Effective management of dengue needed in Chattogram

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Chattogram Bureau :
A patient infected with dengue disease died at Chattogram Medical College Hospital on Thursday afternoon. The deceased was identified as Abu Sayeed, 30, of Tangail. Prof Sujat Paul, head of medicine of CMCH, confirmed the death.
Sayeed was admitted to CMCH on Thursday. He had dengue hemorrhagic syndrome, said Dr Taherul Islam, assistant registrar of medicine department of the hospital. Sayeed, a foreman of a factory in the port city, went there from Tangail about a week ago.
Meanwhile, a total of 4,409 dengue patients were admitted to different hospitals across the country in the first six days of this month. September is considered a high risk period for dengue fever.
The number of dengue cases was 52,636 last month — the highest in a single month ever.Though 700-900 patients are being admitted every day to different hospitals since last week, the number of patients are going down gradually.
According to the data of Directorate General of Health Services (DGHS), 75,146 dengue patients were admitted to hospitals across the country. The official number of deaths caused by dengue this year is 57, though the unofficial figure is well over twice of that.
Dengue is a mosquito-borne viral disease that has rapidly spread in all regions of WHO in recent years. Dengue virus is transmitted by female mosquitoes mainly of the species Aedes aegypti and, to a lesser extent, Ae. albopictus. This mosquito also transmits chikungunya, yellow fever and Zika infection. Dengue is widespread throughout the tropics, with local variations in risk influenced by rainfall, temperature and unplanned rapid urbanization.
Severe dengue was first recognized in the 1950s during dengue epidemics in the Philippines and Thailand. Today, severe dengue affects most Asian and Latin American countries and has become a leading cause of hospitalization and death among children and adults in these regions.
Dengue is caused by a virus of the Flaviviridae family and there are 4 distinct, but closely related, serotypes of the virus that cause dengue (DEN-1, DEN-2, DEN-3 and DEN-4). Recovery from infection by one provides lifelong immunity against that particular serotype. However, cross-immunity to the other serotypes after recovery is only partial and temporary. Subsequent infections (secondary infection) by other serotypes increase the risk of developing severe dengue.
 The incidence of dengue has grown dramatically around the world in recent decades. A vast majority of cases are asymptomatic and hence the actual numbers of dengue cases are underreported and many cases are misclassified. One estimate indicates 390 million dengue infections per year (95% credible interval 284-528 million), of which 96 million (67-136 million) manifest clinically (with any severity of disease).1 Another study, of the prevalence of dengue, estimates that 3.9 billion people, in 128 countries, are at risk of infection with dengue viruses.2
At present, the main method to control or prevent the transmission of dengue virus is to combat vector mosquitoes through, preventing mosquitoes from accessing egg-laying habitats by environmental management and modification, disposing of solid waste properly and removing artificial man-made habitats, covering, emptying and cleaning of domestic water storage containers on a weekly basis, applying appropriate insecticides to water storage outdoor containers.
Using of personal household protection measures, such as window screens, long-sleeved clothes, repellents, insecticide treated materials, coils and vaporizers (These measures have to be observed during the day both at home and place of work since the mosquito bites during the day).
Improving community participation and mobilization for sustained vector control, applying insecticides as space spraying during outbreaks as one of the emergency vector-control measures.
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