Plagued By Dengue Fever, Sri

Lanka Looks to the Weatherman

Schoolchildren hold up a handmade sign that reads: Lets Eradicate Dengue. Credit: Amantha Perera/IPS
COL
OMBO, Jun 30 2014 (IPS) - Whats the connection between weather forecasts and the
mosquito-borne dengue virus? Its not just a question for science nerds; in Sri Lanka,
heath officias beieve answering this question coud save ives!
"# $mantha %erera
&or over haf a decade now, doctors and residents of this isand
nation, es'ecia# those iving in the cram'ed Western %rovince, have been batting
the 'ersistent, sometimes dead#, dengue 'ague, which tends to foow the monsoon
rains that drench the southwest coast from (une to )ctober!
*he tro'ica disease genera# resuts in 'roonged fever, musce and joint 'ains, as
we as skin rashes! In a sma number of cases, the disease turns into the ife-
threatening dengue hemorrhagic fever, characterised b# beeding, ow eves of bood
'ateets, or dangerous# ow bood 'ressure, which can send the victim into shock,
sometimes triggering fataities!
In mid-+,,-, soon after the annua monsoon, dengue
infections increased at an aarming rate across Sri
Lanka! "# the end of the #ear, ./,,-/ 'eo'e were
infected, whie the number of fataities stood at .01!
*he im'act of the e'idemic can be gauged b#
com'aring current infection rates with the ast dengue
outbreak, which was recorded in 2-3-, a #ear that saw
+,, infections and around 2. deaths!
Since +,,- the number of infections has been steadi#
high; the# have never faen beow +3,,,,, whie the
highest number of infections 4 00,012 4 was re'orted
in +,2+!
Whie fataities have been brought down 4 there were
3. deaths in +,2., the same #ear that ogged .+,,,,
infections 4 dengue e5'erts and medica 'rofessionas
sa# there is an urgent need for a com'rehensive
management 'an to curtai the im'act of the disease!
We need a much more stringent 'revention regime,6
7imaka %anniahetti, a consutant communit#
'h#sician at the 7ationa 8engue 9ontro :nit, tod I%S!
It is not that Sri Lanka has been a5 on tacking mosquito breeding grounds; in fact it
has initiated ever#thing from a %residentia *ask &orce on 8engue %revention, to fines
for those who negect 'ossibe breeding grounds, to decaring nationa dengue
eradication 'rogrammes!
:nfortunate#, the combined resut of these 'rojects is that the rate of infection is
e5act# what it was five #ears ago, or 4 in areas where sight reductions are re'orted 4
sti aarming# high!
*he situation is es'ecia# worr#ing in the Western %rovince, home to over +/ 'ercent
of the countr#s 'o'uation of over +, miion 'eo'e, and to 1, 'ercent of a re'orted
dengue cases since +,,-!
;nter the forecasters
<iven that so man# strategies have been tried and faied, e5'erts are now suggesting
that the authorities ca in he' from the nationa =eteoroogica "ureau as the atest
wea'on in the fight against the virus!
&aseeha 7oordeen, head of the de'artment of microbioog# at the :niversit# of
%eradeni#a in centra Sri Lanka, tod I%S that there is a cear connection between
changing cimate 'atterns and the s'read of dengue!
When we have better
forecast data, we
[will] be able to
correlate the disease
distribution in various
parts of the island and
make a feasible
disease map that can
be used for the whole
country." -- Faseeha
Noordeen, head of the
department of
microbioloy at the
!niversity of
"eradeniya
In a research paper she co-authored, 'ubished in the Internationa (ourna of
Infectious 8iseases in )ctober +,2., 7oordeen said that mosquito breeding grounds
increased foowing heav# rains, 'ointing out that the two annua 'eaks in infections
were recorded soon after the two annua monsoons!
7oordeens research aso found that warming weather 'atterns increased the
distribution of the dengue-carr#ing mosquito! She beieves that detaied weather
forecasts coud he' heath authorities to better aocate resources and strategica#
im'ement 'revention cam'aigns!
When we have better forecast data, we >wi? be abe to correate the disease
distribution in various 'arts of the isand >and? make a feasibe disease ma' that can
be used for the whoe countr#,6 she said!
%anniahetti agrees, stressing that detaied forecasts woud be @invauabe6 for 'eo'e
ike her, who are tasked with hunting a s'ecies of mosquito that is constant# on the
move, and eradicating a disease that is constant# changing!
Aight now we are foowing the rains,6 she said! @%reem'tive 'rogrammes coud be
much more effective!6
=idwa# through (une the %revention :nit was scrambing to reocate most of its
resources to the Western %rovince, which absorbed the heaviest rains in the first week
of this month!
*he third of week of (une, meanwhie, saw the aunch of a massive dengue
eradication 'rogramme that incuded members of the armed forces, %anniahetti
added!
Some regions of the 'rovince received four to si5 times their average (une rainfa in
the first week of the month this #ear! %anniahetti said that detaied forecasts woud
have enabed heath officias to raise their eves of 're'aredness beforehand!
<reater risks for ow-income communities
She added that the burden of the disease is uneven# distributed between the rich and
'oor, since the s'read of dengue is arge# determined b# the ceaniness of the
immediate environment, and a communit#s 'ro5imit# to rece'taces ike tanks of
stagnant water, or even accumuated garbage!
What we have seen is that there are more breeding grounds in ow income areas,
where 'eo'e tend to 'a# ess attention to how safe or heath# their immediate
environment is,6 %anniahetti said!
$dditiona#, medica treatment comes at a high 'rice, often eaving the 'oor without
access to quait# care!
LakBumar &ernando, who heads the 9entre for 9inica =anagement of 8engue and
8engue Cemorrhagic &ever at the 7egombo <overnment Cos'ita, ./ km north of the
ca'ita 9oombo, sa#s that dengue can be successfu# treated if detected ear#!
*he first thing is to get a bood test done,6 he tod I%S; but doing so costs about +,,,,
ru'ees Dabout 2/ doarsE at 'rivate cinics, a sum that man# 'eo'e in this countr#
cannot afford!
In a bid to make the 'rocess more accessibe, the government recent# set u' si5 new
bood testing centres in government hos'itas across the Western %rovince, but these
aone wi not be abe to tacke the hundreds of cases coming in ever# singe da#,
according to e5'erts!
*he unit that &ernando heads has been recognised as one of the best treatment
faciities in the countr#, with on# a singe fatait# out of 2,23, cases admitted since
(une +,2.!
We never et our 'atients go into shock, we monitor them round the cock,6 &ernando
said, adding that the most effective treatment for dengue was constant monitoring of
bood 'ressure, 'use and urine out'ut whie maintaining a good fuid intake!
"ut the cost of setting u' the unit, where each of the 2F beds is equi''ed with state-of-
the-art monitoring equi'ment, was about 2,, miion ru'ees, or F/,,,,, doars, hard#
the kind of initiative that can be easi# re'icated around the countr#!
In fact, units ike the one in 7egombo are few and far between in Sri Lankas 'ubic
heath s#stem, which makes an even stronger case for deveo'ing soid 'revention
s#stems, e5'erts sa#!
D;78E