Dengue raises deadly head with May showers

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By Fathima Riznaz Hafi Chief Medical Officer of Health Dr. Pradeep Kariyawasam warned that there could be a large outbreak of dengue in the month of May, given the intermittent showers being experienced at present. Calling for immediate action addressing a press conference on 2 May at the Colombo Municipal Council, alongside Mayor of Colombo A.J.M. Muzammil and other dignitaries from the CMC, he said: “Data so far collected this year shows that the number of dengue fever patients is 10% lower compared with the data of 2013. The decrease so far for the month of April alone is more than 33% less. However, in April we have more patients than in March and we see an upward trend.” He added: “We have one-third of these dengue patients living in the Kirulapone area. Most of the other patients live in Pamankade, Wellawatte, Slave Island and Mattakkuliya. 70% of the patients are below 20 years of age.” He stressed the importance of maintaining a clean and safe environment not only at home but also in schools and public places to prevent the disease from spreading. There is no need to do big things, he said. Simply keeping the environment clean is the main thing to do. Don’t leave room for breeding of mosquitoes: always ensure that there are no open vessels such as containers and yoghurt cups lying around in the garden. Water in these open vessels makes way for the breeding of the Aedes Vectors. Everyone has a role to play here. Housewives too can do their part by just maintaining their home environment. The process starts at home. Biting cycle of Aedes Vectors Then there are schools: referring to the biting cycle of the Aedes Vectors, he explained that the vectors strike mainly in the morning around 8:30 a.m., which is when children are at school and then again in the early hours of the evening. Children are faced with grave danger if their schools are breeding grounds for mosquitoes. The school authorities therefore have the vital responsibility of keeping the school premises clean and safe for the children. Other target areas are construction sites and public areas which are poorly maintained in terms of hygiene. This is where the general community can pitch in. People can join hands and come forward to clear mosquito havens and keep the surroundings clean and mosquito-free. The Police are also cooperating in this initiative. The Police and Health Department are working together to fight the dilemma. Dr. Kariyawasam added that after the problem erupts, nothing can be done – we must prevent these problems from arising in the first place. With this in mind, the Public Health Department set out on this campaign, using the services of around 250 officers of the Public Health Department, in Kirulapone and Pamankade on 3 May, starting from Sithumina Hall in Kirulapone. The program was launched by Mayor of Colombo A.J.M. Muzammil.

Activities being carried

Mobilisation of the staff of all six districts, including medical officers, PHI, nurses, midwives, field assistants, health instructors, labourers and volunteers.

Inspection of households, schools, public and private sector offices and institutions.

Collection of utensils where rain water could collect from the above-mentioned premises.

Carry out an awareness campaign on dengue in these areas.

Spraying chemicals around the houses where patients are detected using Ultra-Low Volume (ULV) machines.

Fog underground drains and surroundings of the houses where patients live.

Initiating legal action against owners of lands where mosquito breeding is detected.

Investigation into other environmental issues.

These campaigns will target high risk areas every week during the next three months. In case of infection In the event that a person is infected by the disease, paracetamol is most often prescribed as part of the treatment. Dr. Kariyawasam advised, “Paracetamol is the preferred choice for managing fever in dengue patients. It is important to seek medical advice if fever and symptoms persist.” Panadol, a partner in this Dengue Control Program, is supporting the amplification of the campaign through a series of awareness messages on mainstream media on the various causes of the epidemic and how to identify the various symptoms of the disease. Pix by Anusha Kanchana

Do not take painkillers other than paracetamol for dengue fever

Consultant Physician Dr. Priyankara Jayawardena in an interview with the Daily FT shared vital information regarding what a person should do when he suspects or gets the confirmation that he has dengue. First of all, he said, when a patient comes in with a fever without cough, cold or a runny nose, we have to assume that it is dengue. This patient would normally have joint pains and high fever, with no cough, cold or a runny nose. There are certain steps we have to take therein. First we have to confirm whether or not it is dengue. The patient has to take the Dengue Antigen test on day one. This is the best test to confirm if it is dengue. The Full Blood Count should be taken on day three. Once diagnosed with dengue, treatment should begin instantly and all necessary precautions be taken to ensure it doesn’t turn fatal. Steps to take upon discovering one has dengue

Absolute bed rest.
Paracetamol to subside the temperature.
Tepid sponging (to cool down the body).
Take adequate amounts of fluid – This could be in the form of water, kanji or fruit juices. For an adult with an approximate body weight of 50 kg, the fluid intake should ideally be 100 millilitres per hour which is 2.4 litres every 24 hours. For a child, the intake is different, depending on his weight.

Avoid going to work.

Do not send children to school or tuition classes.
Do not send children for swimming or any form of sports.
Do not take painkillers other than paracetamol for the fever.
In the case of pregnant women the scenario is different and so extra precaution should be taken – she should see the doctor on day one and be hospitalised on day two.

Dr. Jayawardena said that he expects more cases during the present rainy season but although there are many incidences of dengue, there are fewer incidences of death because of the availability of good treatment facilities. One reason deaths occur is parents send their sick children to school or sports when they should be taking bed rest and treatment. Another reason for deaths is the patient takes strong painkillers instead of paracetamol. Taking other painkillers such as aspirin and ibuprofen can have adverse effects on the patient. Some patients ask for stronger medication in place of paracetamol to bring the fever and pain down. They say that they can always take paracetamol at home and they expect something stronger when they approach the doctors. This is not advisable and will severely affect the outcome of dengue. It is the responsibility of both the doctor and the patient to make the right decision here. He added, however, that a patient has the right to ask questions about his medication and to refuse any medication if he feels it is wrong. The patient has the right to know what medication he is being given, with no information withheld from him.