Dengue fever is a vector borne viral illness. The vector is an infected female mosquito of the ades aegypti species (mainly), which transmits virus through its bite to humans (hosts). In endemic areas, outbreaks occur after a rainfall. Risk factors for contracting this infection include densely populated urban areas with poor hygienic conditions. Severe infections can occur in children who are malnourished or have weak immunity.

Breeding sites for dengue mosquitoes include old tyres, buckets, drains, potted plants, uncovered water tanks/ cisterns and pets feeding/ drinking bowls.

A majority of patients having dengue infection are asymptomatic or have only mild symptoms. Rarely do people develop severe disease. It has an incubation period i.e. time between exposure to virus and appearance of symptoms, of three days to two weeks. The symptoms include high grade fever, muscle pain, nausea, vomiting, headache and dizziness. The rash is itchy, usually flat; red lesions are seen on body, and at times facial flushing is noted. The symptoms last for a week.

It is important to warn patients about danger signs like abdominal pain, breathlessness, vomiting or blood in vomit, bleeding from gums, nose or gut. In severe cases, liver, heart and brain can be affected. It is important to remember that severe dengue can be deadly, so people should be aware of the signs and symptoms.

Mosquito borne diseases like dengue fever tend to increase and spread rapidly in flood-affected areas. Currently, almost every district is reporting cases of malaria, dengue fever and diarrhoea. It is crucial that infectious diseases like these be dealt with promptly in order to keep outbreaks confined to specific areas and to prevent an emergency in the country.

In 2017, peak season for dengue outbreak was in August, September and October. Surveillance teams need to be vigilant. Dengue prevention is not the sole responsibility of healthcare workers; communities should be educated through print, social media and advertisements on radio and television.

As there is a threat of a continuous rise in dengue fever cases during October and November, it is important to provide the public with accurate information in regional languages about dengue fever and its vectors. Knowledge of the vector’s life cycle, ecology and biology will help people understand this illness and lead to healthy practices. There is a need to raise awareness for the control and transmission of the dengue disease outbreak. Prompt preventive measures need to be taken to reduce the spread of dengue fever. This should include community mobilisation and increasing awareness regarding dengue fever prevention.

Some of the key measures that need to be taken by health departments include:

(i) distributing preventive items in schools, local communities, and communal places like mosques, madrassahs, churches, etc. Distribution items should include long lasting insecticidal nets (LLINs), mosquito repellents and dengue test kits.

(ii) identifying mosquito breeding sites and high-risk areas and targeting the most infectious areas.

There is no specific treatment available for the virus causing dengue fever. Doctors only prescribe supportive treatment so the patient’s own immune system halts the progression of the viral infection to a haemorrhagic state. As mentioned earlier it is vital that signs of severe dengue are identified immediately.

In the end, we need to keep in mind that prevention and control measures against mosquitoes are fundamental in stopping the transmission of this disease. Self-medication does not help; always consult a doctor as soon as possible if you are unwell or not sure about your symptoms.

Improving hygiene and sanitary conditions in high-risk areas is of paramount importance. The mosquito breeding sites should be eliminated. Proper disposal of waste materials and wastewater may also help prevent an outbreak. To this end, utilising electronic and print media for creating awareness and changing the behaviour of communities may be helpful.

Individual citizens should take measures to protect themselves and others and be proactive in spreading preventive messages. If we are able to bring about small improvements it will eventually have a snowball effect. Take the initiative, be the change.

Dr Hina Jawaid is an assistant professor in family medicine at the University of Health Sciences, Lahore.

Dr Abdul Jalil Khan is an assistant professor in family medicine at the

Khyber Medical University,  Peshawar