Dengue infection was first seen in Nepal in 2004, but the infection spread and continued after 2006. Garbage disposal, unorganized housing, incessant rains and environmental destruction are contributing factors to the growth of mosquitoes.

According to experts, due to climate change, dengue-causing mosquitoes are moving 21 feet higher every year in different parts of the world. Even if the minimum temperature rises by just 1 degree, the disease will increase by 27 percent. As temperatures rise, mosquitoes have the opportunity to grow faster, become more infectious, have a faster life cycle, and live longer.

According to the World Health Organization, about 3.97 billion people in 128 countries are at risk from dengue. Every year, more than 5 to 100 million infections occur and more than 500,000 are of a severe nature, causing the death of 22,000 children and 24,000 people. Dengue, which was seen in 1 person in Nepal in 2004, was not seen in 2005.

has been appearing and killing since 2006 . In 2019, 17 thousand 992 people were infected and 6 people died in 68 districts. In Nepal every 2/3 years, dengue has become an epidemic. Like every year, this year too dengue infection has been increasing since June and the ministry has predicted that it will be high in August and October. 

Dengue is also spreading in the mountains

Dengue, which is seen only in the summer season and Terai, has started to appear in the twelve month and high Himalayan regions as well. Dengue, which drops to zero in the cold season, seems to be adding to the challenge in the health system after appearing in the winter in previous years. In the Himalayan districts of western Nepal, after the vehicle reaches village after village, mosquitoes are everywhere.

Dengue patients are increasing in Mugu, Jumla, Calikot after being fed up with mosquito bites during the day and night. The number of fever and dengue patients is increasing every year in the eastern hilly districts including Panchthar. Increasing population density and unorganized urbanization of cities including Kathmandu, increasing temperature, forced to collect water in households, prolonged rains and pre-monsoon, climate change and road potholes, tires and water accumulation in Kausi are increasing dengue .

What is dengue?

Dengue is caused by an acute infection of type 1, type 2, type 3 and 4 of the dengue virus belonging to the phlevi virus group . Because there is a lot of pain in the muscles and bones, it is called 'breakbone' or 'bone fever' in the vernacular. It is also called three-day fever because the dengue disease gets milder in three days. After infection with four types of dengue virus, fever that does not show symptoms or cannot be distinguished, dengue fever (DF), dengue hemorrhagic fever (DHF) with blood plasma coming out and hypovolemic shock can be dengue shock syndrome (DSS). 

Transmission - the smart behavior of mosquitoes

Dengue is infected by the bite of Aedes aegypti and Aedes alvopictus mosquitoes. But since alvopictus fills the stomach in one bite, the disease is not transmitted from its bite. Black mosquitoes are transmitted by white dots or mottled or tiger-like mosquitoes. 5 ml of frozen water and a temperature of 16 to 40 degrees are enough to grow. Active during the day and inactive at night. The size is small, it is not visible and the noise is not heard because it comes in the afternoon.

Patting does not bleed, it looks like black, fluffy dust . After being bitten, the body feels itchy, pimples appear, sometimes it itches badly and sometimes the pimples grow and cause big blisters . Grows and blooms in clean water. Mosquitoes are also found in the water of the tank on the roof. Mosquitoes live for 3 weeks and transvirally infected mosquitoes also transmit the virus to flowers . They are usually more active between 7am and 10am and 3pm and 5pm.

This mosquito that only bites in the afternoon is found in awkward places like unnatural rent, stagnant water inside the house like AC, cooler, drinking water tank, vase, pot, discarded tire, empty bottle of mineral water . The most dangerous is the tire where water freezes in every letter or layer. Because it lives in clean water, this mosquito is called the Asian Tiger or  Also called VIP mosquitoes . All mosquitoes born from flowers fertilized by infected mosquitoes remain infected for life. But dengue cannot be transmitted from person to person without mosquitoes. 

symptom 

Almost 80 percent do not show serious symptoms, so most of them have already been infected and once they have been infected, there is a possibility that they will not be re-infected immediately . In 5 to 8 days after the virus enters the body, the symptoms of laziness, headache, dry eyes, and cold will appear. Seen . Fever, chills and headache or body ache are the triad of dengue.

