IssueMay 22Opinion

Monsoon and Vector-Borne Diseases – What Lies Ahead?

Jatin  Mahajan, MD, J Mitra & Co talks about the precautions to be taken during monsoon and to avoid vector-borne diseases

June heralds the arrival of monsoon, weather changes, and the cool breeze and drops of rainwater become a
soothing delight. But the monsoon season also marks some of the deadliest diseases, especially in the tropical and sub-tropical countries like India – malaria, dengue, chikungunya, yellow fever, Japanese encephalitis, Zika and others. These vector-borne diseases are human illnesses caused by parasites,
viruses, and bacteria. Over 700,000 deaths occur every year on account of vector-borne conditions. This is around 17 per cent of all infectious diseases worldwide, as per WHO reports.

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Malaria infection is transmitted by the Anopheline mosquitoes, resulting in over 400,000 deaths every year,
primarily in the under-five years’ age category. Dengue is the most active viral infection transmitted by Aedes
mosquitoes, with 40,000 deaths every year.

The outbreak of these diseases is highest in tropical and subtropical areas, and they disproportionately
affect the poorest populations. Since 2014, significant epidemics of dengue, malaria, chikungunya, yellow fever, and Zika have afflicted people, claimed precious lives, and burdened health systems in many countries.
Symptoms and efficacy fever, lethargy, headache, and breathing difficulty are signs of malaria
and dengue fever. They can both cause moderate upper respiratory troubles to more critical outcomes.

Various symptoms of these vector- borne diseases are similar to COVID-19.

Therefore, an outbreak of these diseases is likely to put a lot of strain on the healthcare mechanism across the world. Every single case of malaria, dengue, and chikungunya will automatically result in a COVID-19 scare. Patients and attendants are likely to overreact, panic, and throng hospitals and diagnostic centres for tests, treatments, and isolation. COVID-19 infection is more likely in patients with malaria and dengue since pre-existing malarial anaemia can result in insufficient tissue oxygen levels- even a slight decrease in oxygen interferes with a person’s coping ability with covid co-infection.

Besides, both malaria and dengue cause the blood to clot, raising the risk of pulmonary thrombosis and
inflammatory cytokines, which can be fatal in patients with covid.

Prevention
Many vector-borne diseases are preventable through protective measures and community mobilisation.
However, behavioural change is a crucial element in reducing the burden of vector-borne diseases. Organizations like the National Centre for Vector-Borne Diseases Control (NVBDCP), National Health Mission, and the WHO focus on providing education and improving public awareness. As a result, understanding ways and means to protect themselves and their communities from mosquitoes, ticks,
bugs, flies, and other vectors are now more readily available.

Access to water and sanitation is essential in disease control and elimination. Therefore, multiple
organisations and entities are working together with different government sectors to improve water storage and sanitation, thereby helping to control these diseases at the community level.

Healthy and safe practices for an infection-free monsoon include

• Wearing long-sleeve clothes and keeping the body covered

• Use of insect repellents on the exposed portions of the body

• Carrying additional face masks. Wet masks don’t protect us from germs and bacteria.

• Carry water bottles to ensure safe drinking water

• Keep yourself hydrated – drink only boiled water

• Keep the immune system strong through a balanced diet

• Consume freshly-washed, boiled vegetables, reduce your intake of fats, oils, and sodium, and avoid
dairy products as they can contain microorganisms that are harmful to your health.

Detection and treatment

Various IVD tests are available for quick and efficient testing for these vector-borne diseases. These tests can even be conducted in rural and resource-scarce settings, with results available within minutes. These tests are highly reliable, fast, and convenient. And thus, testing becomes the absolute first line of defence against these diseases. At the first sign of illness and relevant symptoms, steps should be taken to conduct these tests. All confirmed patients must be provided immediate necessary and remedial medical attention without loss of time since some of these vector-borne diseases may even have fatal consequences.

India is in a significantly advanced stage of vector-borne disease management. Of the six primary vector-borne diseases, malaria, kala-azar, and Lymphatic Filariasis (LF) are in elimination mode. Malaria is targeted to be eliminated in phases, starting from 2020 to 2030. The cases of dengue and chikungunya are increasing spatially as well as temporally. Let us prepare ourselves to counter the threat correctly and in time with
minimal casualties.

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