Amid an outbreak of cholera in various places of Kathmandu Valley, several cases of dengue have been detected in Lalitpur Metropolitan City.

At least 13 of all cases of dengue infection in the Valley have been reported from Lalitpur. Of them, 11 cases have been reported from Tikhedewal, which is in Ward-5 of the metropolis.

“We have started a dengue search-and-destroy campaign in the affected areas, following reports of infection of the virus in several people,” said Satis Bista, chief of Health Office Lalitpur. “We have alerted all agencies concerned about the risk of the spread and asked them to take preventive measures.”

Dengue is a mosquito-borne disease, transmitted by female Aedes aegypti and Aedes albopictus mosquitoes. The same vector also transmits chikungunya, yellow fever and Zika viruses, according to the World Health Organisation.

Although post-monsoon is considered a high transmission season for the dengue virus, Nepal has witnessed outbreaks of the deadly disease in the pre-monsoon, monsoon and post-monsoon seasons.

Experts warn that the timing of the dengue outbreak is serious, as the country has already been dealing with a double whammy—outbreak of cholera and resurgence of Covid-19.

“We used to talk about double whammy, but there is a chance of a triple whammy—surge in Covid-19 cases, cholera and dengue,” said Dr Baburam Marasini, former director at the Epidemiology and Disease Control Division.

In 2019, at least six people had died and over 16,000 were hospitalised with dengue fever. The outbreak, which had started in the pre-monsoon period from Dharan, spread to 68 districts throughout the country.

Doctors say with the infection of dengue detected in Lalitpur, the disease can spread easily in other places of the densely populated Valley. Sporadic cases of dengue have been reported in many districts, including in Kathmandu, this year.

At least four cases of dengue infection have been reported in Kathmandu so far this year. Officials at the division informed that at least 164 cases of infection have been reported in the country so far this year.

Officials at the Epidemiology and Disease Control Division say that the rise in dengue infections amid cholera outbreak and the surge in new cases of coronavirus is concerning.

“We held a meeting with the directors of private hospitals and staffers working at the medical records section and asked to report the cases of infection at the earliest,” said Dr Gokarna Dahal, chief of the Vector Control Section at the division. “But the problem is over 70 percent of the infected people do not get seriously ill and do not visit hospitals, but they can spread the infection.”

Mosquitoes that cause dengue breed in clean water and infect people in daylight. Due to an acute drinking water crisis, people in the Valley store water in jars and pots, which could be ideal breeding grounds for these mosquitoes. Uncovered water tanks, discarded plastic cups and bottles could also shelter dengue-carrying mosquitoes.

Most of the dengue cases reported in Lalitpur are indigenous—meaning, the infected people contracted the virus locally, officials said.

According to doctors, mild to high fever, severe muscle pain, rashes, severe headache, and pain in eyes are some of the symptoms of dengue.

The UN health agency says that there is no specific treatment for severe dengue, but early detection and access to proper medical care can lower the fatality rate.

Amid rise in dengue cases, at least 27 cases of cholera infection have been confirmed in Kathmandu Valley, according to the Epidemiology and Disease Control Division. Meanwhile, the country reported 102 cases of Covid-19 on Saturday, according to the Ministry of Health and Population, taking the number of active cases in the country to 605.

Marasini, the former director at the Epidemiology and Disease Control Division, said authorities should pay extra attention given the vectors that spread dengue are already present in the Kathmandu Valley, which has a suitable environment for them to breed.

“Authorities concerned should launch an awareness drive and search-and-destroy campaigns to lessen the risks,” he said. “What is alarming is that the spread of infection could continue throughout the monsoon.”