Dengue, consult your doctor first

by Asma EDRIS

Health Officials last week pointed out that the main reason for dengue related fatalities was the failure of patients to seek immediate medical attention.

Consultant of the Government Epidemiology Unit Dr.Hasitha Tissera told the Sunday observer that it was of "utmost importance that people don't take home remedies, but seek professional medical attention".

It was very important that people go to a government hospital and get themselves examined by a qualified medical personnel and if this was not possible they must see the family doctor who was aware of the patient's background and medical history.

Speaking about the issue of people taking remedies on their own, Dr. Tissera said that a major problem was when patients decided to visit doctors with test results that they had prescribed for themselves.

"On the first day itself they get their blood tested and the disease more often than not doesn't show itself. But sometimes just as a patient comes the doctor also feels bad to prescribe another test," he said that in most instances patients had to undergo expensive blood tests which were not relevant! "What is needed is a simple test," the Consultant said emphasizing the importance of letting a qualified doctor "be the judge of the required test and the disease".

"When a doctor examines a patient he can come to certain clinical judgments" that a layman would not be able to, Dr. Tissera said adding that it was only a doctor who would be able to differentiate between "dengue, swine flu and common fever".

Speaking about the overflow of patients at government hospitals, the consultant said that there was a 200 percent increase in the number of dengue patients in the country and that "the overflow was an obvious result of the epidemic status that dengue has reached".

Though there would be minor delays at government hospitals due to this factor, the doctors and staff at these institutions "knew what to do and are very capable of handling emergencies," the doctor said emphasizing that people should not make this an issue to avoid government hospitals.

"The doctors and staff at these hospitals are capable of handling the situation. When you go to a government hospital there is a level of standards and there is responsibility. But if you go to a private institution it might not be the case". Discussing the importance of preventing the spread of mosquitoes, doctor Tissera emphasized the importance of people taking a degree of responsibility upon themselves without waiting for authorities to intervene.

"When dealing with mosquitoes a thing that we need to always keep in mind is that the transmission of disease in mosquitoes happens for about six or seven cycles. So even if you kill a mosquito its larvae would still carry the disease".

When mosquito breeding grounds are being destroyed attention needed to be paid to containers, water tanks etc. and if they are not cleaned, eggs could survive dormant for upto two years.

"If this happens and anytime within this period if water is let to the container the eggs will hatch," the doctor warned. He added that research had shown that ground level water tanks were identified as the "ideal breeding ground," for mosquitoes.

Meanwhile with the disease reaching epidemic proportions and fingers are being pointed in all directions, there has been a turn of events in the Colombo Municipality.

According to the Colombo Municipal Council's (CMC) Chief Medical Officer of Health Dr. Pradeep Kariyawasam while the number of dengue patients was rising through out the country, the Colombo Municipality has been "very successful" in its "dengue prevention program".

Speaking to the Sunday Observer Dr.Kariyawasam said that the CMC's prevention programs have led to a decline in the number of patients in the municipality areas.

"In 2004 the number of patients in the Colombo Municipal area for the month of July was as high as 300, but this year the total number of cases for this month has gone down to 180," the doctor said adding that they expect the numbers to decline further.

Dr. Kariyawasam said that because Dengue was an urban disease that had its roots in the unhealthy lifestyles of city dwellers, a larger share of the burden of eradication fell on the municipality. The CMC had carried out "constant campaigns," as well as over a hundred "shramadanas, " (community programs) especially targeted in shanty-areas.Systematic inspections were also carried out by CMC officials at private homes as well as institutions in collaboration with area police officers, where people were made aware of ways to prevent and destroy mosquito breeding grounds.

Speaking about the strict imposition of the Mosquito Breeding and Controlling Act, the doctor said that it had helped in getting people to make an effort to clean their houses and gardens.

He added that a total of 54 cases resulting in fines being instituted.As the epidemic state of mosquito-born diseases depended on the density of mosquitoes, the Municipality had also taken steps to use anti-mosquito sprays in high mosquito density areas.

"There are about 14 kinds of mosquitoes found in the Colombo area and it is not practical to differentiate between dengue carriers and others.

So we use sprays in high risk areas where the mosquito density is also high," Dr. Kariyawasam said.

Discussing challenges faced by the Colombo Municipality in preventing dengue as well as other mosquito borne diseases, the Chief Medical Officer said that the problem of dumping garbage was "an issue".

"But we haven't given up. We have made sure that all the places where garbage is collected are also frequently sprayed with anti-mosquito sprays."

Facts:

According to the Health Ministry's Epidemiology Unit web sight the number of dengue patients was 11,968 while the fatalities were 143.

Facts:

* One of the most common diseases spread by mosquitoes, dengue first appeared in the 18th century in South-East Asia. But the post 2nd world war era saw a steady increase in the spread of the disease.

* According to United Nations statistics about 500,000 people worldwide are hospitalized yearly due to dengue.

* Dengue There are two types of Dengue fever, caused by a virus carried by mosquitoes. The severe form of the disease is called Dengue haemorrhagic fever.

* Symptoms of the disease are high fever, headache, red rashes on the face-trunk and extremities, muscle and joint pain, nausea and vomiting.

* Dengue Haemorrhagic fever (DHF) - Symptoms similar to dengue fever.

-Haemorrhagic manifestations.

-Bleeding from nose, gums -Brown, black residue in vomit and faeces.

-Severe, continuous stomach pain.

-Enlargement of the lever.

* Dengue Shock Syndrome While the fever has subsided, patients might still feel ill. This might be signs of the syndrome.

* Symptoms: -coldness/paleness of body -restlessness and paleness -increase in pulse and acceleration of breathing. About the Dengue Carrier Mosquito. The disease is spread by mosquitoes belonging to the Aedes variety called Aedes albopictus and more commonly, the Aedes aegypti. As in the case of all mosquitoes only the female bite and they are active for only two hours after sunrise and two hours before. According to health officials this is a fact that most people need to be aware of. The Dengue mosquito likes dark places such as closets as well as cool and shaded areas outdoors.

* Statistics The total number of dengue patients by the 24th of June was 12,387 while the death toll has risen to 146.

Resources: The Government Epidemiology Unit Website.