Sudden shivering with a feeling of cold, high fever, severe headache, pain behind the eyes, leg muscles, bones, back and joints start to ache . The main symptom is extreme physical pain. Most of the infected people are at home with symptoms and are working continuously in their daily work. 

  1 out of every 20 infected people may have complications and the death rate is 1 to 2 percent. Senior citizens, chronic patients, pregnant women, small children and repeated infections may have complicated problems. After severe fever of dengue virus infection, symptoms of bleeding appear which is known as 'DHF' without healing for a week.

Bleeding, bleeding spots, loss of blood, pale face, severe abdominal pain, sweating, abdominal pain, back pain, blue mouth, water accumulation in the body, decreased amount of albumin in the blood, black stools and can affect the liver .

DSS-shock can affect living tissue. About 5 percent of dengue cases have low plasma volume, low water content, and hypovolemic state and require hospitalization. After dengue suppresses bone marrow, the total count and platelets decrease . Platelet count should be monitored for 2 to 3 days as platelets should be transfused.

second, third time more complicated than the first

It becomes more complicated because the virus that infects the first time and the second time is different. Because previously formed antibodies do not work and the antibodies are easily spread using the cells of the immune system, vaccine development and effectiveness have not been achieved. Common people do not have many complications, but chronic patients and those with health complications can affect a lot .

danger signs and symptoms

Sudden vomiting, excessive stomach pain, bleeding from the nose, gums or other parts of the body, blood in stool, urine or vomit, laziness or restlessness, rapid breathing or difficulty in breathing.

When examined by the doctor, it appears that water has accumulated in the stomach or lungs, the size of the liver has increased by 2 cm more than normal, and the number of platelets in the blood has dropped sharply . Dengue fever remains severe for 2 days. Like the model of covid-19, dengue infected are many and only some are serious, so it is important to take treatment at home, but if there are symptoms of complications, it is necessary to go to the hospital immediately .

post Dengue is also the same

In Nepal, those who have recovered from dengue have problems such as insomnia, increased heart rate, irritation at small things, rigors, eyeball pain, mental problems, anxiety, unwillingness to work, anxiety, skin diseases, itching, weakness, joint and muscle pain, loss of appetite, hair loss, etc. for 6 months or more. They have been seen for a long time.

For one and a half months after the infection, the skin may become dry, itchy, sick, and the problem of hair loss is seen temporarily especially in women . Also, the effect lasts for a long time in those with reduced immunity or chronic diseases. Post dengue is seen in 15 to 25 percent. Post-dengue syndrome is more common in those who have been hospitalized and recovered.

Fainting by eating fruit leaves

Eating fruit leaves cures the disease quickly, prevents platelet reduction and normalizes the decrease quickly. After using the fruit leaves, there are many people who have abdominal pain, nausea, vomiting and go to the hospital for consultation. In the long run, it has a negative effect on the liver and other organs.

prevention

Dengue is a disease caused by the infection of the virus, so there is no cure. Treatment is based on symptoms. Classic dengue is the common type and is self-limiting and rarely fatal. If dengue hemorrhagic fever or dengue shock syndrome occurs, death will occur if not treated properly. 

Medicines like aspirin and brufin should not be taken . Real and quick treatment by giving plenty of liquid and loose food to eat can reduce the symptoms as well as the complications and death of the disease by less than ten percent . Dengue vaccine is available in developed countries but not here. The vaccine has been found to reduce dengue complications by 90 percent, hospital admissions by 80 percent, and symptoms by 50 percent.

The government has made and implemented a clear annual action plan. It has been sent to all 77 districts for implementation. In the action plan, there is a special circular with vector control, how to prevent the growth and development of mosquitoes, what to do, the role of the local level, the role of the Red Cross, and action plans for 92 local levels with high risk. In order to prevent and control