Epidemic word is originated from Greek combination of two words- Epi which means- “Upon or above” and demos means “People”.
Epidemic diseases are the kind of diseases which infect a large number of populace within a short span of time. For example- Plague, Dengue, Cholera, Measles etc. This is caused through contaminated food or water intake or in particular season when vector animal population migrates from one place to another.
On 2011 there was outbreak of Dengue at Pakistan and 15000 were reported to be under mortality threat at Lahore. More than 1000 were reported dead. It is estimated there is a reported dengue attack of at least 100 million people world -wide every year. 2.5 per cent of the infected die every year.
Dengue still infests the developing countries every year and becomes a cause of concern specially during the post monsoon period.
Here, we detailed about “Dengue”. Dengue is an epidemic viral disease which is caused by Dengue virus (DENV), a mosquito borne flavivirus. It is a member of family Flaviviridae, genus Flavivirus and is a single stranded RNA positive strand. Dengue spreads by female mosquito (species- Aedes aegypti). This disease is rapid grown in decades & infected number of population & proves itself as fatal also. The possible factors of its spread includes stagnant pool water for mosquito breeding; Inadequate housing facility leads to poor sewage & waste systems; Climate change leads to viral evolution & travel to endemic areas leads more prone to this disease. The disease is also of two types- Dengue and Severe Dengue. Severe Dengue leads to death stage also if not taken care in early stage. Recent study estimates 390 million infects per year.
Major symptoms of Dengue include increase in body temperature up to 104°F, severe headache, joints pain, vomit sensation, vomit and a pain behind eyes. Symptoms usually commence after 4—10 days after mosquito bites (incubation period) and it lasts for 2-7 days. Whereas for severe Dengue major symptoms includes respiratory distress, severe abdominal pain, bleeding gums, fatigue, restlessness & bloody sputum. It warns after 3-7 days after its first conjunction where next 24-48 hrs may be lethal if not paid good attention to this.
There is no specific treatment for Dengue. And for severe dengue, medical care needs to be taken which can save lives by maintaining the deficiency created by the diseases. If the treatment is not be proper may lead to death of the patient. Through medical care, the mortality rate coz of Dengue has been reduced to 1% from 20%.
Dengvaxia is the first dengue vaccine developed by Sanofi Pasteur. It got its license in Dec 2015 which is now approved by Regulatory authorities for its usage at endemic areas ranging age from 9- 45 years. In April 2016, WHO recommended the usage of this vaccine which is highly epidemic as mentioned 70% or above as per sero-prevalence. One more additional analysis to retrospectively determine sero-status at the time of vaccination were released in Nov 2017.
For dengue control program, the countries which are highly infected are considered and those persons who were only vaccinated who have a past dengue infection. Pre-vaccination should be implemented or not that could only be decided after a rigorous assessment at region or country level. This could be conducted through the available test considering its sensitivity & specificity.
The only possibility to prevent is this vaccination & this will be the control strategy to be followed at the infected regions. If the individual even vaccinated or not, founds any symptoms of dengue should immediately seek medical care, whereas delayed action can be lethal.
The transmission of dengue virus through combat vector mosquitoes, following are various methods used to control them & to prevent its multiplication:
- Solid wastes shall be properly disposed of.
- To take care that the stagnant water shall not be pooled where vector mosquitoes will access it for their egg laying.
- Application of proper insecticides to prevent mosquitos’ multiplication & its survival.
- Appropriate action to be utilized for storage of water in tanks, timely cleanliness to ensure clean water storage.
- Using long-sleeves clothes, proper net screens shall be utilized to prevent mosquito bite.
- Usage of mosquito repellent at homes while sleeping.
- Covering & vacating the drums etc. To ensure no survival of vector mosquito.
- To educate at the slum areas where unawareness of this is observed.
- Active monitoring shall be done to ensure no place is available for vector mosquito survival & its multiplication.
Timely attention of disease & through proper medication, doctors & practitioners can significantly reduce the mortality rate caused due to severe dengue.
WHO is taking number of initiatives to fight from this epidemic disease in the following ways:
- WHO is providing the technical support to the infected country for managing the epidemic disease.
- WHO is making infected countries aware by publishing handbooks for its surveillance, diagnosis & its prevention.
- WHO is helping them to report by preparing a effective reporting systems.
- New insecticides & more effective tools are being developed.
- Data is being gathered from the around 100 member states for its analysis & effective treatment.
Though there has been a new vaccine come out in the year 2016 which has helped to arrest the outspread than before, in late November 2018 outbreak of Dengue has been reported in Jaipur and Delhi of India. The developing countries still suffer the menace and the WHO needs to be more vigilant on the arresting of mosquito breeding in contaminated water and propagation of the disease through passengers cross-country.
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