ast month’s devastating floods in Khyber Pakhtunkhwa have killed 289 people and left 348 injured. The floods have impacted people, destroyed crops, hurt businesses and swept away communication infrastructure. Now, another threat lies around the corner. The dengue fever is spreading across the province and posing a new challenge for the provincial administration.

The Integrated Disease Surveillance and Response System (IDSRS) data of the directorate general of health services, for September 12 says that a total of 3,005 confirmed dengue cases have been reported in the province so far. Four deaths have been reported in the province – three in Khyber and one in Mardan district.

Twenty-five-year-old Nusrat, from Masood Khail, an urban area in old Charsadda Bazaar, has tested positive for dengue fever. She had been admitted to an isolation ward for women at Charsadda hospital. “After severe body pain, fever and vomiting I was brought to the hospital, where I tested positive for dengue fever.” “There are other cases in our neighbourhood. Last week, my husband recovered from dengue fever,” Nusrat says.

Charsadda is one of the flood-hit districts. Two isolation wards have been established, one each for men and women, at the district headquarters hospital. Between July 12 and September 13, at least 103 dengue cases were reported at the hospital.

The IDSRS data shows that at least 1231 severe dengue cases were reported in Mardan, 615 in Khyber, 299 in Nowshera, 231 in Haripur, 126 in Peshawar, and 99 in Charsadda. At least 2,675 dengue-positive people have recovered in the province.

Over the past few years, dengue has become endemic, surfacing every year, mostly hitting urban parts of the country. The recent heavy rains have provided favourable conditions for mosquitoes to breed in.

On September 8, during a meeting of the Secretaries Committee, chaired by Chief Secretary Dr Shahzad Khan Bangash, it was decided to take prompt action to control dengue and malaria in the flood-hit areas.

Dr Kachkol Khan, the Mardan district health officer, says that their IDSRS is active and monitoring the disease. He says dengue fever cases have been reported in two union councils – Shergarh and Babuzai. Babuzai is a mountainous terrain where community members drink and store water from a hill stream at home.

The Integrated Disease Surveillance and Response System (IDSRS) data of the directorate general of health services, says that a total of 3,005 confirmed dengue cases have been reported in the Khyber Pakhtunkhwa so far.

“We have carried out four community awareness sessions in the affected UCs,” the DHO says.

“In Babuzai, at least 542 dengue cases have been reported. Seventy percent of the mosquito larvae spotted so far have been identified inside homes. These have been destroyed by our surveillance teams through fumigation and sprays.”

The dynamics of Shergarh are different; it is a congested urban area. Following the blockage of the main drainage system in the city, larvae have been detected outdoors. “Larvae were also found in the market basements. Proper drainage can reduce the number of dengue cases by 60 percent,” Dr Kachkol Khan says.

Alarming new research by Nature – the world’s leading science journal – published in August says that among the many infectious diseases likely to worsen with climate change, mosquito-borne diseases like dengue will be prominent. Also known as “breakbone fever” because of the severe pain it can cause, dengue is currently the fastest spreading tropical disease. The viral infection is transmitted to humans through the bites of female aedes mosquitoes, which thrive in tropical and subtropical urban areas.

A World Health Organisation (WHO) report says that more than half of the global population is now at risk of dengue fever, with 390 million people infected every year. In 2019, a record 5 million dengue cases were reported worldwide and economists estimate the global cost of dengue to be close to $9 billion per year. Despite a risk of infection in 129 countries, 70 percent of the actual burden is in Asia.

The latest report by the United Nations Intergovernmental Panel on Climate Change (IPCC) concludes that warming temperatures are expanding the geographies suitable for dengue transmission. An additional one billion people are projected to be at risk of dengue fever by 2080.

Dr Kachkol Khan says the district administration and the tehsil municipal administration are cooperating with the Health Department to control the spread of dengue in Mardan.

Wajid, 45, a taxi driver from Sarki area of Charsadda, has tested positive for dengue. Currently, he is admitted in a dengue isolation ward. “After severe body pains and fever, my family brought me to the hospital where I was diagnosed with dengue fever,” says Wajid adding that he is now being treated for it.

Dr Qasim Afridi, an epidemiologist, who is working as a programme manager at the integrated vector control programme, says warm and humid weather is favourable for the spread of dengue. “The recent rains and floods have increased the incidence of dengue cases in the KP. Heavy floods and rainwater increase the chances of dengue fever,” says Dr Afridi.

Adequate investment in urban planning, infrastructure and housing design can reduce mosquito breeding sites and opportunities for human-mosquito interactions. “We can mechanically destruct larvae. But rains result in the accumulation of water, providing a breeding ground for dengue,” says Dr Kachkol Khan.

The writer is a multimedia journalist. He tweets @daudpasaney