Presence of Aedes aegypti and Albopictus mosquitoes and their larvae in huge numbers in Kaski district, especially in Pokhara, is a cause for concern, an entomological study by the Vector-borne Disease Research and Training Center shows. What is more worrying, according to those involved in the study, is that larvae and mosquitoes were found in April, a dry month. Concerning that the Kaski Health Govermnent, Gandaki Medical College, Rotaract club of Pokhara Gandaki Medical College did 3 days screening program on Ward number 8 and 9 and surprisingly we got many larva on the clean water the house owner were not aware about it.   Female Aedes aegypti and Albopictus mosquitoes transmit the dengue virus. The same vector also transmits chikungunya, yellow fever and Zika viruses, according to the World Health Organisation.  “Vector is already there in huge numbers. If they get a chance to bite dengue-infected people, they can easily spread the deadly disease.”

Pokhara is the main tourist hub of the country, where thousands of tourists from across the world visit round the year. It is also the gateway to some of Nepal’s world-famous trekking destinations. The Epidemiology and Disease Control Division said that over 5,500 people were infected with the deadly virus last year and the entomological study was carried to assess the risk of an outbreak. “We are greatly concerned over the findings of the dengue vector in Pokhara,” Ghanashyam Pokhrel, a senior public health administrator at the Division, told the Post. “We have also alerted the provincial government and other agencies concerned.” Panta said that drinking water scarcity in Pokhara was the main reason for the dengue outbreak last year. Due to an acute shortage of drinking water, people in Pokhara would hoard water in jars, buckets, gallons and other pots, creating a fertile breeding ground for the dengue mosquito to spread.

The vectors breed in clean water and are active during the day.  Uncovered water tanks and discarded plastic cups and bottles also are a breeding ground for dengue-carrying mosquitoes.About 1,000 people of the sub-metropolitan city have been infected with the deadly virus in the last two months. “Every day 15 to 20 new people infected with dengue virus have been receiving treatment at various health facilities.

• This Dengue can take outbreak on any corner of the world so we need to be concern about the preventive measures, Dengue mosquito, Aedes aegypti prefer to bite indoors primarily during the day.
• The biting behavior of this mosquito is peculiar. It can bite one without being noticed and usually it approaches from behind and bites mainly on the ankles and elbows. Only female mosquito bites to obtain blood to lay eggs.
• The mosquito lay eggs during the day in water containing organic material, like decaying leaf, algae, etc.
• Dengue is a febrile illness with symptoms appearing 3-14 days after the infective bite.
• Dengue is inflicted in two forms:

–Dengue Fever,Dengue Haemorrhagic Fever (DHF), which is complicated, a severe and more dangerous form of Dengue. Haemorrhagic affected in the areas of skin (easy bruising), gums and gastrointestinal tract.

The symptoms generally last for about ten days and can include:

• Sudden high fever
• Severe headache
• Swollen lymph glands
• Severe joints and muscle pain
• Skin rash (Appear between two to five days after the initial fever)
• Mild to severe nausea
• Mild to severe vomiting
• Mild bleeding from nose and gums.
• Bruising on skin
• Febrile convulsions
• Pain behind the eyes
• Drowsiness or irritability
• Pale, cold and clammy skin
• Difficulty in breathing

In some cases, the symptoms get worsened and can become life-threatening as well. Blood vessels often become damaged and leaky resulting in the drop of the number of clot-forming cells (platelets) in the bloodstream. This can lead to:

• Heavy bleeding from the mouth and nose
• Sharp pain in abdominal area
• Persistent vomiting for a long time
• Bleeding under the skin, that might look like bruising
• Problems in the lungs, liver and heart.

Complexities of Dengue Fever: Haemorrhagic Fever

 Small percentage of individuals who suffer from dengue fever can develop a more severe form of disease known as dengue haemorrhagic fever. The risk factor for developing dengue haemorrhagic fever include:

• Presence of having antibodies to dengue virus from the previous infection
• Being under the age of 12
• A weakened immune system.

In this case, the blood vessels or capillaries become excessive leaky, allowing the fluid component to escape from the blood vessel. This situation can lead to the collapse of the circulatory system and eventually may result in death without prompt and appropriate treatment.

Tests and Diagnosis

Diagnosing dengue fever ca be a difficult task because its signs and symptoms are confusing with those of other diseases such as malaria, leptospirosis, typhoid fever, etc. However, listed below are some of the tests that can be done to diagnose the condition:

• Antibody titer for Dengue virus types
• Complete blood count (CBC) Test
• Polymerase Chain Reaction (PCR) test

Preventive Points

A common phrase used in medical parlance is ‘Precaution is the best cure’. There is no vaccine to prevent dengue fever. Also, there are no appropriate medications that can target the dengue virus directly. The best method of precaution is to avoid mosquito bites and to reduce the mosquito population. Below are few precautions which if followed can minimise the chance to get infected with the lethal viral disease.

• Avoid densely populated residential areas.
• Keep your home and environment hygienic. If your surroundings are clean, there will be no room for the mosquitoes to breed.
• Mosquitoes breed at stagnant water places. So do not store water in empty containers. Throw away or recycle water-holding containers that are not in use. Change flower vase container weekly. Check for hidden water bodies like manholes, septic tanks, clogged drains, wells, etc.
• The areas where still water can collect such as, birdbaths, pet dishes, empty planters, flower pots, cans, etc., should be checked, emptied or changed regularly.
• Use mosquito repellents on exposed skin.
• Use air conditioning instead of opening windows.
• Use mosquito net if sleeping areas are not covered.
• Wear long sleeve clothes and long pants when mosquitoes are most active (primarily during the day).
• Make sure windows and door screens are secure and free of holes.
• Seek early consultation, if experienced with Dengue symptoms.

A timely detection can help in the proper treatment of this lethal disease. If you or your loved ones happen to experience any of the symptoms mentioned above, do not take it lightly.

  Reference: The Kathmandu Post , www.lalpathlabs.com