Andhra Pradesh alerted over surge in dengue cases

Andhra Pradesh dengue cases: The National Vector Borne Disease Control Programme has cautioned Andhra Pradesh alongside a few other states to simultaneously launch anti-dengue programmes in full force alongside the existing Covid-19 programmes to prevent unnecessary spurt in the former.

This warning become necessary in view of the similar symptomatology of fever, myalgia, running nose, malaise, etc., at least in the initial period of infection, thus making the clinical diagnosis difficult in infections like Covid-19, dengue, H1N1 and chikungunya.

In the eventuality of a patient being simultaneously infected with more than one virus (co-infection), the diagnostic challenge is further compounded, it said.

The Andhra Pradesh government should wake up to the reality sooner as the dengue cases are only rising this year as per the records available. While up to 750 cases of dengue had been registered till July this year according to the National Programme records, intermittent rains are only worsening the situation.

Every year, a few thousand cases of dengue are registered in AP, but these cases have come down in the last one year, records show. Still, in this post-Coronavirus world, the combo of the diseases would prove deadly health experts suggest.

Visakhapatnam has already shown a record of about 250 dengue cases till August this year alone. The agency population encounters this menace more than anyone else due to multiple factors, including low awareness levels and hygiene issues. Its dependence on quacks only multiplies the tribal population's misery.

The National Programme experts have asked the governments to focus upon specific clinical features in the categorical clinical diagnosis of a case. The treatment is mainly dependent on the severity or predominant infection of either dengue or Covid-19.

They have also suggested that mild to moderate dengue and Covid-19 co-infected patients should be monitored closely, preferably at the hospital, as they may rapidly progress to the severe stage.

Therefore, they should be referred to the higher centre at the early stage by recognising warning signs. At the same time, all secondary and tertiary level hospitals should be prepared to manage severe dengue and Covid-19 cases, they said.

It is not clear whether the medical and health department has developed protocols for clinical management of acute febrile illness, based on a scenario of co-circulation of arboviral diseases, Covid-19 and other respiratory viruses (like influenza).

Also, it is not known whether the need to specifically mention in reports about the co-infection of dengue and Covid-19 is being followed.

The coincidence implies the two outbreaks may happen during the same period with possible co-infections with both viruses leading to the overlap of symptoms, misdiagnosis and case management. Efforts must be made to lower the population of vector mosquitoes and this should result in lowering the risk of dengue, the National Programme has warned.

Yet another proof that dengue is spreading fast is the running out of Carica Papaya leaf extract tablets from the Ayurvedic outlets in the state. "Liquid is available but not in tablet form. This being the most preferred medicine to increase the platelets count, people prefer the tablets as the liquid has a pungent taste and the children may, especially, avoid taking it," says a leading Ayurvedic shop owner in Patamata in Vijayawada.