Before dengue joins measles to cause a health crisis!

While measles cases and deaths show no sign of relenting, dengue is staging a comeback. Notwithstanding the commendable vaccination drive against measles, the daily confirmed deaths from measles and measles-like symptoms together with new arrivals of patients of the disease for admission to hospitals continue with no letup. By this time, according to the health minister's claim, 20 million children have been vaccinated with the rate of coverage reaching 122 per cent of the target. The minister claims that the 18 upazilas where the government initially launched the vaccination campaign are now reporting near zero cases of measles.

In this context, his disclosure that the interim government was warned as many as seven times of the danger lurking in case it failed to procure vaccines. Instead, the Yunus-led government was seeking to purchase vaccines privately with the ulterior motive of extracting commission from the deal. If this is so, wanton neglect and the foul motive have been responsible for the breakout of measles on an epidemic scale. Both the chief adviser and the health adviser of that government are to blame for the outbreak of the disease and its consequent deaths. This is unpardonable and the duo should be legally held accountable for inviting this child health disaster.

The health minister claims that his government has continued the programme of vaccinating those children who are yet to receive the shot. At the same time, the ministry has supplied paediatric ventilators, oxygen concentrators and other medical equipment to 10 districts. Intensive care services will be available there. Now here is a problem involving the diagnosis of the disease. The Institute of Public Health (IPH) is the only facility in the country with its laboratory to confirm measles but its capacity to test cases is limited. This is exactly why statistics of confirmed cases and suspected cases are shown separately. The danger of these data is that cases and deaths are never authentic. Many cases and deaths go unreported. Not all parents can come to Dhaka for their children's treatment. Therefore, the government could do better by forming medical teams under a coordinated emergency programme to fight the disease. The upazila health complexes could be revamped for the medical team's operation there. They could refer the serious cases needing ICU attention.

The total confirmed cases by this time have reached 900 plus mark and the suspected cases about 70,000 with daily admission crossing 500 cases. So far, the official death count is around 600. These figures speak for themselves. Perhaps the situation is graver than this if the unreported cases and deaths are taken into consideration. Mass travel by people during the Eid-ul-Azha holiday may trigger another round of outbreak of the disease because of its highly contagious nature.

Clearly, the health facilities are under severe stress. If dengue cases start to proliferate, the system is expected to break down. The early monsoon has brought the nation to face such a daunting challenge. If the Directorate General of Health Services (DGHS) and the city corporations do not make ready the preparedness for dengue well in time, they may have to encounter the problems of both measles and dengue. Such a prospect will be most unwelcome. The magnitude of the problem may be more like the worst case scenario faced during the Covid-19 pandemic.

The rainfalls during the summer have been unprecedented. Mosquitoes are breeding at a faster rate because of the rains. True they were almost absent earlier and now their presence is felt. A crash programme for destroying the breeding grounds of mosquitoes at this early stage can bring the vector aedes under control. If allowed to proliferate, the spread of dengue may not be contained. Earlier, dengue was an exclusive problem for congested cities like Dhaka and Chattogram. But this is not the case anymore. Last year, other cities and smaller towns also reported dengue. So it would be advisable to take adequate measures by not only the large cities but also by those smaller urban centres against aedes well before they can become active to spread dengue.          

nilratanhalder2000@yahoo.com