Dengue, kala-azar and malaria cases are being reported in several parts of the country amid the coronavirus crisis.

According to the Epidemiology and Disease Control Division, as many as 53 dengue cases have been reported in various districts, including in Kathmandu and Lalitpur.

"Eight cases of dengue—four from Kathmandu and four from Lalitpur— have been reported recently,"Uttam Raj Pyakurel, a senior vector control inspector at the division, told the Post. "All the cases reported from Kathmandu Valley are indeginious, as patients do not have history of travelling to other parts of country recently."

Likewise, 14 dengue cases have been reported in Rupandehi, eight in Myagdi, four in Pokhara of Kaski, three each in Morang and Kapilvastu and two from Sunsari.

"The data is based on hospitalisation cases reported by the state-run hospitals. It does not take into account the patients being treated in private hospitals or those who were returned from the out-patient department of state-run health facilities with medicines," Pyakurel said.

Dengue sufferers with mild symptoms do not visit the hospital and 70 to 90 percent of the cases are asymptomatic, suggesting that the incidence rate could be much higher, health officials say.

Dengue is a mosquito-borne disease, which is transmitted by female Aedes aegypti and Aedes albopictus mosquitoes. The same vector also transmits chikungunya, yellow fever and Zika virus.

Dr Basudev Pandey, director at the division said that the surge in vector borne cases including dengue in big cities like Kathmandu Valley and Pokhara is a matter of serious concern.

"At a time when we all are focussed in the fight against the Covid-19, we are also witnessing a surge in the number of several vector-borne diseases," Pandey told the Post.

He warned that rising temperature and increase in pre-monsoon rainfall could make the matter worse.

Last year, six people died and over 16,000 people were hospitalised due to dengue outbreaks in 68 districts.
An entomological study by the division had found that serotype-2 dengue virus was responsible for last year’s outbreaks. There are four serotypes of the dengue virus and all of them have been known to exist in the country.

Health officials warn that it would be risky if the people who were already infected by one serotype of the dengue virus were to be infected again with a new serotype.

"We are planning to perform a nation-wide study of the vector this year," Pandey said. "Budget has been allocated for 140 local levels for the preparedness against the vector borne diseases and awareness drive."
There has also been an explosion of kala-azar, also known as Visceral Leishmaniasis or black fever, in many parts of the country.

Health authorities have recorded at least 65 kala-azar cases in 51 districts, including those districts that were considered non-endemic in the past, such as Kalikot, Humla, Dolpa and Okhaldhunga. 

Six cases have been reported in Kalikot, five in Dolpa, and four in Humla.

"We had committed to declare elimination of kala-azar by this year, but cases have been expanding in the hill and mountain districts at an alarming rate," Pyakurel, the senior vector control inspector at the division, said. “We are preparing to send our team to Manebhanjyang area in Okhaldhunga to study the vector of kala-azar.”

Kala-azar is transmitted through the bites of infected female phlebotomine sand flies.

Detection of kala-azar cases in areas above 650 metres where it was thought impossible for female phlebotomine sand flies to survive is a cause for serious concern, health officials say.

Weight loss, weakness, cough and fever that lasts from a few weeks to months are common symptoms of kala-azar.

Besides dengue and kala-azar, health officials say malaria cases are also being reported in several parts of the country.