the count in the province has crossed the 4,000 mark, as confirmed by Health Secretary Muhammad Jehanzaib Khan.
Though the statistics given by the World Health Organisation (WHO) are slightly lower at 3,270 confirmed cases in Punjab and at least 9 deaths, one thing is painfully clear: the epidemic is far from being controlled and is slowly spreading across the country. The WHO reports that 35 cases of dengue have been reported in Islamabad, 195 in Sindh, 25 in Khyber Pakhtunkhwa, and 5 in Azad Kashmir.
The unofficial figures, however, are higher as some media outlets are reporting as many as 330 patients currently being treated in Islamabad alone. The government of Punjab, the province most strongly hit by the epidemic this year, is still grappling with the sheer volume of cases and scrambling to get its act together. Holding true to the tradition of reacting to events rather than taking pre-emptive measures, the provincial government only now ordered for chemicals and anti-mosquito sprays to be imported from India. A team from Punjab is bound to leave for India to ensure the products they buy meet the standards set by the WHO.
An 11-member team of health experts has also arrived from Sri Lanka to assist the local staff on the prevention and cure of dengue fever. The team has been dispatched by the Sri Lankan President Rajapaksa after the request was made by the Punjab Government through Pakistan High Commission in Colombo. In addition to this, the government recently held an awareness campaign in Lahore where traffic wardens, inspectors, volunteers and scouts distributed pamphlets to citizens on the road.
All these measures, taken within a week or so, raise the questions about their timings. Considering Punjab has been hit by dengue every year since 2006, such awareness campaigns should have been launched months ago. Now, decisions such as shutting down all schools and colleges in Punjab for 10 days, and closing all fountains in Islamabad, is creating a sense of fear among public. Unconfirmed reports of fumigation being conducted only in high-income areas in different cities also serve to heighten this fear.
It is ironic that near the end of July, a study compiled by medical experts from AIMC/Jinnah Hospital and Royal Bournemouth Hospital, UK, had predicted a "locally acquired outbreak [of dengue fever] of a larger magnitude in the future." The research had based its claim on the discovery that the outbreak of 2010 in Punjab had seen a "new dengue virus serotype DENV-4."
It is unclear whether the Punjab's health department was aware of the new epidemiology of the virus. But the fact that its officials are admitting that the dengue mosquito seems immune to the sprays currently being administered around the province shows their lack knowledge about the locally changing face of dengue fever.
As Punjab battles with this epidemic, new cases are being reported in Sindh as well, with most of them centred in Karachi. With the recent spate of torrential rains, there are fears of an outbreak of dengue fever in the province. However, considering that many districts in Punjab, including Rajanpur and Lodhran, were hit by floods last year, but did not report a single case of dengue fever provides hope for Sindh as well. Yet it will be wise on part of the Sindh government to not wait for an outbreak before getting into top gear. The most effective measure against this disease is a preventive one, something which Punjab government should have learnt after dealing with this menace for five years.
It seems that the federal and provincial governments have finally awakened from their slumber as they agreed to the creation of a contact group in collaboration with WHO. A nationally co-ordinated strategy seems to be in the pipeline as all provincial government representatives have agreed on community involvement via "media, neighbourhoods and educational institutions" to create awareness about dengue fever. Similarly there is also talk of asking all housing societies to ensure that their basic sanitation systems are up to date. Though the government has lost precious time in its slow response to dengue epidemic, effective measures now taken can save many more people in the coming months.