Dengue type 2 cases rise, prevention key, say experts

As authorities stay focussed on the Covid19 pandemic another health challenge has emerged from different parts of the country including Maharashtra mdash steep rise in dengue subtype 2 considered a more severe form of the disease Wellknown virologist Dr Jacob John who has done extensive research on it said this is the first time after a long gap such an outbreak has surfacedDr Wiqar Shaikh Professor of Medicine Grant Medical College and Sir JJ Group of Hospitals said 11 states have so far reported a spike in dengue cases He said the viral infection spread by the Aedes mosquito has 4 variants mdash DENV1 DENV2 DENV3 and DENV4 Headaches shooting pain in eyeballs nausea Joint bone or muscle pains and rashes are among its common symptomsDr Santosh Bansode HoD Emergency Medicine Wockhardt Hospital Mumbai CentralEven if a person develops immunity to one particular serotype after getting infected by it there are chances of getting the other infections ldquoIt is possible to be infected 4 times and a repeat infection increases the risk of complications The current infection sweeping across India is caused by DENV2 which can trigger a high number of cases and increased complicationsrdquo This infection can cause Dengue Shock Syndrome in which the blood pressure becomes dangerously low and Dengue Hemorrhagic Fever which results in severe bleeding Dr Shaikh said DENV2 is known to be more lethal in childrenManagement of dengue patients is supportive and symptomatic he said ldquoAs in all viral infections early diagnosis is the key and early and prompt medical care can reduce the death rates to less than 1 per centrdquo he said adding that the disease claims about 40000 lives in India every year ldquoDENV2 cases this year may surpass all previous dengue recordsrdquo Cautioning against the commonly used lsquopapaya extractrsquo for dengue patients he said there is no authentic and scientific evidence to recommend it Dr Santosh Bansode HoD Emergency Medicine Wockhardt Hospitals Mumbai Central said studies have shown that serotype 2 infects and invades mosquitoes at a faster rate ldquoThatrsquos why if it starts spreading in humans we can get a rise in the number of dengue cases which if spread may become a challenging situation for us to handle We are already fighting against covid and we donrsquot want another epidemic nowrdquo he saidDr Bansode said prevention is the best way to control dengue ldquoGeneral population must be made aware of this variant and overall dengue Vector control should be done aggressively Use of mosquito repellents should be encouraged Doctors should also suspect and investigate fever patients to rule out dengue Early detection is important in treating denguerdquo said Dr Bansode He added ldquoBlood banks should be alerted to keep adequate reserves of blood components especially plateletsrdquoFast rise of DENV2 and DENV4According to Dr Subhash Hira Professor of Global Health at the University of WashingtonSeattle and an expert of infectious diseases DENV2 and DENV4 variants have been spreading more rapidly in India for the past few yearsHe said ldquoThe conservational treatment of dengue by hydrating and managing fever works well for most patients except those who progress to dengue haemorrhagic fever and dengue shock syndrome The latter may benefit from monoclonal antibodies that are presently in experimental use Like many vectorborne infectious diseases dengue is preventable by eliminating daytime biting Aedes aegypti mosquitoes that breed in freshwater stagnated sitesrdquoTop virologist speaksVellorebased top virologist Dr Jacob John said ldquoWhen health experts say that high prevalence of serotype 2 dengue virus is unprecedented the fact is that type 2 was the predominant virus in Western UP during 1969 and 1970 In fact the dengue virus type 2 was first isolated in India in Vellore in 1964 Since then types 1 2 3 and 4 had taken turns in causing outbreaks in different parts of the countryrdquoHe said the 1996 Delhi dengue outbreak was with type 2 ldquoIn recent years types 1 and 3 have dominated So the long absence of type 2 is the reason why it has now become dominantrdquo explained Dr JohnldquoDengue by itself is not lifethreatening but Dengue Haemorrhagic Syndrome is and dengue 2 has been associated more frequently than others with DHS If diagnosed early and treated correctly DHS need not cause deathrdquo he concluded11No of states that have seen a spike in cases