Vector-borne diseases: prevention and management

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

The long uninterrupted rain that inundated parts of India in late September may signal the retreat of the four-month-old Southwest Monsoon, but the stagnant water is a concern as it becomes a breeding ground for mosquitoes that carry various vector-borne diseases.

The World Health Organization (WHO) estimates that 50 million people are affected by dengue every year and that it causes about 4% of deaths, which calls for measures to minimize dengue morbidity and mortality.

Dengue and chikungunya are mosquito-borne viral infections common in warm, tropical climates, where vector-borne diseases are most prevalent. The infection is caused by any of four closely related dengue viruses (called serotypes), and these can cause a wide range of symptoms, including those that are quite mild (invisible) to those that may require medical intervention and hospitalization. Fatalities may occur in severe cases.

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

To fight infection, here are some precautions shared by doctors across hospitals that you should know.

Dr Rajiv Dang, CEO & HOD – Internal Medicine & Medical Director, Max Hospital, Gurugram

Dengue outbreaks are on the rise, due to water logging and the proliferation of Aedes mosquitoes.

Most of the cases we get are with high grade fever on day 1 or 2 and most of them turn out to be dengue.

The first symptoms of dengue fever begin four to ten days after a mosquito bite and last for three to seven days.

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

Dengue virus can cause a severe flu-like illness, but most infections cause only mild illness. This can sometimes develop into severe dengue caused by the DENV-2 strain. The DENV-2 strain is considered the worst. It can result in two or more typical dengue infection symptoms in addition to fever and can be fatal.

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

Apply mosquito repellent at home, wear long-sleeved shirts and pants outdoors, and avoid stagnant water at home.

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

Every year during the monsoons, we see a rapid increase in dengue cases. There are four main types of dengue virus. DENV serotype 2 is prevalent in Delhi this year.

Over the years, the death rate due to dengue has decreased significantly. However, we must be careful about the disease.

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

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

Mosquitoes lay their eggs on wet surfaces above the water line. It can be found in bottled water, coconut shells, flower pots, water coolers, etc. multiply in it. Therefore, people should try to avoid even small amounts of stagnant water nearby. Using insect repellent and wearing full-sleeved clothing when outdoors can be additional ways to prevent mosquito bites.

Symptoms of dengue include high fever, headache, rash, muscle and joint pain.

Dr Niranjan Patil, AVP Scientific Business Head – Infectious Diseases, Microbiology; Molecular Biology – Chief Biosafety Specialist at Metropolis Healthcare

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

Currently, all 4 Dengue virus species co-circulate. But increased severity is usually observed with Den-2 type strain. In addition to increased virulence, Den 2 can also manifest as high-grade fever, arthralgia, vomiting, altered sensorium, and, in some cases, bleeding complications leading to circulatory shock and death.

As part of global warming, erratic weather conditions such as rising ambient temperatures, increased rainfall, and seasonal changes contribute to increased mosquito populations.

Fresh water storage practices should be followed; construction sites are also important breeding grounds for mosquitoes.

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

However, prevention is better than cure and we need to start eliminating mosquito breeding places such as lakes, ponds, water tanks, mud pots, buckets, flower pots, cisterns, discarded tires or containers, any form of collected fresh water such as top water. tanks etc. These should be emptied periodically.

As the mosquitoes that cause dengue are day-biters, it is advisable to wear protective full-sleeved clothing when outdoors. When you are at home, using mosquito repellents and bed nets will help.

Nowadays, even the Dengue vaccine is available in India and can be used in selected individuals who have had dengue fever at least once before. 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 with it a ‘Dengue Health Crisis’ attributed to the ‘defective DENV-2’ strain which has witnessed outbreaks of Dengue fever in states like Delhi, UP, Bihar, Tamil Nadu and Maharashtra.

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

Vaccinate children for prevention In dengue-endemic areas, with laboratory-confirmed cases of prophylactic dengue 9-16 years of age, wear covered clothing, use mosquito repellents and nets, and clean standing water

Also as part of treatment keep yourself hydrated, get plenty of rest and take pain relievers such as paracetamol, and avoid non-steroidal anti-inflammatory drugs, which can increase the risk of internal bleeding.

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

Dengue is caused by a virus of the Flaviviridae family and there are four different ones. A fifth variant, DENV-5, 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 reasons for the emergence of a new serotype. Currently, there is no indication of the presence of DENV-5 in India.

Stop mosquitoes from entering egg-laying habitats through environmental management by removing man-made habitats that can hold water;

Use protective equipment such as window screens and repellants.

Dr. Santosh Kumar Agrawal Sr. Consultant Internal Medicine Marengo QRG Hospital Faridabad

In the case of dengue, there are several aspects of prevention.

The first is source reduction, which means finding potential mosquito breeding sites, such as outdoor or indoor water bodies.

Fresh water in these storage containers should be refilled after cleaning at least once a week.

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

Wear shoes, full-sleeved shirt and full pants/trousers during outdoor activities

Dr Trupi Gilada, Infectious Disease Specialist at Masina Hospital

There are four strains of dengue and there is no evidence of a newer strain of dengue since the last strain we have seen in the last two years.

Prevention protocols for all malaria and all mosquito-borne diseases remain at various levels, including the government level and the policy level involving the prevention of mosquito breeding sites.

This is the hardest to deal with. So, on an individual level, it is important to take care to prevent mosquito breeding in and around the house. To prevent mosquitoes from entering the house, keep your windows closed at night and in the morning, wear long clothes, especially when children go out to play in the evening, and use mosquito repellent.

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