The District Health Office Lalitpur has urged local units in the district to launch a mosquito search-and-destroy campaign in light of the increasing number of dengue cases in the Valley.

The local units, however, have said they do not have a budget for the drive and asked the government to provide necessary funds.

“We have requested the local units to launch a search-and-destroy drive but they have put up a demand for budget,” said Satis Bista, chief of the Health Office. “Since the Health Office has not allocated a budget for such drives, we have written to an agency under the provincial government requesting for the same.”

The Health Office can only request the three tiers of government—local, provincial, and federal—to adopt preventive health measures but cannot dictate their implementation.

The Epidemiology and Disease Control Division said that around 1,200 cases have been reported in 61 districts including Jumla and Kalikot until Monday. Lalitpur reported over 300 cases of dengue infection mostly from the metropolitan’s wards 5, 9, 11, 12, 14, and 15, and some wards of the Mahalaxmi Municipality.

Experts say the delay in taking preventive measures such as launching a dengue search-and-destroy drive means the infection rate could increase exponentially.

“We also don’t have a budget to provide to the local units to launch the drive,” said Dr Chuman Lal Das, director at the Epidemiology and Disease Control Division. “Local units concerned should use their own resources.”

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 the post-monsoon period 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.

Officials at the Ministry of Health and Population said that of the total cases of infections reported so far this year, 70 percent of cases are in 10 local units—including in Lalitpur, Kathmandu, Rupandehi, Dhading, Gulmi, West Nawalparasi, Palpa, and Arghakhanchi.

Officials at the Epidemiology and Disease Control Division said that reported cases of dengue could be just the tip of the iceberg, as around 90 percent of the total infected people do not exhibit symptoms.

“Asymptomatic people can easily spread the deadly disease through the vector (mosquitoes),” said Dr Gokarna Dahal, chief of the Vector Control Section at the division.

Some patients have been hospitalised and hospitals have also reported a decline in white blood cell count, officials said.

Doctors at Sukraraj Tropical and Infectious Disease Hospital said that the number of new cases of dengue infection has surged many folds of late.

“Around 30 patients come to our hospital for treatment of dengue daily,” said Dr Sher Bahadur Pun, chief of the Clinical Research Unit at the hospital. “Some have also been hospitalised due to complications.”

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

Experts warn that the timing of the dengue outbreak is serious, as the country has already been dealing with a rapid surge in Covid cases, and problems with waste disposal.

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 provide ideal breeding grounds for these mosquitoes. Uncovered water tanks and discarded plastic cups and bottles could also shelter dengue-carrying mosquitoes.

“We still have a few weeks of the monsoon but the end of the monsoon season does not mean dengue will stop spreading,” Pun said. “In fact, the virus-spreading vector becomes more active in the post-monsoon period. The post-monsoon period poses more risk this year since the authorities concerned are only focussed on Covid.”

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.

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.