If the figures provided by the Ministry of Health and Population are anything to go by, 62 people died of dengue infection in 2022 that spread in all 77 districts throughout the country.

However, data from the Epidemiology and Disease Control Division, an agency responsible for containing epidemics and outbreaks throughout the country, shows that at least 88 people succumbed to the deadly disease.

“We are still verifying several other deaths considered responsible for the dengue infection,” said Dr Gokarna Dahal, chief of Vector Control Section at the division. “The number of the deceased could increase after final verification.”

Around 54,000 others were infected with the virus in 2022 and what concerns entomologists more is dengue infection has not stopped in the midst of the winter season. According to Dahal, 10 to 15 cases of dengue infection are still being reported every week in the early warning reporting system of the division.

Experts say the reported dengue cases could be just the tip of the iceberg, as around 90 percent of the infected people do not show any symptoms. Those closely tracking the cases suspect that many more people may have succumbed to the disease as not all deaths get reported, just like during the Covid-19 pandemic.

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, according to the World Health Organisation.

Although the post-monsoon season is considered fertile for dengue transmission, Nepal has witnessed outbreaks of the deadly disease since the start of the year and in the pre-monsoon and monsoon seasons as well. Experts say the virus has become endemic, as cases of infection have been reported throughout the year.

“If we look closely, we can see mosquitoes active in houses,” said Meghnath Dhimal, chief researcher at Nepal Health Research Council whose PhD research is cited by the United Nations ‘Climate Change 2022: Impacts, Adaptation and Vulnerability’ report. “Cases of dengue infection are still being reported, which means dengue spreading vectors are not only alive but also spreading the virus.”

The UN report states that at least six major vector-borne diseases affected by the climate drivers have emerged in Nepal and are now considered endemic, with climate change implicated as the primary driver.

Officials at the Health Ministry said that use of air conditioning in hotels and offices could have provided suitable temperature to the dengue vectors in which they are breeding and spreading infection.

Of the total 88 confirmed deaths, 52 percent died of severity from dengue infection, 23 percent had other infections along with dengue and 22 percent of the deceased had comorbidities. Cause of the death of three percent of the deceased has not yet been established.

Of the total deceased, the number of male were high (47) compared to females (41). Nearly one third of the total deceased (31) are elderly people between 55 and 74 years.

The disease control division said 55 deceased were hypertensive, 22 had diabetes, five had alcoholic liver disease and five were renal patients.

Number of deaths from dengue infection in Nepal is considered too high. In 2019, only six people died of dengue infection, which was spread in 68 districts throughout the country. The Health Ministry is also studying the cause of the high mortality rate from dengue infection.

Negligence in the case of management, taking preventive measures, lack of public awareness of the risks, and delay in seeking health care services after infection could be among the reasons for the high death rate due to the virus, according to experts.

Doctors say many people infected with dengue have not been seeking hospital care, which is also the reason for the decline in reported cases.

Dengue virus serotype 1 (DENV-1), 2 (DENV-2), and 3 (DENV-3) have been found responsible for the dengue epidemic in the country. Studies were carried out at the Tribhuvan University and the BP Koirala Institute of Health Sciences, according to officials at the Health Ministry. Another extensive study jointly carried out by the National Public Health Laboratory and the Nepal Health Research Council has also been completed.

Entomologists warn that dengue spread, which has gone down naturally, could surge again once the temperature rises, as no serious initiatives have been taken to destroy the eggs of infected mosquitoes.