The mortality rate from the disease this year is approximately 0.53 percent, or 1 in every 189 patients
Published : 19 Jul 2023, 01:12 AM
In addition to the large number of dengue cases in 2023, the year has also seen a shockingly high mortality rate from the disease, setting new records.
Public health experts say that an analysis of the situation suggests that a major disaster looms.
The Aedes mosquito-borne disease has claimed hundreds of lives before, but this time the mortality rate has exceeded 0.50 percent.
As of Jul 16, 22,467 people have been hospitalised with dengue since January 1 this year, of which 127 have died. This means one of every 189 patients is dying, putting the mortality rate at 0.53 percent.
In 2019, Bangladesh saw a record 101,354 dengue patients in hospitals. Among them, 179 people died. That is, on average 1 in 566 patients, a mortality rate of 0.18 percent.
In 2021, 105 people died of dengue, 28,429 people were infected and treated in the hospital. That is, 1 in every 270 people died for a mortality rate of 0.37 percent.
In 2022, out of 62,382 dengue patients who went to the hospital, 281 died. Accordingly, 1 person in 222 died, putting the mortality rate at 0.45 percent.
The highest number of dengue deaths occurred at Mugda Medical College Hospital, where 27 people died. The public hospital is also the one that has seen the most patients infected with the disease.
Hospital Director Dr Niatuzzaman says those who died came to the hospital very late and had to be sent to the ICU.
“Many patients come to the hospital so late that nothing can be done. Ninety-five percent of our deaths are in the ICU. Each of them had complex issues.”
“The ICU is a place where patients are usually admitted with multiple problems. They don’t have sufficient oxygen saturation, their blood pressure cannot be recorded, which means they are suffering from multi-organ dysfunction syndrome.”
Niatuzzaman observed that, due to the change in symptoms, many patients do not know they have dengue. That is why they come to the hospital late.
He said, "We are seeing complicated dengue syndrome. If infected, the patient’s symptoms will also be unusual.”
“We have seen many patients who have come in with diarrhoea. Many experienced vomiting. There are also patients who accumulated water in their stomachs and chests, and had swollen hands and feet. They have inflammation of the brain, brought on by convulsions. Many are conscious, but their blood pressure cannot be recorded. Sometimes they have fever, sometimes they do not. Many times patients think they are getting better.”
Medicine specialist Prof ABM Abdullah says, “The common symptoms of dengue like fever of 103-104 degrees Celsius, pain, rash on the body, decrease in platelet levels have changed now.”
"There are no clear symptoms of dengue this time. Since there are no typical symptoms, people don't understand, so they delay getting tests. Delayed response to serious conditions make it difficult to save patients.”
Those who have pre-existing complications, like those with kidney, heart, and liver issues and cancer patients are dying more frequently, he said.
This expert said that most of the people whose condition is deteriorating have been infected with dengue before, “There are four types of dengue. If someone is infected for a first time, the situation is not very difficult. But the second, third or fourth attack becomes very serious.”
He said that if someone was infected with dengue in the past, they can be infected with another subtype for a second, third or fourth time. And in that case they do not exhibit the usual symptoms like 103-104 degree fever, body and head aches – instead, experiencing other symptoms like low fever, diarrhoea, vomiting or uncontrolled blood pressure. In such cases, their health can deteriorate quickly.
Public health expert Dr Lelin Choudhury thinks that since 2000, many people are suffering from 'secondary dengue' due to the increasing incidence of dengue in Bangladesh.
“There are basically four types of dengue. Having previously been infected with one variant, this time they are being infected a second or third time with a different type. As these secondary dengue symptoms and signs change, so does the risk of complications and death.”
"Most of the dengue cases in Bangladesh this year are second or third cases. This is one of the reasons for the severity of death and illness in dengue this year.”
According to the pre-monsoon survey of the Department of Health, there is a dangerous concentration of dengue-carrying Aedes mosquitoes in all 55 wards of Dhaka this year.
In the seven months until July last year, 2,660 people were infected with dengue, 10 people died. In the first 18 days of July this year, 16,022 cases were detected, 80 people died. In June, 5,956 people were infected and 34 died.
Dr Abul Bashar Mohammed Khurshid Alam, director general at health services, suggests the dengue outbreak will be prolonged this year due to the late arrival of the monsoon season.
Dr Lelin Chowdhury, director at the Health and Hope Hospital in Dhaka, fears a major disaster.
"There has been an outbreak of dengue since the beginning of monsoon. It has started increasing at a higher and higher rate. If dengue transmission continues in this pattern during the first two weeks of July, August and September, the situation will be dire.
[Writing in English by Shoumik Hassin]