The Dengue fever outbreak of 2011 has been worse than anyone expected. It arrived sooner than anticipated, and is far more widespread than anyone could have prepared for. Starting in early August, Dengue fever has in two months affected many thousands of people. Almost 200 have perished. Every day it seems there are a few more lives lost to this public health disaster. The relentless media reminds us every day that no one is safe, and people everywhere are in anguish over this ever-present mosquito and the virus it bears.
On the 10th of August I wrote that a Dengue outbreak was imminent. I am no Nostradamus; I was merely reporting what I was seeing in my lab. Today, at the risk of sounding silly, I want to tell you that I think the Dengue outbreak is finally coming to an end. At the least it seems the worst is behind us. There has been a steady decline in the number of new cases diagnosed over the last week or so.
While this outbreak may be coming to an end, we all know that Dengue will be back. There are many lessons to be learned from the crisis and our collective response to it. I thought this might be a good time to discuss some. So here are a few things that I have learnt:
- Cleanliness is half the faith for a reason. Perhaps it was going to take a disaster such as this to remind us of the sheer importance of hygiene and cleanliness. Dengue seems to be on the decline. I hope the lessons in cleanliness we have had to learn in a hurry will stay with us for some time to come.
- Mosquitoes love water! If we have gathered one thing from the unending footage of the bold chief minister draining water coolers, it is that water sits and collects in more places than we might imagine. And every such small puddle of water could be a breeding ground for a new generation of mosquitoes.
- Dengue can kill in more ways than one. As doctors, our understanding of Dengue fever and its management has taken a quantum leap in the last 6 weeks or so. Patient management has grown from simply the prevention of bleeding to the management of third compartment fluid loss as well. And we know that 80-90% of Dengue fever patients are asymptomatic; they never even know they had the illness! I myself was not sure how useful the Sri Lankan and Indonesian experts would be in this time of crisis. I have to admit that the knowledge they imparted and the endless seminars and lectures based on their experience and insight have raised the general level of expertise in the local medical community.
- Perhaps most importantly, we now know that no one can do this alone. Two months ago, it was Shahbaz Sharif Vs Dengue Fever. Today, it is Us Vs Dengue Fever. The most successful initiative of the Punjab government in the face of this crisis has been to get the public involved in public health. There is a limit to how much fumigation the government can do. There is a limit to how many water coolers Shahbaz Sharif can drain for the benefit of TV crews. This is a public health issue, and unless everyone gets involved, we don’t stand a chance.
If experts are to be believed, Dengue fever will be back in the spring. And it is going to be with us a few more times after that as well. I hope and pray that it is never as bad as it has been this year. Hopefully we will remember the lessons of 2011, and they will better equip us to deal with this menace in the future.