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| Tuesday, 25 May 2004 |
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Cleanliness - the key to dengue control by Chandani Jayatilleke More environment pollution means more dengue patients. Dengue is a deadly disease and 12 persons have been victims of the disease so far this year. If we are to control the further spread of dengue, we need to put much emphasis on a clean environment. Following rapid urbanisation and the adoption of convenient lifestyles, Sri Lankans are ignorant of what is happening in their own environment, said Epidemiologist of the Epidemiological Unit of the Ministry of Health, Dr. Nihal Abeysinghe.
Dengue is transmitted through a mosquito which is believed to be bred in clear water. Dengue spreads usually after the beginning of the monsoon rain. Come Monsoon rains in May/June/July or December/January, the mosquitoes causing dengue will begin to bare their stings. Polluted surroundings and unattended clear water containers and things in which water can collect (be it a flower pot or a vase or an ill-maintained swimming pool) can be a paradise for dengue mosquitoes.
So far this year, 2,682 dengue cases and 12 deaths have been reported, of which 65% are adults and 35% are children. In comparison to last year's figures (4,749 cases and 32 deaths for the year), this is certainly an increase. The areas in which most cases were reported include Colombo, Gampaha, Kandy and Kurunegala. A significant number of cases were also reported from Anuradhapura, Trincomalee and Kalmunai. Until 1996, dengue was mainly confined to Colombo Municipal Council areas. But after '96, it has spread to many other areas in the country. What is the main reason for the disease spreading into other areas? Dr. Abeysinghe says the country's environment is polluted to such an extent that dengue is spreading at an alarming rate. This may be due to urbanisation coupled with many other reasons. Although cleanliness of the environment is a hot topic in this country, our people are not concerned about keeping their own environs clean. "When there is a dengue outbreak people expect us to spray chemicals and control the spread. This is a very unfair situation. Just spraying some chemicals doesn't mean that it can control the disease. Health authorities alone cannot solve this problem. Communities should realise that they have to keep their gardens and courtyards and houses clean and tidy, so that there won't be easy places for mosquito breeding," Dr. Abeysinghe said. Dengue can be prevented only if all residents, health authorities, school administrators and students come together and make a serious effort to keep the country's environment clean and tidy. This is the opinion of all health authorities concerned and the officers of the preventive bodies. Residents will have to make much effort to keep their houses and gardens free of fresh water collectors, CMC's Chief Medical Officer of Health, Dr. Pradeep Kariyawasam said. They should trim grass, clean flower pots, fish tanks and other containers leaving no place for mosquito breeding in their houses, he said adding that mosquitoes causing dengue cannot fly more than a length of 200 yards. "Therefore, one can assume, residents largely help in the breeding of mosquitoes which could make their family members sick," he said. The dengue mosquitoes breed in clear water. Even muddy water can become clear after a few days and dengue mosquitoes can be bred in such water too. Therefore, residents should try to keep their households free of mosquitoes, which means they should clean their gardens and houses, including interior flower pots and fish tanks on a regular basis. "Clean the containers and flower vases on a regular basis. It is necessary that you do this with a brush. Otherwise, the eggs will remain in the containers and continue to breed mosquitoes even if it has been once cleaned," Dr. Abeysinghe said. What can we do to keep the dengue menace at bay? According to Dr. Abeysinghe it depends on four factors: keep the mosquito density low, predict the outbreak, identify cases early and inform the community and prevent deaths. While the communities have to be responsible for keeping the mosquito density low, authorities are answerable for the other factors. However, he added that there is no particular or a single method to avoid dengue. It has to be a collection of efforts, Dr. Abeysinghe said. Director, National Hospital Colombo, Dr. Hector Weerasinghe said that 15 patients were admitted to the hospital on Tuesday of which two were dengue confirmed and others were suspected cases. These patients are from various places such as Kurunegala, Avissawella and Colombo. He said few cases were reported early this year, however the number began to increase following the Monsoon rains. The CMC launched a program on May 9th with 1,000 volunteers to investigate and clean some of the influential residential areas in Colombo. According to the CMC, the high risk areas in Colombo include Cinnamon Gardens, Wellawatte, Kollupitiya, Bambalapitiya, Narahenpita, Kirillapone and Thimbirigasyaya. Dr. Kariyawasam said an investigation team would go to Maligawatte, including the housing scheme this week and to Vekanda and Slave Island next week. The CMC continues to carry out its dengue prevention and control programs. At present the CMC staff, about 200 people, go on regular investigations to various areas. "If a particular house was found to have breached the instructions they have been already given, a notification would be issued to them to eliminate such breeding places within seven days," he said. Having realised the need to activate systems prior to the spread of dengue, the CMC plans to carry out two major awareness campaigns every year beginning this October. "I believe, we should carry out two major public awareness programs before dengue raises its head." "We have printed leaflets and posters and put them up in various places to educate people on this issue. The Rotary Clubs are also helping us in this endeavour," Dr. Kariyawasam said. According to Dr. Abeysinghe, there is a Task Force on dengue which meets once in three months and discusses various issues in relation to the disease. "We also go to schools and various other places to educate people too." However, he raised a point on the need for a national policy on dengue, which would be of help to eradicate the disease in Sri Lanka. At present, there's no special treatment for dengue patients. The disease comes as viral fever and sometimes it cannot be identified at the first stage. Some patients get dengue haemorrhage, which is the dangerous form of the disease and about 1% of such patients would die. They would show symptoms such as oblivious bleeding, bleeding gums, bleeding with urine or vomiting (in black). The health authorities we spoke to emphasised one main advice to communities: Keep your house and the garden free of clear water collectors and containers and water tanks on a regular basis. Surely... the dengue menace could be avoided. |
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