Minister for Health and Population Pradip Paudel has directed heads of departments and divisions to start preparations for a possible outbreak of communicable diseases in the coming days.

The direction comes amid the heightened risk of a Covid-19 outbreak and the imminent monsoon, which is considered an epidemic season in the country.

“Start preparation to save people from water-borne and vector-borne diseases,” Minister Paudel was quoted as saying. “Don’t wait for the disaster to happen, rainfall has already started.”

Thousands of Nepalis get infected with water-borne and vector-borne diseases in the monsoon season, which is set to start within two weeks. Health problems could be exacerbated in the coming days, as the country is expected to witness above-average rainfall in the monsoon.

According to the seasonal outlook issued last week by the Department of Hydrology and Meteorology, both maximum and minimum temperatures are expected to be higher than average across the country between June 1 and September 30.

“We have started preparation according to the minister’s direction,” said Dr Chandra Bhal Jha, director at the Epidemiology and Disease Control Division. “We have alerted all agencies concerned about the possible risks, asked them to carry out a dengue search-and-destroy drive and make people aware of the risks. Apart from that, we have also supplied rapid diagnostic test kits to carry out coronavirus testing at the health desks set up at the point of entry.”

The division has reported over 1,100 dengue-positive cases from 71 districts since January. Of them, Kathmandu has reported the highest number at over 100 positive cases.

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

Since dengue became endemic in Nepal years ago, meaning people get infected throughout the year, health officials no longer classify it as an outbreak of a deadly virus.

At least 15 died and 41,865 others were infected in 2024 as the virus spread to 76 districts. Health facilities in Tanahun were overwhelmed with dengue patients. Experts say reported cases may only represent a small fraction of the true scale of the dengue outbreak, as around 90 percent of the infected people are asymptomatic, and deaths and infections often go underreported.

Many people infected with dengue show mild symptoms, which do not need any treatment or can be managed with paracetamol at home.

Experts warn that rising temperatures, coupled with pre-monsoon rainfall, create the perfect environment for dengue-spreading vectors to breed. They say that unless the general public is made aware of the problem, the spread of the dengue virus will not lessen. They ask the authorities concerned to learn from past experiences while taking preventive measures.

Doctors say along with launching a search-and-destroy drive on a regular basis, authorities should also focus on strengthening the capacity of health facilities to prevent them from being overwhelmed in the event of a possible massive outbreak, experts say.

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

Apart from the risk of a massive outbreak of the dengue virus, thousands of people also suffer from waterborne diseases—diarrhoea, dysentery, food poisoning, and viral fevers—during monsoon. Cases of snake bites also surge in the season.

“Most sources of drinking water get contaminated with rainwater during monsoon season, meaning that drinking water from unknown sources is not safe to drink,” said Jha. “One must ensure that the water is safe before drinking.”

Meanwhile, the division said that rapid diagnostic testing kits for coronavirus testing are limited and have already been supplied to the point of entry. Health workers are directed to carry out testing on those with fever and Covid-19-like symptoms at the point of entry. Health officials say that they have informed Minister Paudel about the dwindling stock of rapid diagnostic kits, and may have to fast-track the purchase if cases of coronavirus spike.

The risk of a new surge of the coronavirus has heightened of late due to a surge in cases in neighbouring India and China.

India has confirmed the emergence of new Covid variants NB.1.8.1 and LF.7.

As many as 20 Indian states have reported active coronavirus cases, including those which either border Nepal or host thousands of Nepali migrant workers. According to media reports, active cases climbed to 1,009 from 257 last week. Seven people died of Covid-19 infection in a week.

The World Health Organisation has clasified NB.1.8 subvariant as a variant under monitoring. The UN health body said that additional public helath risk posed by NB.1.8.1 is evaluated as low at the global level as per the available evidence.