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Dengue prevention efforts stifled by the coronavirus pandemic

JAKARTA, Indonesia (AP) – To slow the spread of the coronavirus, governments have issued blockades to keep people at home. They cut back on businesses that involved services like waste collection. They tried to protect hospitals from a wave of patients.

But the cascading effects of these restrictions are also hindering efforts to deal with seasonal outbreaks of dengue fever, an incurable disease caused by mosquitoes, also known as “fracture fever” for its severely painful symptoms.

Southeast Asian countries such as Singapore and Indonesia have faced simultaneous outbreaks of dengue and coronavirus this year. In Brazil, where there are over 1

.6 million COVID-19 infections, at least 1.1 million cases of dengue have been reported, with nearly 400 deaths, according to the Pan American Health Organization.

Dengue cases are likely to increase soon with the onset of seasonal rains in Latin American countries such as Cuba, Chile and Costa Rica, as well as in the South Asian countries of India and Pakistan.

Dengue is generally not fatal, but severe cases may require hospitalization. Prevention efforts aimed at destroying mosquito breeding sites, such as removing old waste or tires and other objects containing stagnant water, are still the best ways to curb the spread of the disease. But blockages of the coronavirus era and other restrictions have meant that these efforts have been reduced or stopped altogether in many countries.

In northwestern Pakistan, plans to disinfect tire shops and markets that experienced dengue outbreaks in 2019 have been shelved because of the funds used for coronavirus, said Dr. Rizwan Kundi, head of the Young Doctor’s Association.

Healthcare workers who would destroy mosquito breeding sites in the Indian capital of New Delhi are also checking people for the virus.

Having to identify thousands of virus cases has meant that dengue surveillance has suffered in many Latin American countries, added Dr. Maria Franca Tallarico, health manager of the Regional Office of the Americas of the International Federation of the Societies of the Cross Red and Red Crescent.

Experts say stopping such prevention efforts is disturbing about the global battle against dengue.

The World Health Organization says 2019 was the worst year for dengue cases, with all regions affected and some countries having been affected for the first time.

Aedes aegypti, the mosquito that spreads dengue, is more prevalent in cities and experts warn that increasing urbanization and warming temperatures due to climate change means that its range will continue to increase.

Experts say that while reducing travel means fewer opportunities for mosquitoes to bite people with dengue fever to become carriers, the coronavirus pandemic has introduced other variables.

Staying at home – a way to slow down the outbreaks of COVID-19, especially in cities – carries greater risks for the spread of dengue, said the Singapore National Environment Agency (NEA). This is because Aedes mosquitoes bite during the day, and with more people staying at home, where mosquito populations are high, the greater the chance that they are bitten.

The impact is already visible. Singapore experienced a five-fold increase in mosquito larvae found in common homes and corridors in residential areas during the two-month blockade of the coronavirus, compared to the previous two months. As of July 6, the total number of dengue cases in Singapore was over 15,500. The NEA says the number of cases this year is expected to exceed 22,170 cases reported in 2013, which at the time was the largest dengue outbreak in Singapore’s history.

Oliver Brady, associate professor at the London School of Hygiene & Tropical Medicine, said that Central America and the Caribbean are at higher risk due to overlapping outbreaks.

Working with communities in Latin America to stop mosquito breeding has been the most successful anti-dengue strategy in recent years, Tallarico said. But with strict movement restrictions, he said they didn’t know if these measures were still happening and “that’s the big concern for us.”

A shortage of protective equipment also means limiting the number of first responders who can monitor people with fever or cough, he said.

“My concern is that you have (many) more cases of dengue … but the system’s ability to notify (and) tests is limited,” he said.

Dengue patients need acute care, and this could lead to a “double hit” that overwhelms health systems, said Scott O’Neill, founder and director of the World Mosquito Program.

“The health system is already crumbling. … I’m not sure how the existing health care system in India will handle this load, “said Dr. S.P Kalantri, a public health specialist.

Global research on dengue will also be affected by the coronavirus pandemic, Brady said.

At the WMP Tahija Foundation Research Laboratory in Yogyakarta, Indonesia, which has been studying dengue for years, “it has become too difficult to enroll patients with social exclusion measures,” said O’Neill. The facility is now being used as a COVID-19 test site.

Likewise, the National Institute of Malaria Research in New Delhi stopped all field activities after being converted into a center for validating COVID-19 test kits, said Dr. RC Dhiman, who studies mosquitoes and climate change.

In Bangladesh, where the dengue season has just begun, the launch of a mobile app to help people report their cases has been delayed by the pandemic, said Afsana Alamgir Khan, who oversees the country’s dengue program.

Experts say that such interruptions by the coronavirus will only increase the risks of dengue infections.

Ghosal reported from New Delhi. Associated Press writer Edna Tarigan in Jakarta, Indonesia, Kathy Gannon in Islamabad and Julhas Alam in Dhaka, Bangladesh contributed to this report.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science Department. The AP is solely responsible for all content.

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