Bangladesh dengue deaths ‘lowest’ in the world, Health Directorate chief Azad says

Bangladesh has witnessed the “lowest” deaths from the dengue outbreak this year compared with other countries, the chief of the health department says.

“We don’t expect a single death. Even then I have calculated the death rate was only 0.002 percent among the patients who have been hospitalised,” said Prof Abul Kalam Azad, director general for health services, on Wednesday.

“If we consider the outdoor and private chamber patients, then the rate will be even lower,” he told reporters. “This is the lowest in the world this year.” The director general cited examples of 128 other countries that faced dengue outbreak this year.

The government’s disease monitoring arm, IEDCR, with the Bangladesh Health Reporters’ Forum or BHRF, organised the knowledge-sharing workshop for journalists on dengue following this year’s devastating outbreak.

Over 77,000 patients have received treatment in hospitals so far this year. Of them, hospital data suggest 191 died. But the IEDCR which is reviewing all deaths said 60 deaths were confirmed to have been caused by dengue among the 101 they have reviewed so far.

Does it mean that 40 percent cases were wrongly diagnosed in hospitals? The bdnews24.com public health correspondent asked the director general.

“In case of dengue, maybe a few cases were wrongly diagnosed because it’s a common disease this year. But that does not mean that their treatments were wrong,” he said.

“Hospitals give symptomatic treatment to the emergency patients. They follow the vital signs such as blood pressure, pulse and respiratory system and act accordingly. So we cannot say that the patients did not get treatment”.

But, he said IEDCR will analyse and try to find out the reason of deaths of those cases that were found dengue negative.

“Our efforts have been to prevent all deaths,” he said.

This year Philippines recorded highest number of cases of 208,917. Of them 882 died. In Thailand 70 patients died out of 70,000 admitted in hospitals. Malaysia recorded 131 deaths out of 82,270 hospitalised.

IEDCR Director Prof Meerjady Sabrina Flora said there is an overall increase in dengue cases in 2019 from previous years both in hospitals and private practices.

“Among patients with fever, 10-20 percent is suspected dengue cases,” she said.

“Some of the clinicians mentioned increased number of patients with atypical presentation. These might be co-infections with enteric fever or seasonal influenza,” she said, adding that although number of patients increased but complications and mortality remained “very low or moderate”.

Dengue is a mosquito-borne viral infection. The infection causes flu-like illness, and occasionally develops into a potentially lethal complication called severe dengue.

The global incidence of dengue has grown dramatically in recent decades. About half of the world's population is now at risk. There is no specific treatment for dengue, but early detection and access to proper medical care lowers fatality rates below 1 percent.

Dengue prevention and control depends on effective vector-control measures.

The IEDCR said of the patients outside Dhaka, they have found travel history within last two weeks of the onset of dengue fever among 59.4 percent.

In Dhaka, Aedes aegypti mosquito is mostly causing dengue and outside it is aedes albopictus which is dominant.

Prof Flora shared some preliminary data from Barishal that suggested that the patients in that district were mostly affected by alopictus variety of mosquito.

“We did not find any Aedes aegypti in the surveyed locations,” she said, adding that they had surveyed some areas in Barishal city from where most of the patients were admitted to hospital.

They also collected larvae which were later hatched in the laboratory.

“Out of the 755 adults mosquitoes that emerged (in the lab), 14 belonged to the Aedes species, seven to albopictus and the rest to other species. But none were aegypti,” she said.

But in a village in Kushtia, they found the presence of aegypti along with albopictus.