NIH warns of dengue surge after rains



A delivery boy rides past the National Institute of Health (NIH) building in Islamabad on August 16, 2024. — AFP
A delivery boy rides past the National Institute of Health (NIH) building in Islamabad on August 16, 2024. — AFP 

ISLAMABAD: Issuing an urgent advisory, the National Institute of Health (NIH) Islamabad on Wednesday warned of a potential dengue outbreak following recent heavy rains in Northern Pakistan, Punjab and Balochistan and called for immediate action to curb mosquito breeding and prevent a surge in dengue cases.

As per the NIH advisory, authorities and the public have been urged to stay vigilant, implement preventive measures and enhance disease surveillance to mitigate the risk.

Dengue fever, a mosquito-borne viral disease is transmitted primarily by Aedes aegypti and Aedes albopictus mosquitoes, the NIH advisory says, adding that virus thrives in warm, humid conditions, making the post-monsoon period particularly high-risk.

According to the NIH, dengue cases in Pakistan typically appear between April and June, peaking from September to November. In 2023, the country recorded 21,018 confirmed cases, while in 2024, the number surged to 28,427, signaling an escalating threat. The NIH has warned that multiple dengue virus serotypes are circulating in different regions, increasing the likelihood of severe infections. Temperature thresholds between 26-29°C and humidity levels above 60% significantly contribute to mosquito breeding, raising concerns about another outbreak.

Several factors contribute to the dengue surge, including rapid urbanization, inadequate waste disposal, stagnant water pools, poor water storage practices and climate change. The advisory stresses that these risk factors, coupled with inadequate response measures, could lead to another nationwide health crisis.

Dengue fever presents flu-like symptoms such as high fever, severe headaches, retro-orbital pain, muscle and joint aches, vomiting and skin rashes. Severe cases can progress to dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS), which can be fatal if not treated promptly. Warning signs of severe dengue include persistent vomiting, severe abdominal pain, sudden temperature drop, unexplained bleeding, mental confusion and a platelet count dropping below 100,000/mm3. Patients exhibiting these symptoms should seek immediate medical attention.

The NIH has advised health facilities to strengthen laboratory diagnostics for timely case confirmation. Recommended tests include the NS1 antigen test (detectable from Day 1 to Day 7 of illness), IgM ELISA test (best performed after five days of illness onset), Real-Time PCR (for early and precise virus detection), and IgG serology (to confirm previous exposure and secondary infections). Proper specimen collection, transport and testing protocols must be followed to ensure accurate diagnosis. While there is no specific antiviral treatment for dengue, supportive care is crucial. The advisory recommends staying hydrated with oral fluids, managing fever with acetaminophen (paracetamol) and avoiding aspirin and NSAIDs due to bleeding risks.

Patients with severe dengue symptoms, warning signs or platelet counts below 10,000/mm3 should be hospitalized. Platelet transfusions are only recommended for patients with active bleeding and dangerously low platelet counts. Intravenous (IV) fluid therapy should be administered to those with significant dehydration or shock.

To prevent an outbreak, the NIH has urged a multi-pronged approach including strengthening disease surveillance, vector control measures and community engagement. Eliminating standing water, conducting targeted fogging, applying WHO-approved insecticides, ensuring proper waste disposal and deploying mosquito traps are essential actions. The public is encouraged to use mosquito repellents, wear protective clothing, sleep under mosquito nets and recognize early symptoms for prompt medical care. Awareness campaigns through electronic and social media will also play a vital role in prevention.

The NIH has called for coordinated efforts between health and non-health sectors to tackle the dengue threat. Local governments, environmental agencies, waste management authorities and public health institutes must work together to implement effective prevention strategies. With the dengue season approaching, proactive measures and early detection will be key in preventing another large-scale outbreak. Immediate and sustained efforts are crucial to mitigating the risk and safeguarding public health.


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