Dengue fever

Dengue fever is a nasty business. Caused by a virus transmitted by Aedes mosquitos, most people with Dengue recover without any lasting problems. The mortality rate is around 1–5% even without treatment; however severe disease carries a mortality of 26%.

Dengue is endemic in more than 110 countries worldwide. It infects 50 to 390 million people worldwide a year, leading to half a million hospitalizations, and approximately 25,000 deaths. Considered second to malaria in importance, Dengue fever has a geographical distribution that spans the equator with 70% of the total 2.5 billion people living in endemic areas from Asia and the Pacific regions.

Dengue fever has increased in its incidence around 30-fold over the last 50 years. This increase is thought due to a combination of urbanization, population growth, increased international travel, and global warming. Global warming is thought responsible for the spread of Dengue fever to areas that were previously spared; an outbreak of Dengue fever this year in Maderia is a clear example of this.

Control measures generally focus on adequate drainage and the elimination of mosquitos and their breeding grounds. Inadequate sanitation and standing water must be eliminated.

It is something of a surprise therefore to read of claims that Experts term hospital waste source of dengue. Why should this be so?

The interpretation however is somewhat different. Claims that hospital waste is a source of dengue growth and if hospital waste is not disposed off as per Standard Operating Procedure (SOP) in both public and private sector hospitals, there is a fear that this dangerous waste may cause spread of dengue through emergence of dengue positive cases from such places may be wide of the mark.

The claim had been made by ‘experts’ while expressing their concern over poor arrangements vis-à-vis disposal of hospital waste. Of course, if hospital waste or any other waste is left to accumulate, rotting down to create a boggy mess fed by solid wastes often mixed with sewage and hospital wastewater, then a breeding ground for Aedes mosquitos will develop.

It is demanded that hospitals’ administration should take immediate steps to drain rainwater and remove heaps of garbage, since it is feared that further Dengue patients would emerge from within the hospitals – would that be a hospital-acquired infection?

It is clear that mismanagement of solid and liquid wastes from hospitals contributes significantly to the risk of Dengue fever in affected areas. However, it is far more an infrastructure problem that a hospital waste problem per se, though it might be misconstrued by this type of highly focussed report. Certainly, in these regions, in the case the Punjab, hospitals make a considerable contribution to pollution and Dengue fever is a further and most unwelcome consequence.

 

 

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