Feature Tropical Disease

What can India do about dengue fever?

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f643 (Published 04 February 2013) Cite this as: BMJ 2013;346:f643
  1. Mohuya Chaudhuri, freelance journalist, New Delhi
  1. mohuya.chaudhuri{at}gmail.com

Each year India’s dengue epidemic gets worse, with almost 50 000 cases reported in 2012. Mohuya Chaudhuri gives some reasons

It has taken several outbreaks for the government of India to realise that dengue fever is a serious public health problem. Every year, without fail, this tropical infectious disease affects thousands of Indian lives.

In the past decade, according to the National Vector Borne Disease Control Programme (NVBDCP), the number of cases has escalated steadily from 3306 in 2001 to 47 209 in 2012. Deaths have risen from 53 in 2001 to 242 in 2012. However, these figures were collected only from government hospitals and not the private sector. Scott Halstead, adjunct professor in the department of preventive medicine and biometrics at the Uniformed Services University of the Health Sciences, Bethesda, has stated that India has an estimated 37 million cases of dengue, with 227 500 hospitalisations.

Last year’s outbreak saw a sharp rise in cases of dengue hemorrhagic fever and dengue shock syndrome along with regular dengue fever. Hospitals in Tamil Nadu, Kerala, Andhra Pradesh, Maharashtra, and Bengal, the states with most cases, found it hard to cope with the number of patients affected.1

Size of the problem

Several studies have examined the size of the problem and why dengue has spread so rapidly.2 3 4

The findings show that initial outbreaks, from the late 90s until the beginning of the millennium, were limited to urban areas. As cities and towns modernised in an unplanned fashion, construction sites became breeding grounds for the Aedes aegypti mosquito, the commonest vector for dengue in India.

Dengue is no longer restricted to urban centres, with outbreaks now occurring in rural India. Nearly every state in India, including isolated islands such as Andaman and Nicobar, now reports cases.

P Vijayachari, director of …

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