KOCHI: Kerala is facing yet another healthcare challenge as the spike in cases of dengue and other vector-borne diseases is likely to worsen with the onset of the monsoons, caution experts.
According to official data, Kochi and Thiruvananthapuram are the major hotspots of dengue this year. As many as six dengue deaths have been reported in Ernakulam alone over the past two weeks, setting off alarm bells in the health department.
The district has been witnessing a steady rise in the number of fever cases, says Dr Maria Varghese, former president of the Indian Medical Association (Kochi chapter). “The out-patient attendance has increased drastically in the last two weeks. Many are consulting doctors with fever. We need to wait and watch to get a clear picture of the severity of the spread of other diseases,” she says.
Calling for urgent attention of the authorities, health experts note that the number of dengue cases in the state has doubled when compared to the same period last year. As per the data with the Integrated Disease Surveillance Programme (IDSP), this month, till June 8, around 1,500 dengue cases were reported across Kerala. Of these, over 500 cases (confirmed and suspected) have been reported in Kochi.
This year, so far, dengue has claimed 14 lives (suspected + confirmed) in the state. Health experts warn there can be a dengue wave, similar to the 2017 outbreak, when Kerala reported 21,993 confirmed cases and 165 deaths. Dr Rajeev Jayadevan, member of the Indian Medical Association’s public health advisory panel, says the rainy season brings a higher risk of infections, including viral fevers.
“It is important to take precautions to prevent their spread. These pathogens enter the human body through four routes: blood, skin, mouth, and nose. Preventive measures can help stop their spread,” he adds. “Infections like dengue and malaria are transmitted only through mosquitoes. Initial dengue infections may not be severe, but repeated infections can lead to serious health issues. Malarial parasites are transferred from infected individuals to others through mosquito bites. Other diseases like chikungunya can also spread during the rainy season. Therefore, vector control at multiple levels is essential.”
Buildings, construction sites turning into mosquito breeding grounds
Poor waste management, ineffective pre-monsoon cleaning, water-logging, and ineffective source reduction activities are cited as the cause of the growing mosquito population. Officials also flag indoors and private property – apartment complexes, households, construction sites, etc. – turning into mosquito breeding grounds.
A senior official of the Directorate of Health Services (DHS) says enforcement and awareness activities have already been launched across the state. Corporation areas, especially in Thiruvananthapuram and Kochi, are more vulnerable, the official adds. “After the Covid outbreak, many people took up indoor gardening. Indoor plants, such as money plants, are the main breeding grounds of mosquitoes now,” the official continues.
“The second issue is the lack of proper source-level waste management. We have launched campaigns and drives at places where more cases are being reported. Strict action will be taken under the Public Health Act. Inspection squads under the District Medical Offices (DMOs) are issuing notices to households and apartments to keep their surroundings clean and free of mosquito sources.”
Notably, the Thiruvananthapuram DMO has already started slapping notices on households. According to an official there, if breeding grounds are found on the premises or inside houses, a `10,000 fine will be imposed.
‘Coordinated efforts lacking’
Health activist and former planning board member B Iqbal believes the state has to come a long way. “Kerala’s health sector is a role model in many aspects, but, when it comes to infectious disease control, the state has to improve a lot. Coordinated efforts are lacking in the prevention of communicable diseases,” he says.
“We still lack a sustainable waste management system. Mosquito menace hasn’t gone down despite repeated disease outbreaks. Leptospirosis is a major concern and preventive medicines are there but still, an average of 50 to 70 people die every year. During emergencies, we act, other times, the system doesn’t act.”
Iqbal highlights that the high prevalence of lifestyle diseases in Kerala is another worry. “Our morbidity rate is very high and, hence, infectious diseases and even fever can turn villain. Communicable disease can make the condition of the patient with underlying health issues severe. Mortality rate can go up,” he says.
“The primary health centres are undergoing drastic development and these sub-centres should act as centres for health promotion and disease prevention.”
Communicable diseases reported in Kerala (from Jan 1 to June 8, 2023)
Fever: 11,57,976 [Death: 4]
Dengue: 7,882 [Death: 14]
Leptospirosis: 1,211 [Death: 59]
Chikungunya: 18
Zika: 2
Cases reported in June 2023 in Ernakulam
Dengue 133
Leptospirosis 2
Hepatitis 5
Malaria 4
Fever 6,967
*Official data as on June 10
Keep the blood-suckers away
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Dengue symptoms
Zika symptoms