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DENGUE: AN URGENT PUBLIC HEALTH CONCERN

Jun 30, 2024 News, Waterfalls Magazine

By Dr. Karen Cummings MP

Former Minister of Health

Waterfalls Magazine – Understanding that the incidence of Dengue has increased over the past four decades and that the highest number of cases has been noted in the Americas. According to PAHO (2024), the Americas had recorded the largest proportion of the global burden in 2023, registering more than 4.1 million new infections.

The Guyanese population notes the valiant efforts being made by the Ministry of Health to secure vaccines to arrest the dengue transmission and the engaging of technical partners and stakeholders such as the Pan American Health Organization to build the capacity of health care professionals to manage clinically the Aedes aegypti mosquito, the primary vector of dengue.

However, is the Health Sector prepared to avert a major public health crisis, this vector borne disease, in a climate changing world?

The Dengue virus, an arthropode-borne virus of the genus Flavivirus family presents as four different serotypes (DEN -1, DEN-2, DEN-3, and DEN- 4).

Dengue is a common tropical infection transmitted to man by the Aedes mosquito and occurs from dawn to dusk. There is Dengue Fever and the Dengue Hemorrhagic Syndrome which can progress to Dengue Shock Syndrome. The general symptoms of Dengue include high fever, severe headache, retro-orbital pain, myalgia and arthralgia (muscle and joint) and a rash to the face or thorax-chest.

However, Dengue Hemorrhagic fever manifests itself with vomiting- hematemesis or as hematochezia (blood or blood in the stool), abdominal pain and difficulty in breathing. The Dengue Shock Syndrome occurs when the circulatory system fails, and is usually accompanied by tiredness, restlessness, irritableness, shock, organ impairment and death.

With 2,852 cases being positive and 265 persons needing hospitalization, with two deaths recorded eight weeks ago, and with 60 percent of the regions affected by the vector borne disease are cause for concern. With the recent death of an eleven-year-old child in Bartica, as reported 72 hours ago, seventy percent of our administrative regions have now been placed on the dengue alert.

A collaborative effort among the relevant stakeholders must be quickly undertaken.   With the advent of climate change, there must be strategic

efforts to involve the meteorology department to inform us of the meteorological factors such as temperature fluctuations, the pattern of rainfall, and the vector ecology. The One Health Concept, which recognizes the intrinsic link that connects human health directly to the health of animals and the environment, must not only be adopted but practiced.

It has been well established that the Dengue mosquitoes are susceptible to temperature changes and rises- a range between 20 to 35 degrees Celsius.   Hence owing to the vectorial capacity, there are now higher biting rates, more transmission, and more feeds.  Other drivers that can affect the vector competence will include land use changes and agricultural practices in urban settings, and a breakdown of public health. These players provide conditions for a wider spatial distribution, increase frequency, intensity, severity, and create the dynamics for increasing contact rates.

It will be foolhardy to think that the recent floods in Linden in Region 10, and in Region 5, will not create the opportunity for the vector- borne disease.

  • There must be better prevention and control that is intersectoral and involve the family and the community.
  • There must be a focus on Public Education and Awareness of this Vector – Borne Disease to include the reduction of breading sites and on personal protection.
  • Make repellants and mosquito nets free to the populace.
  • There should be One Health Surveillance.
  • The country may also need to relook the legislation on legal and illegal trade of wild- life and the legislation to protect Wildlife.

There must be sustainable vector control. There must be scheduled fogging. The environmental units of all Municipalities should have access to chemicals and fogging machines.

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