Last week, a six-year-old boy from Sitalchowk in ward 4 of Vyas Municipality in Tanahun district who was admitted to Gandaki Medical College in Pokhara, died of dengue infection.

With the death, the number of people who succumbed to the deadly disease in the district has reached five. Four others—a 13-year-old girl, a 15-year-old boy, a 34-year-old woman and a 35-year-old man—reportedly died from dengue infection this year.

The Epidemiology and Disease Control Division, the federal agency responsible for containing the disease outbreak in the country, however, has not updated the number of the deceased. If the official figure of the division is to be believed, only 20 people have died from it so far this year.

But some districts have reported high fatalities from the disease. Sunsari suffered around one-and-a-half dozen deaths from dengue. Health ministry officials do not agree that they have downplayed dengue fatalities.

“Without verification, we cannot declare deaths as resulting from dengue infections,” said Dr Gokarna Dahal, chief of the Vector Control Section at the division.

Dahal concedes that a cluster outbreak of dengue has been reported from several districts. Tanahun of Gandaki Province reported 3,138 dengue cases in the past 15 days, which is the highest in the country, in the first 15 days in October. Kaski reported 955 cases, followed by Gorkha’s 479.

The division said that Kathmandu has 178 cases of infection, but the local health office said that around 80 cases are reported in the district every day.

“We would like to urge all to be cautious, as the immediate aftermath of monsoon, which is a dengue season, has just started,” said Dahal. “Some districts reported an alarming surge in new dengue cases. We suspect cluster outbreaks in those places.”

Doctors say the rapid increase in transmission right before Dashain is a matter of concern, as the outbreak could put a damper on the festival, especially since most health workers will also be on Dashain vacation.

Dengue is a viral disease, transmitted by the female Aedes aegypti and Aedes albopictus mosquitoes. The same vector also transmits chikungunya, yellow fever, and Zika virus, according to the World Health Organization.

What concerns health experts more is that no preventive measures against dengue infection have been taken by any agency in the Valley. This could make infection of the virus widespread in coming days. Some municipalities in Kathmandu Valley had launched a dengue search-and-destroy drive after the start of the monsoon season, but stopped later.

Experts said a lackadaisical approach of the authorities is responsible for the spread of the virus. They said search-and-destroy and awareness campaigns should be initiated to contain the spread.

Over 39,000 cases of infections from the virus have been reported since January. The virus has spread to 76 out of the 77 districts.

Public health experts suspect health authorities are understating the number of dengue deaths, as there have been reports of more casualties from several districts than those confirmed. They say the real number of infected persons could be several times higher, as the government’s case reporting system is not effective and over 80 percent cases are asymptomatic. Many dengue patients show mild symptoms and do not need any treatment or can be treated with paracetamol at home.

Last year, 88 persons died and more than 54,000 were infected by the virus, which had spread to all 77 districts. At the time, hospitals in Kathmandu Valley were overwhelmed with dengue patients and pharmacies had run out of paracetamol, the most widely used medicine to treat fever.

In 2019, the disease killed at least six people and more than 16,000 were hospitalised across the country. The virus had spread to 68 districts at the time.

Dengue-transmitting mosquitoes breed in clean water and bite people in daylight. Uncovered water tanks and other discarded objects such as plastic cups and bottles could provide breeding grounds for the dengue-carrying mosquitoes.

Symptoms of dengue include mild to high fever, severe muscle pain, rashes, bad headache and pain in the eyes, doctors say. Patients with these symptoms are advised to seek immediate treatment. While there is no specific cure for the disease, early detection and access to proper medical care can prevent death.