Everyone’s fight

Nagaland faces a huge challenge as number of dengue cases spiral upwards and in the foothill areas, the weather condition such as searing heat and high humidity coupled with long period of power cuts have only contributed to the problem. Hospitals in foothill areas are overwhelmed by daily cases of suspected dengue as many patients suffering from the affects of dengue fever cannot get admitted simply because all beds are occupied. The outbreak of dengue fever especially in Dimapur is sweeping the foothill areas even as the searing heat and humidity of the monsoon is coming to an end. Because it is spreading like an epidemic, dengue virus, has risen almost to the menacing proportion as Covid-19 and with cases of severity that are often fatal. A gauntlet has been thrown at the medical department as hospitals are teeming with fresh dengue cases each day. There are hardly any beds available and staff are overstretched due to increasing number of patients needing treatment or hospitalisation. Also the acute shortage of blood for transfusion has become critical especially for some blood groups such as ‘AB’ and ‘O’ negative etc. The few blood testing laboratories in Dimapur are equally overwhelmed. Test reports are expected at the earliest possible time period but the number of patients is so huge that sometimes test reports get slightly delayed. The main challenge is to halt the spread of dengue fever caused by the Aedes mosquito- a small insect with black and white stripes on body and legs with around 5 to 7 millimetres in length. Aedes mosquitoes are aggressive during day time- two hours after sunrise and several hours before sunset. Aedes mosquitoes also bite at night in well lit areas. The areas where Aedes mosquitoes bite are usually on the ankles and elbows and this is the reason why people are advised to wear long shorts and sleeves. Aedes mosquito is also responsible for spread of other deadly diseases such as Zika and Chikungunya. All the four serotypes of dengue viruses-DENV1, DENV2, DENV3 and DENV 4- are primarily transmitted by Aedes aegypti. Infection with any one of these serotypes generally leads to a mild, self limiting febrile illness (classical dengue fever (DF). However, in few cases DF also leads to severe life threatening dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Dengue causes reduction in the number of blood platelets (small blood cells) produced by the bone marrow which inhibits blood clot and inability to fight infections. In severe cases,, it causes life-threatening thrombocytopenia (extremely low platelet count in blood) and shock syndrome. The platelet count may drop from lakhs to thousands making it a serious concern for the affected individual. The current dengue virus outbreak is testing the ability of the health system encompassing medical doctor, staff, hospital capacities, blood banks and ability of laboratories to provide early tests results. It is also a wake up call on all health institutes to upgrade in order to prepare to face any such situations. Even the community has to play a role in tackling spread of dengue by using mosquito nets, keeping surroundings clean, getting rid of garbage dumps and stagnant water, use of insecticides etc. A collaborative effort is the best strategy to contain the spread of dengue.