@WHO @Hep_Alliance sharing my story on viral #hepatitis #Nepal and want to contribute #ThinkHepatitis writing http://t.co/yywncaRfGP

— Anuj Bhattachan (@Yeti4mNepal) July 24, 2014

Remembering Dengue Fever

True, Dengue is a fatal disease and can fetch you to intensive care unit in few days. This viral illness is spread by the bites of Aedes mosquito, particularly A. aegypti.The infected mosquito harbors Dengue virus (DENV). It is commonly reported that DENV consists of 4 stereotypes. However, there is a recent report of fifth serotype. Text book writes that the illness starts with fever, headache, muscle ache and joint pains, which is followed by "blue patches" suggestive of decrease in platelet counts. We need to remember that platelet is important for blood clotting process in the body, so its compromised number can lead to severe bleeding problem. Notoriously, we call this situation as Dengue Hemorrhagic fever (DHF), which can even take one's life if not treated timely or properly. Another remarkable feature of this disease is said to be the intensity of its pain so people have remembered it as "Break Bone Fever" in some community. These days, we have enough pain killers available in health post or clinics, so we may alleviate ourselves from this intense pain. However, I can imagine, there are still pockets of community in low income countries, where people are devoid of access to even paracetamol !! 

Source: www.facebook.com [Yugesh Dhungana 22/July/2014

Those who have survived this disease truly know the suffering in and out - bed ridden, weak even to walk, dizziness, nausea and vomiting, bleeding from your orifices or impending fear of losing your life. For some of us, this may sound pontificating on your thoughts, but this is what a friend of mine has to say recalling his good memory intermixed with period of illness, diagnosed as suspected dengue fever. Here is how he reminisces the disease, " Today, I observed my profile picture keenly and discovered a lot of changes on me. This was the photograph of mine when I was on a first honeymoon trip to UK, India....from where I caught DENGUE (manifested, I would rather say)....a narrow escape from death with platelet count plummeting to 30,000. I look thin n young....subtle changes over four years has given a cumulative difference turning me more plethoric n wrinkled. Everyday, ageing engulfs us deducting each moment from life's tenure. That's why BHUPI ( Nepali poet) once told...HAR DIN JINDAGI CHHOTIDAICHHA YASARI NAI, TOOTH PASTE JASTAI..!!"

In Nepal, all 4 serotypes of DENV have been reported through government reports and journal publications. Therefore, Dengue is not anymore a new exotic disease in our part of the world. Yearly, we hear and read news reporting of suspected or confirmed outbreaks of Dengue fever in Terai (East to West). It is said, Dengue is related closely with urbanization and weather. So, we read that most of the outbreaks occurs in cities. Now, we also fear and already starting to hear the spread of DENV in hilly districts. Now, majority of the districts in Nepal are linked with roads, so there is easy mode of transportation within matter of hours. You can imagine, it used to take days and days to travel from hilly districts to Terai but now we can travel in a matter of hours. This expose us to importation of various diseases through person to person or through vector like mosquito. Another important global phenomenon that has contributed to the dynamic of vector borne diseases is climate changes - increasing temperature, further compounded by increasing population density and rapid urbanization. Therefore, we need to act fast reasonably and in SMART ways so we can do away with these emerging illnesses, which we can control and prevent, otherwise let me say - more of such stories where this disease will leave no one - rich or poor !! To end this short scribble on DENV, there are some encouraging news, we can hear that DENGUE Vaccine availability to the population is just few years away. There is a recent press release (11 July, 2014) that particularly says that clinical phase III trail on DENV vaccine has shown encouraging results.  

Anuj Bhattachan
22/July/2014