Flood and disease

Apart from dealing with the massive loss of loved ones and property, flood survivors also have to deal with a range of health issues; one of these expected risks is mosquito-borne infections. Apocalyptic floods have caused historically significant epidemics of mosquito-borne diseases in various regions of the world. Pakistan is no different and we are already getting reports of dengue and malaria outbreaks in flood affected areas.

One reason for this increase in mosquito-borne infections in flood-affected areas is that receding flood waters can create perfect conditions for mosquitoes to breed. Like all insects, mosquitoes thrive in warm conditions. Water is also important to the life cycle of mosquitoes because they lay their eggs in and around water. More water means more mosquitoes. With this increased reproduction, affected people are at risk of contracting life-threatening mosquito-borne diseases.

Dengue virus and the plasmodium parasite (the parasite that causes malaria) cause the most common mosquito-borne infections in Pakistan. Moreover, the coronavirus is still almost present in Pakistan.

According to experts, after Covid-19, these are the five families of viruses that can cause the next pandemic: coronaviridae, flaviviridae, orthomyxoviridae, paramyxoviridae and togaviridae (alphaviruses). The concern is that one of these families is the dengue virus family (flaviviridae). In addition to dengue, viruses of this family can cause a number of diseases, including Japanese encephalitis, Zika, West Nile disease, and others. Mosquito bites can spread the viruses of all these diseases when it comes to each virus.

Aedes mosquitoes, which transmit these viruses, are widespread in most parts of Pakistan and are routinely detected through surveillance. However, some regions of the country are free from this type of mosquito. Another concern is that existing research on rainfall has focused on changes in the distribution of mosquito populations as the primary outcome, rather than the spread of human disease. Changes in the distribution of mosquito populations can have a negative impact on human health, so we need to take prompt action in these areas to prevent the spread of mosquito-borne diseases.

Here are some personal precautions that people can take to reduce the risk of being bitten by mosquitoes. The first step is to educate communities and provide flood victims with essential personal protective equipment such as mosquito repellent lotions, bed nets and full-sleeved clothing. Local administrations must organize massive clean-up operations as soon as the flood waters recede and last for weeks. There’s not much you can do to stop mosquitoes from flying into neighboring non-flooded areas, but spraying insecticide can provide some short-term protection.

The management should try to draw people’s attention to repairing, replacing or installing insect screens on windows and doors, as this can create a physical barrier to mosquitoes that want to fly inside their homes and offices. Municipal authorities should pay special attention to regular cleaning of ditches, drains and water tanks in flood-affected areas, which can become abode for mosquitoes. The government should provide insecticide-treated clothing to military and paramilitary personnel involved in rescue operations in flood-affected areas.

Climate change is expected to increase the frequency of flood events as well as the spread of mosquito-borne diseases. So what should we do in the long term for the health of people who are already facing an immediate disaster? In order to get answers to these questions, Lahore Institute of Public Health organized an international hybrid seminar in collaboration with the Punjab government on August 11 this year. International and local experts on mosquito control discussed the diseases spread by mosquitoes in Pakistan and expressed their views on the prevention of these diseases. Experts have shed light on the link between climate change and mosquitoes in particular, and vector-borne diseases in general.

The seminar’s question-and-answer session showed that we need public awareness campaigns here. It was also concluded that perhaps the main reason for not understanding the depth of the problem is ignorance. We need a large-scale health awareness campaign on this issue, among other day-to-day activities. Because mosquito-borne diseases are community diseases, and prevention of these diseases is impossible without public participation.

The burning question is: are we willing to play our part in improving our own health and the health of our families rather than looking to the government? The sadder fact is that people are unwilling to play their part until they are satisfied with the government’s actions.

The writer is an Associate Professor in the Department of Medical Entomology and Parasitology, Institute of Public Health, Lahore. He can be contacted at: uzair.mukhtar@punjab.gov.pk

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