Dengue Control activities are being carried out by staff appointed under NVBDCP and staff working at Primary Health Center level. Separate Dengue Control Programme is proposed and is under consideration at National level. In the beginning, Dengue outbreaks were reported from Urban and Peri Urban areas. But during last three years, dengue outbreaks are being reported from rural area also.
In India, dengue infection is known to exist in endemic proportions for a very long time. The first major outbreak of dengue fever accompanied by dengue haemorrhagic fever was reported in Calcutta in 1963. About sixty outbreaks have been reported during the period 1956 to 1996. Because dengue infections have the potential of rapid spread leading to an acute public health problem, special attention is required to be paid for its surveillance, prevention & control.
Objectives
To reduce morbidity & mortality due to Dengue at least by 50 % in next 5 years.
Services to Common People
All Govt. Hospitals have been instructed to provide free treatment and laboratory facilities to the suspected Dengue patients.
Service centers available in each district
Treatment for Dengue is available at All Govt. Hospitals at Taluka and Dist. level & Medical College Hospitals.
Role of other sectors
Involvement & co–operation of other related sectors is obtained through the Umbrella Societies at District levels.
Impact
Non availability of separate infrastructure for Dengue Control and water scarcity leads to increase in number of Dengue cases and deaths due to dengue day by day.
Strategy of National Dengue Control Programme
Implementation strategies
Considering major outbreaks of dengue in the State of Maharashtra, the State has started vector surveillance from 1999 in all districts by giving training to 2 MPWs from each district. On the basis of entomological findings, following measures were undertaken to control/prevent dengue in the State. State has also prepared action plan for controlling Dengue outbreaks during 2003–04.
| a. | Fever Survey. | |||||
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| b. | Indoor/outdoor fogging with Pyrethrum Extract/Synthetic Pyrethroid Ultra Low Volume(ULV ) | |||||
| c. | To empty all domestic & Peri domestic water containers to eliminate the Aedes breeding. | |||||
| d. | The indoor residual spraying with Synthetic Pyrethroid. | |||||
| e. | The State has also supplied rapid diagnostic dengue kits (Panbio) to selected districts. | |||||
| f | IEC: Health Education regarding seriousness of Dengue disease, its spread and measures to be undertaken is given at the time of house visits. Posters, Pamphlets are also distributed. |
Activities of National Dengue Control Programme
- Regular surveillance
(a) Active.
(b) Passive.
Rapid Fever Survey. - Collection and Examination of Blood Smears for Malaria.
- Collection of 5% Serum Samples of Dengue suspected cases for Viral isolation.
- Fogging.
- Entomological Survey for search of Dengue Vector i.e. Aedes Aegypti.
- Container survey: House Index (H.I.), Brautaeu’s Index (B.I.)
- Workshop for all district level officers regarding Dengue prevention and control.
- Arrangement for plate–late count and treatment of dengue cases in Govt. Institutions.
- Guidelines issued to all District level officers.
- Health Education to community through different medias.
- Visits of Health authorities from various levels.
Dengue Situation
| Year | No. of Outbreaks | Total | Serum samples | ||
| Attack | Deaths | Sent to NIV | Dengue Positive | ||
| 2001–2002 | 23 | 2917 | 5 | 237 | 56 |
| 2002–2003 | 137 | 2984 | 19 | 1216 | 409 |
| 2003–2004 | 301 | 4583 | 43 | 3177 | 804 |
| 2004–2005 | 432 | 3186 | 22 | 2136 | 855 |
| 2005–2006 | 267 | 21390 | 56 | 1534 | 396 |
| 2006–2007 | 190 | 11053 | 27 | 1163 | 609 |
| 2007–2008 | 160 | 4219 | 25 | 1439 | 620 |
| 2008–09 up to 25/6/08 | 10 | 421 | 0 | 349 | 88 |
(NIV – National Institute of Virology, Pune)
Expected Community Participation
Community participation is essential for the prevention & control of an outbreak of Dengue Fever (DF)/Dengue Haemorrhagic Fever (DHF). The community must be encouraged to take steps to protect themselves from mosquitoes by eliminating mosquito breeding sites and taking personal measures such as use of bed nets, mosquito repellents etc. The co–operation of the community is also important during the periodic insecticides spray.
In pockets of high risk, active surveillance of DF/DHF should be encouraged so that first case(s) is (are) immediately reported to the local health authorities.
Co – ordinated efforts by government departments such as sanitation. urban development, education etc. are essential so that risk factors for mosquito breeding can be reduced and other control measures taken up effectively.
In an event of an outbreak, the co–operation of other government departments will help to bring it more effectively under control. An inter departmental committee for outbreak prevention and control should be constituted which should meet more periodically. Panchayat members, key community representatives and NGOs should be included as members of committee. A meeting of the committee should be convended before the expected seasonal increase of water and vector borne diseases. In districts where risk n factors exist, status of control measures of DF/DHF should also be assessed.
Important Health Education Messages
Health education to the community regarding
- Emptying of all household water containers at least once in a week.
- To keep surrounding of the house clean & dry.
- Not to keep unused materials on the roof and around the house.
- State has prepared IEC messages for health education about Dengue.
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| Important Health Education Messages | |