|Two men clean standing water |
from a canal in Matara,
preventing mosquito infestation.
, a mosquito-borne viral infection, is endemic in Sri Lanka and many other countries with tropical climates. Dengue can present a wide range of symptoms and can even lead to death. Within the last year in Sri Lanka, more than 4,000 people have acquired dengue and at least 22 have died as a result of the infection.
In Sri Lanka, the tsunami damaged water and sanitation systems, threatening potential disease outbreaks including cholera, typhoid, hepatitis, malaria and dengue. Luckily, and with planning and programming by the government and nongovernmental organizations, these threats were not borne out.
But some of these diseases, like dengue, continue to present a challenge to coastal communities.
Mosquitoes, in particular the easily recognizable white-spotted Aedes aegypti, carry the dengue virus from human to human.
In the camps where many of the survivors of the Dec. 26, 2004 tsunami have been living for the last year, residents lack a proper way to dispose of cups and other containers where water can pool and become a mosquito breeding ground, says CCF Sri Lanka’s National Health Advisor, Dr. P. Ekanayake.
In addition, he says, many of the people have no way to use a mosquito net because the tents or barracks are too crowded.
In particular, during the monsoon season, the collection of stagnant water can lead to another outbreak of dengue fever or the deadly dengue hemorrhagic fever. Sri Lanka tends to experience dengue outbreaks during two times of the year:
June to August or
December to February.
| A group clears a blocked drainage |
system in Matara.
Cases are confirmed, however, year round.
“We could have an outbreak now that it’s the rainy season and there are many mosquito breeding places,” said Dr. Ekanayake. In the first nine months of 2005, Matara District reported 102 infections. Each year since 2000, the public hospital reports at least one dengue death.
CCF-Sri Lanka is working closely with the public health units in Hambantota, Matara and Ampara districts to educate communities and remove or clean up mosquito breeding areas, including canals and water containers.Water containers include discarded tires, uncovered barrels, buckets, flower pots, cans and cisterns.
ACCF’s awareness and prevention programs engage youth from the youth clubs, parents and other community members engaged in the Child Well Being Committees that CCF opened following the tsunami disaster. These groups have partnered with local health officials in Matara to clean up the camps for the internally displaced and their surroundings.
“We involved all the public health staff, even the midwives. We invited the government workers, and we supported their program when they asked our help to clean up the coastal areas,” said Dr. Ekanayake.
The Virus and its Spread
Dengue — meaning “break bone” — fever is characterized by a sudden onset of a high fever, and may be accompanied by severe headache, pain behind the eyes, severe joint pain, skin rash, nausea or vomiting. Most patients can be treated at home, although there is no cure or vaccination.
While people do not die from dengue fever, it can also present as a severe, potentially fatal hemorrhagic disease — either dengue hemorrhagic fever or dengue shock syndrome — both of which can be treated. In Asia, dengue hemorrhagic fever is most commonly found in infants and children less than 15 years of age who are experiencing a second dengue infection.
Dengue hemorrhagic fever was very rare in Sri Lanka between 1960 and 1988. But in 1989, approximately 200 cases were reported in the Colombo area. Since then, thousands of cases have been reported and the caseload grows each year.
The worst year on record was 2004, with more than 10,000 cases of hemorrhagic fever on record.
Globally, more than 2.5 billion people are at risk of infection. An estimated 50 to 100 million people contract dengue each year. The Centers for Disease Control states that the incidence of the hemorrhagic fever, which has a case fatality rate of about 5 percent, has been increasing in Southeast Asia and the South Pacific.