After over a dozen and a half people died from dengue and thousands got infected, the Ministry of Health and Population is working to declare a dengue epidemic in the country.

Officials hope that the declaration would be helpful in taking coordinated measures against the spread of the deadly virus, which has been recorded in 75 out of 77 districts throughout the country.

“The Epidemiology and Disease Control Division has forwarded us a proposal for declaring an outbreak or epidemic of the dengue virus,” an official at the Department of Health Services told the Post on condition of anonymity, as he is not authorized to talk to the media.

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.

So far, 20 people have died and over 16,587 people have been infected with the dengue virus throughout the country.

This is the first time so many people have succumbed to the virus. Experts say reported cases of dengue could be just the tip of the iceberg, as around 90 percent of the infected people do not show any symptoms.

Asymptomatic people can easily spread the disease through vectors [disease-carrying mosquitoes], according to experts.

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

Nepal witnessed a major dengue outbreak in 2019 also in which six people died and over 17,000 were hospitalised. The outbreak, which had started in the pre-monsoon period from Dharan, spread to 68 districts.

According to the officials at the Epidemiology and Disease Control Division, 75 percent of the total deceased from the infection of dengue virus are under 40 years old. At least four children under 12 have succumbed to the infection.

“Both infection and death patterns show that mobile populations are at high risk and infection and getting severe,” said Dr Gokarna Dahal, the chief of the Vector Control Section at the division. “People are not only getting infected at home but also in offices and schools.”

Virologists as well as epidemiologists have long been calling for effective intervention measures including search and destroy drives to lessen the spread of infections. Search-and-destroy campaigns are the most effective means to eliminate the breeding sites of mosquitoes and to raise awareness among the people to take precautions.

“We have been asking for effective measures to prevent a massive outbreak of dengue virus since the beginning,” said Dr Sher Bahadur Pun, chief of the Clinical Research Unit at Sukraraj Tropical and Infectious Disease Hospital. “The dengue mosquito has already entered every house and infection become widespread, but the local authorities have just begun covering the puddles and pools.”

Officials at the Health Ministry said that some local units apparently think they have completed their duty just by launching the drive once.

Due to the surge in infection especially in the Kathmandu Valley, major hospitals have been overwhelmed with dengue patients. Patients have been forced to wait for hours at the emergency wards of hospitals and return home without treatment due to unavailability of hospital beds.

“I have seen many patients collapsing while waiting in queue,” said Dr Shrawan Mandal, who serves at the emergency department of the Sukraraj Tropical and Infectious Disease Hospital, Teku. “The number of patients seeking hospital beds is so huge that we cannot arrange beds for all. Serious patients have occupied all the beds.”

At Teku, doctors administer intravenous drips to patients, who collapse or complain of severe body ache. Owing to lack of beds, patients are made to lie on the benches in the hospital’s waiting area and given intravenous fluids and sent home in the evening.

Doctors at Patan Hospital said over 150 dengue patients have been seeking care at the hospital every day.

“Serious dengue patients have occupied all intensive care unit beds of the hospital and we have to send other critical patients to other hospitals for intensive care,” said Dr Ravi Shakya, director at the Hospital. “What is alarming is patients suffering from other ailments are also getting infected with dengue in the hospital.”

The hospital administration has asked all non-dengue patients admitted to the hospital to bring along mosquito nets.

The Kanti Children’s Hospital, the national referral center for pediatric care said the number of dengue cases has been increased several fold and all intensive care unit beds and high dependency units of the hospital have been occupied by serious patients.

“Small children are also getting infected with the dengue virus,” said Dr Yuba Nidhi Basaula, the director of the hospital. “Many ailing children are brought to our hospital but we have limited beds in the intensive care unit.”

Dengue cases have been detected every month since January. The virus has already become endemic to Nepal, public health experts say.

The World Health Organisation says there is no specific treatment for severe dengue, but early detection and access to proper medical care can lower the fatality rate.

Meanwhile, the Epidemiology and Disease Control Division said that it has forwarded a set of guidelines on indoor fogging and spraying mosquito repellents to the Department of Health Services.