KARACHI: Prevalent indifference intensifies threat: PMA session on dengue
By Faiza Ilyas
KARACHI, March 18: If the looming dengue threat is to be thwarted, groups and committees should go out and check on mosquito breeding places in neighborhoods.With the prevalent indifference, there is every possibility that dengue this year will cause more death and disease.
This warning came from doctors at a scientific session on dengue organised by the Pakistan Medical Association on Saturday. The speakers included Dr Shehla Baqi, in charge of the infectious diseases unit (isolation ward), Civil Hospital Karachi, Dr Naseem Salahuddin, infectious diseases department head of Liaquat National Hospital, and PMA General Secretary Dr Qaiser Sajjad.
Addressing the gathering, Dr Naseem Salahuddin said prevention was the only solution since no vaccine for dengue existed. Countries like Cuba, Malaysia and Singapore had considerably reduced dengue incidence by using public health measures.
“We can do it, too, if everyone knows about the disease, vector and how to prevent and control it in homes and community. For this, government and media must do their job. People should set up committees at mohalla level for the purpose,” she said.
Recalling the past dengue episode which claimed 50 lives and affected 4,500 people in Sindh, the experts expressed apprehension that this year dengue’s attack would be harsher in the absence of preventive measures. They warned that the people who had a previous history of dengue fever should be more cautious this year as they were vulnerable to a severe form of the disease.
“Karachi is now a hyper-endemic area where three serotypes are present. After a fall in cases, there will be an increase in dengue cases in later months. The disease will spread to more cities and there will an upsurge in morbidity and mortality,” said Dr Naseem Salahuddin.
From her last year’s experience at the Liaquat National Hospital, where 336 patients were admitted, she said male to female ratio was 70:30. She said if the patient had classical dengue symptoms, doctors should not waste time on dengue tests and start treatment. They shouldn’t show hastiness in administering blood or platelets if patient’s condition was stable and there was no bleeding. A lot of money was wasted last year on platelet kits owing to the poor management on part of doctors, she said.
About the history of dengue, Dr Shehla Baqi said it was described in the 18th century and the virus was isolated in 1944. It came to Asia in 1950s and its first episode in Pakistan occurred in 1994. As the management of this infection was predominantly supportive, the emphasis should be on prevention.
Dr Qaiser Sajjad said though the government aimed to launch ambitious health projects, it was not ready to spend money on provision of basic health facilities. For instance, he said, the government should set up a laboratory for viral diagnosis as none existed at present. He admitted that doctors’ mishandling caused complications in many patients last year and they needed to be educated about the disease. Fluid management was the best supportive treatment and no anti-viral and antibiotic should be given to dengue patients, he said.
