HEALTH: Sri Lanka’s Battle With Dengue
Amantha Perera
COLOMBO, Jul 3 2009 (IPS) – Sri Lankan health authorities have had to combat an upsurge in cases of the lethal Dengue flu in the island nation this year. They have used mass man-power, public awareness campaigns and even threatened incarceration to stem the spread of the killer disease that has touched epidemic levels in the past six months. But it won t be easy to stop the disease from spreading.
The viral flu has so far infected over 14,000 people and killed 162 around the island. In their battle against the virus, health officials have declared Dengue prevention weeks, sending out fumigators with ominous-looking smoke guns to breeding grounds. Authorities also jailed some owners of mass breeding locations.
Recently, they decided to import a strain of bacteria from Cuba, called Bacillus Thuringiensis Israelensis or BTI, which will be released in mass breeding centers to neutralise the threat of mosquitoes. BTI is a biological control agent that is used to control the spread of larvae.
It will be brought into the country in early July for release, according to Dr Palitha Mahipala, deputy director (public health) at the Ministry of Health.
The bacteria stops the spread right at the breeding locations and we will target the large breeding areas, Mahipala said.
Environmental experts rule any threat of this bacteria strain to the eco-system.
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It is a bacteria that is used for a specific purpose and will not harm the environment, said Jagath Gunawardena, an environmental expert. Tests had been conducted on the use of BTI in Sri Lanka between 1999 and 2000 that had proved that the bacteria isn t harmful to the environment.
Doctors, however, warn that BTI will not be the final solution to the spread of dengue.
Most of the breeding areas are manmade, like used tyres, pools of water, garbage dumps, these have to be regularly cleaned. It is no issue doing it once and then forgetting it, Dr Mahipala warned.
Experts at the Epidemiology Unit of the Health Ministry say that the Dengue mosquito eggs can survive as much as three months and hatch within 10 days.
Water has to be cleaned at least once every week, said Dr Mahipala, warning that even seemingly innocuous ornaments like flower trays could be deadly breeding grounds.
Health authorities in Sri Lanka were forewarned of an escalated dengue spread earlier in the year when infections rose sharply. The Epidemiology Unit warned of a severe epidemic when dengue cases increased three fold compared to 2005 between January and March, recording 2,821 cases and 7 deaths.
It was in 2005 that a similar high risk approach was adopted by health officials to curb its spread and the same action plan went into effect this year, too.
Since March, however, the number of cases have steadily increased, with the highest being recorded in June a total of 5,900 infections.
With the onset of the south western monsoon from July, there are added fears of more breeding space for the dengue carrier.
Dr Mahipala said that health officials suspected change in weather patterns also may have contributed to this year s rise.
We have witnessed a high number of cases in the central hills, we feel that the changing rain patterns may have contributed to this, he said
The central hilly district of Kandy accounts for the largest number of infections 2,071 cases this year, 26 of which resulted in death this June. Gampaha district reported 31 deaths, the highest on the island.
Close to 60% of the deaths have been women and children, and health authorities suspect that it is mainly due to the behavioral patterns of the dengue carrier. The mosquito is believed to be active during day light hours.
Men tend to be lot more active and move about during day time, while women and children remain at homes or in gardens, Dr Pabha Palihawadana, the head of the Epidemiology Unit said.
We have launched several programmes targeting schools and other places where children can fall victim, she added.
Dr Palihawadana also categorises most public bus terminals as breeding areas.
These places are dark, moist and dingy. There are also a lot of used tyres where water can easily get clogged within, mosquitoes frequent these places.
Health authorities have solicited the assistance of the police, the civil defence force and other local public officials for mass cleanup projects. Dr Mahipala says that the public health officials have been raiding suspected breeding grounds, and fining owners that did not comply with health guidelines.
The best option, Dr Mahipala said is to destroy breeding areas, there nothing better than that. Once someone in infected then it is a medical case, but Dengue prevention can take place well before that if people are mindful of their environment.