India on pace for record dengue fever cases

Doctors say they are overwhelmed with cases of the 'break-bone disease' and that cases are being underreported.

Mohammad Awwal, 19, who has dengue fever, rests at home in New Delhi. Manan Vatsyayana / AFP

NEW DELHI // The factory worker Mohammed Awwal was gripped by fever, sweats and the sort of agonising aches that cause his condition to sometimes be called “break-bone disease”.

It is an annual plague in India and a hidden epidemic, say experts.

Dengue fever is a mosquito-borne disease with no known cure or vaccination that strikes fear into the citizens of New Delhi when it arrives with the monsoon rains – just as the scorching heat of the summer is subsiding.

Hospital wards are overwhelmed and tales abound of deaths and cases while New Delhi authorities have insisted that only 3,500 have fallen sick this year, with only five fatalities.

“I took him first to a government hospital. I was shocked to see that it was packed with dengue patients. There was not even a single bed available,” said Mr Awwal’s mother, Mehrunissa.

She has been treating him at their home, giving him multivitamins, paracetamol and water as he lies on the floor with two pillows and a bedsheet but no mattress.

In a sign that this year’s outbreak could be as bad as a record-breaking 2010, the city’s largest public hospital, Hindu Rao, said this month that it had suspended all routine surgeries to make room for more dengue patients.

The Delhi government has blamed prolonged monsoons for the increase in infections, but said it has added beds at hospitals and increased resources for spraying insecticides to tackle the mosquito menace.

“It’s nothing to worry about, there is no crisis,” Charan Singh, the additional director of Delhi health services, said, dismissing allegations that the city of 17 million underreports the problem.

“It is a lot of hype going on ... The government is in action and we report all cases according to international guidelines.”

The virus affects two million people across the globe annually, with the number of cases up 30 times in the past 50 years, according to the World Health Organisation.

Transmitted to humans by the female Aedes aegypti mosquito, it causes high fever, headaches, itching and joint pains that last about a week. There are four strains, one of which can cause fatal internal bleeding.

In India, cases have increased sharply over the past five years, there have been 38,000 so far in 2013, but doctors say these numbers only capture part of the problem.

At the All India Institute of Medical Sciences, India’s most prestigious public hospital, doctors were overwhelmed by patients.

Medics said they were seeing 60 new dengue patients a day, an influx they suspected was not reflected in the official figures.

“Maybe it’s because they don’t want to create panic or because they don’t want to be blamed, but if they hide, people won’t know how bad the situation is,” said a doctor.

Sandeep Budhiraja, internal medicines director at the private Max Healthcare hospital in Delhi, blamed city authorities for failing to be prepared and said cases would only decline with the onset of winter next month.

“It’s an epidemic that hits the country every year, yet there is never any preparedness by officials. It just keeps getting worse,” said Dr Budhiraja, adding that Max had opened its fever wards to accommodate dengue patients.

While dengue is painful and debilitating, death is usually rare but patients are vulnerable to other fatal viral infections during or shortly after the time of illness.

There is still no specific treatment, but last year French healthcare giant Sanofi Pasteur said it would begin tests for a dengue vaccine in India before making it available internationally by 2015.

A leading Brazilian biomedical research institute, Butantan, also said last month it was working on a dengue vaccine that they hoped would be ready by 2018.

British firm Oxitec has also created genetically modified sterile male Aedes mosquitoes – what they call “birth control for insects” – but met with severe criticism for releasing unnatural species into the environment.

The only defence so far is preventive steps, like removing stagnant water near residential areas, spraying insecticide, applying mosquito repellent and wearing long sleeves and trousers.

Many victims in India gulp down papaya-leaf juice believing it to boost blood-platelet levels, which are decimated by the virus.

“It is a largely preventive, self-limiting virus, but we still hardly invest in research for treatments,” said Dr Budhiraja from Max Healthcare.

“There are only some vaccines being tried out, but no luck yet.”

* Agence France-Presse