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Friday, May 16, 2025

Deadly dengue dilemma

by

Dr Joel Teelucksingh
308 days ago
20240711

Dengue fever is a vi­ral ill­ness trans­mit­ted by the Aedes ae­gyp­ti mos­qui­to. The vec­tor thrives in trop­i­cal cli­mates like ours. Un­like sea­son­al out­breaks, dengue is “en­dem­ic” in Trinidad, mean­ing it is con­sis­tent­ly present in our en­vi­ron­ment. This steady pres­ence cre­ates an on­go­ing health chal­lenge, but dead­ly pe­ri­od­ic surges can over­whelm our health­care sys­tem.

Com­mon symp­toms in­clude:

• High fever

• Se­vere headache

• Pain be­hind the eyes

• Joint and mus­cle pain

• Rash

• Mild bleed­ing (eg, nose or gum bleeds)

Ab­dom­i­nal pain, per­sis­tent vom­it­ing, bleed­ing, con­fu­sion, drowsi­ness, rest­less­ness and fea­tures of de­hy­dra­tion are “red flags” for se­vere dengue. Fog­ging is a com­mon method to re­duce adult mos­qui­to pop­u­la­tions, but its ef­fec­tive­ness is ham­pered by in­con­sis­ten­cy. Un­for­tu­nate­ly, lar­val pop­u­la­tions re­main unchecked.

Im­prop­er waste dis­pos­al and stag­nant wa­ter cre­ate ide­al breed­ing grounds for mos­qui­toes. In­creas­ing fund­ing and sup­port for the In­sect Vec­tor Con­trol unit will en­hance its ca­pac­i­ty to con­duct more ef­fec­tive in­ter­ven­tions.

Ad­di­tion­al­ly, in­vest­ing in new tech­nolo­gies, such as drone sur­veil­lance for mos­qui­to breed­ing sites, could rev­o­lu­tionise our ap­proach.

The fol­low­ing pre­cau­tion­ary mea­sures may pre­vent dengue trans­mis­sion:

1. ↓Mos­qui­toes breed in stag­nant wa­ter. Reg­u­lar­ly emp­ty and clean con­tain­ers that col­lect wa­ter such as flower pots, buck­ets and dis­card­ed tyres.

2. ↓Ap­ply in­sect re­pel­lents con­tain­ing deet, pi­caridin, or oil of lemon eu­ca­lyp­tus to ex­posed skin.

3. ↓Long-sleeved shirts, long pants, socks and shoes help min­imise skin ex­po­sure to mos­qui­to bites.

4. ↓Sleep­ing un­der mos­qui­to nets, es­pe­cial­ly dur­ing the day when Aedes mos­qui­toes are most ac­tive, can pro­vide sig­nif­i­cant pro­tec­tion.

5. ↓En­sure that win­dows and doors have in­tact screens and use mos­qui­to coils or elec­tric mos­qui­to re­pel­lents.

There is no spe­cif­ic an­tivi­ral treat­ment for the virus. Man­age­ment in­cludes oral re­hy­dra­tion so­lu­tions or in­tra­venous flu­ids to pre­vent de­hy­dra­tion, man­ag­ing pain and fever with parac­eta­mol (avoid­ing as­pirin and non-steroidal an­ti-in­flam­ma­to­ry drugs due to their po­ten­tial to in­crease bleed­ing risk) and mon­i­tor­ing for any signs of se­vere dengue.

Reg­u­lar med­ical check-ups are cru­cial for mon­i­tor­ing platelet lev­els and oth­er vi­tal signs. While some home reme­dies like pa­paya leaf ex­tract have been pop­u­larised, there is no sci­en­tif­ic ev­i­dence sup­port­ing their ef­fec­tive­ness in treat­ing dengue, and they should not re­place con­ven­tion­al med­ical care.

Amidst our cur­rent dengue surge, we must ap­proach the chal­lenge with a com­bi­na­tion of in­di­vid­ual vig­i­lance and sys­temic ac­tion.

Our ef­forts must be un­der­pinned by a ro­bust pub­lic health sec­tor that pri­ori­tis­es vec­tor con­trol, en­hances health­care sys­tem pre­pared­ness and ad­dress­es so­cio-eco­nom­ic dis­par­i­ties that ex­ac­er­bate vul­ner­a­bil­i­ty. 


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