The mosquito-borne disease, once largely confined to Dhaka, is spreading across the country as climate fuels quintuple in cases in a year, and the actual numbers are likely several times higher.
All through Fabeha Monir for WHO
In a small, dimly lit control room at the Directorate General of Health Services (DGHS) in Dhaka, information about the dengue outbreak in Bangladesh appears on several computer screens. Government analysts have been busy collecting and tracking the effects of the disease across the country since the first cases were reported last April.
In 2023, the total number of dengue cases reported was 321,179, with 1,705 deaths recorded, a large increase from last year, when 62,000 more people contracted the virus and 281 died from it. This is the number of annual deaths from the mosquito-borne disease ever recorded in Bangladesh.
Last year’s deaths affected at least 113 young people. According to Save the Children, most of those deaths occurred among children under the age of 10, with 38 deaths among those under the age of five.
“Children account for about 30% of all dengue cases in Bangladesh and are vulnerable to the virus due to their underdeveloped immune systems,” says Dr. Shamim Jahan, Save the Children’s country director in Bangladesh. “Children under the age of five are at risk for severe symptoms, such as dehydration and shock. “
In months, emerging cases have pushed Bangladesh’s fitness formula to the limit, with hospital corridors saturated with patients and wards without beds.
“It’s been the deadliest outbreak of dengue the country has ever seen,” says Dr Mohammad Shafiul Alam, a scientist at the ICDDR,B health research centre in Dhaka.
The higher number of deaths continued into the new year. As of Wednesday, the outbreak had affected another 756 people so far this month, leading to 10 deaths, up from 424 cases and three deaths in the same period last year.
However, official figures may not give a real indication of the scale of the epidemic. “It is very likely that these announced figures underestimate the true burden,” says Alam. “Many fitness facilities in Bangladesh operate beyond the framework of reporting. This underscores the likelihood that the actual numbers are several times higher. “
Dengue cases have been on the rise especially around the world, with 70% of them occurring in Asia. Globally, the World Health Organization (WHO) estimates that 3. 9 billion people (part of the world’s population) are at risk of infection. Half a million cases were reported in 2000, up from 4. 2 million in 2022, an eight-fold increase.
The increasing frequency of extreme weather events is fueling the spread of the disease in new places and extending dengue seasons in countries where the disease is already present.
In Bangladesh, unusually high rainfall, combined with hotter temperatures and high humidity, has resulted in an increased mosquito population throughout the country. “Climate change is the critical link to the increase in numbers that we’re seeing,” says Alam.
In Mirpur, a district northeast of Dhaka, Masuma Begum cares for her nine-month-old daughter Sohana, who has contracted dengue fever and sleeps under a ventilator. “He doesn’t have the strength to get up and play anymore,” Begum says. “It’s been over 4 weeks and he’s still getting better. “
Outside your home, an open drain and overgrown yard create an ideal breeding ground for mosquitoes.
“We can’t admit her to the hospital, so I’ve done everything I can to protect her at home,” says an exhausted Begum, who hasn’t left her daughter’s appearance since she fell ill. “I’ve used mosquito repellent and mosquito repellent to keep leeches away, but they still manage to go unnoticed. “
Bangladesh has experienced frequent outbreaks of dengue fever over the past two decades. Still, the recent outbreak has been surprising: Not only has a build-up of cases begun beyond the usual (cases typically begin between the June to October monsoons), but the disease has also spread beyond its concentration in Dhaka and Chattogram (or Chittagong, as the term suggests).
“In 2022, the city of Dhaka accounted for 63% of cases, while in 2023, 66% were reported outside Dhaka,” says Alam. “Now dengue is being reported in all 64 districts of the country. “
In response, the DGHS has repurposed six hospitals in Dhaka allocated to Covid-19 patients to control the dengue outbreak and increased the supply of intravenous saline and other medicines across the country.
For many urban poor in Bangladesh, dengue fever places a greater burden on their households.
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Sumon Miah, 28, has spent most of the past few weeks recovering under a flimsy mosquito net. After contracting dengue, he was unable to work and was fired from his job at a facility. “I couldn’t take days off, but my health was too bad to go,” Miah says. “After 10 days, they let me go. “
His wife, Kolpona, a cleaner, had to work around the house to take care of him and their two-year-old son, but she too lost her job.
“I don’t know how we’re going to deal with it,” Miah sighs. We have no savings and with the money spent on medicines, there is not enough left to pay for food and rent. The tension worsens Miah’s already poor health.
Miah likely contracted the virus at work. The puddles of drinking water discovered in the structures are an ideal breeding ground for Aedes mosquitoes, the main vector (or transmitter) of dengue in Bangladesh.
Last July, Dhaka municipalities began fining owners of structures that allowed mosquitoes to proliferate on their premises. The local government minister warned that structure paintings would stop if dengue larvae were discovered for the third time at the site of a structure.
Challenges are likely to persist this year. Experts warn that more needs to be done against mosquitoes and giant outbreaks must be avoided.
“Bangladesh has good enough policies to treat dengue patients,” says Alam. “However, there is a pressing need to increase investment to strengthen fitness infrastructure, especially at the sub-district level.
He added that no vaccine has yet been shown to be effective against all four variants of the dengue virus, so it is imperative to how the virus spreads. “All four have been recorded in Bangladesh at other times since 2000. “he says.
Referring to reports of success in releasing Aedes aegypti mosquitoes inflamed with a bacteria that prevents their eggs from hatching, Alam says: “Implementing national-level built-in vector control is crucial, while exploring cutting-edge approaches such as the release of Wolbachia -Inflamed Aedes mosquitoes will also be considered. . »
At the Jurain cemetery, Mohammad Ismam prays at a new grave. She mourns her aunt, who died of dengue. ” She’s very pregnant and she’s going to be born any day,” says Ismam.
“His sudden death came as a surprise to our entire family. Before she contracted the virus, she was perfectly healthy.
Ismam, who works in a small shop in the old Dhaka, laments the lack of management of the situation. “It turns out that everyone has been affected in one way or another,” he says. “I myself got fired up a year ago. It never goes away and only gets worse.