THE first dengue case surfaced in Punjab in 2003. Since then the government, especially in Lahore, did not take necessary precautionary measures, including spray of killer mosquitoes, ending slums and unnecessary pools of water which caused breeding of the dengue virus.

The negligence caused the outbreak of the disease in 2011, claiming 205 deaths and 15,035 infections by Oct 8.

A similar negligence is being observed by the city government and the cantonment board, Hyderabad. The three localities of Hyderabad, Latifabad and Qasimabad have always been a safe haven for mosquitoes and flies. Improper or no disposal of garbage, the under-capacity drainage system, ubiquitous slums, pools of stagnant water and infrequent use of anti-insect spray provide a friendly atmosphere to mosquitoes and flies.

The tag-team of two insects has been working round the clock for the last many decades, sending defenseless citizens to hospital. While seeing Hyderabad at Google maps, one observes three large water bodies: two on both sides of the National Highway segment N5, and the third one behind Hyderabad Gymkhana. Perhaps, all three within the jurisdiction of the Hyderabad Cantonment Board.

If I am not mistaken, I have been seeing these massive pools of water for the last two decades. The mix of sewerage and rainwater is so consistent that an ecosystem has established in there.

Migratory birds in the winter season get deceived and land on these waters, perhaps mistaking the waters as the Manchar Lake. Mosquito farming is at full swing, and the water or airborne diseases are rooted in these waters. Up to now, a few cases of dengue fever have been reported in Hyderabad. If this disease turns into an epidemic, these water bodies will be one of the main sources of the disease.

The responsibility lies on authorities who failed to plan and execute a project in the last two decades for the permanent disposal of stagnant water. Let us pray for invoking the divine that the life-hogging disease doesn’t spread anymore and the court need not take any suo motu action against the authorities concerned.

AFTAB AHMED MEMON Hyderabad

Ocular complications

DENGUE fever is rampant in various parts of the country, causing a great concern among people. The disease can cause eye complications, threatening vision in 10 per cent of sero-positive patients during hospitalisation.

Dengue fever is caused by a virus, which has predilection for small blood vessels in the body and central nervous system. It is an immune-mediated disorder rather than a direct viral infection. During hospitalisation a patient may complain of gross visual disturbances in one or both eyes. He may suffer permanent loss of vision if not treated well in time.

A detailed study has been reported by two main hospitals from Singapore and, accordingly, the usual complications of dengue fever are optic neuritis and dengue neuropathy, mainly involving the optic nerve and macula -- the most sensitive part of the retina (the visual membrane) with maximum vision.

Treating physicians are advised that if they find the signs of the above-said afflictions, the patients should be treated with a course of IV methylprednisolone (starting with 1G daily for three days), to be repeated if necessary after consulting the senior eye specialist of the hospital.

The complications are uncommon, yet very serious as these have far-reaching economic consequences for society.

Therefore, the patient in general and the treating physician in particular must keep in mind the possible complication while evaluating the patient.

In fact, a routine examination should be carried out if the patient complains of slightest visual disturbance.

PROF (DR) M. YASIN KHAN DURRANI Rawalpindi