An increase in dengue cases in various parts of Nepal, especially Kathmandu and Pokhara, is worrying. While the carrier mosquitoes have been found in tropical and temperate climate belts the world over, they were not commonly found at higher altitudes. Recent cases in the Kathmandu Valley have been found to be indigenous, meaning that the persons affected were bitten by carrier mosquitoes—called vectors—in the Valley itself. Unless a drive to eradicate the mosquitoes is successful, which is unlikely judging by the Health Services Department’s inability to control an outbreak in Dharan, the mosquitoes and the dengue virus they carry are here to stay in the high altitudes of Nepal. Such are the issues climate change brings to areas previously unaffected. In the case of dengue, the authorities concerned need to coordinate across the tiers of government with a multi-sectoral approach. The entire chain, from the life cycle and habitat of the vectors to information regarding prevention and treatment, needs to be addressed simultaneously.

Aedes aegypti and Aedes albopictus are the two species of mosquitoes that act as vectors for the dengue virus. Besides dengue, the same vector is also known to carry other dangerous disease-causing viruses such as chikungunya, yellow fever and Zika. Dengue has no cure, and only early diagnosis or prevention can mitigate the effects of the disease, which can lead to hospitalisation and even death. Although this disease was usually not found in colder temperate belts and at higher altitudes, such as those found in the hilly and mountainous parts of Nepal, changing weather and temperature patterns have made them more common.

This is in itself dangerous, since locals are not worried enough to seek treatment when symptoms begin to show. Most may never suspect dengue to be the cause of the symptoms until the disease reaches a point where the afflicted’s life can be at risk. Many in Nepal often switch between paracetamol, aspirin and ibuprofen—all easily available over the counter—during times of pain and headaches. Since those affected with dengue often experience these symptoms, many do not seek treatment and simply take one of these medications. The problem here is that unlike paracetamol, these other medications can cause internal bleeding when people are suffering from dengue. Patients may also need constant observation and treatment with hydrating fluids, which they will not seek if they are not aware that the disease they carry is much more dangerous than a common cold.

The mitigation of dengue causing vectors is difficult. The mosquitoes breed and lay their eggs on clean, stagnant water. Climate change has not only increased temperatures in Nepal, making the country more habitable for Aedes aegypti, it has also brought water security issues—which has escalated due to mismanagement on the government’s part. People all over the country, especially in urban areas, are forced to store water in containers for lack of a running source. These containers become breeding grounds for Aedes aegypti. Therefore, to mitigate the rise of disease-carrying mosquitoes, a long-term multi-sectoral approach is necessary. Meanwhile, governments across tiers need to push out effective information campaigns so that people are aware of the danger, and can take the necessary preventative steps.