SRI LANKA AT WAR WITH DENGUE

T.Sabaratnam

Sri Lanka is now at war.

Prime Minister Ranil Wickremesinghe has placed the nation on alert and has appointed a task-force to conduct the war.

“It’s a war that has to be won. It’s a war, in which the enemy has to be exterminated totally,” he told a meeting of government legislators.

He said Malaysia and Singapore had contained dengue, a deadly tropical disease, spread by two species of mosquitoes.

Health Minister P. Dayaratna has apprised the cabinet of an impending dengue epidemic outbreak. “We’re sitting on a volcano. If we fail to take immediate action, then we are in for trouble,” he warned.

The Dengue Task-Force set up early this year, sprang into action. Health inspectors, armed with emergency powers, ordered the closure of the country’s two top public schools, the 165-year old Royal College where over 7000 students study and the prestigious Buddhist Ladies College. It also ordered the shut down of the Colombo Museum.

Royal College, the alma mater of the prime minister, and other institutions were ordered to remain shut till they clear the mosquito breeding spots. At the Royal Collrge, used tyres were piled up in the open. School authorities complied with the directive, closed it on June 21, cleaned up the polluted area and resumed classes on June 24, the after the poson public holiday.

Buddhist Ladies College failed to comply. The principal said she was not served with the order and claimed that, there were no mosquito breeding spots in her school premises.

Powers vested on the Dengue Task-Force, headed by Health Secretary Dr. Reggie Perera, were extensive, including the right to enter any property, inspect it and order the closure of the buildings and premises, till the areas where dengue virus carrier mosquitoes Aedes Aegipti and Aedes Albopictus breed, are cleared. They breed in clean water.

Dengue Task-Force is vested with authority to hold the owner of the building or premises, where breeding grounds exist responsible, for the offence. So are the heads of public institutions and local bodies held too could be also held liable.

Health ministry’s Epidemiological Director Dr. T. A. Kulatileke said: "We are looking for every kind of container that holds water. We found that coconut shells, king coconut husks, empty milk and fish tins, used bicycle and car tyres and unclean gutters the biggest source for the spread of the two species of the mosquito. Sri Lankans habitually throw these articles in their compounds."

EPIDEMIC THREAT

The government and health authorities fear another outbreak this year, as dengue deaths in the first five months this year rose to 25 on June 21 when six-year-old boy Yasan Gunawardene of Madambe and seven-year-old girl of Maligawatte died, to a 45% rise, compared to the corresponding period last. Nisha Habaraduwa, 24-year-old office worker, died in a private hospital in Colombo the previous day.

Eighteen of these deaths were in Colombo and its suburbs. Gampaha, Kandy, Hambantota, Kurunegala, Ratnapura, Kalmunai and Matara are the other dengue affected centers.

The number of suspected infections was 3809 for January- May this year. It was 4275 for entire 2001 and 3343 for 2000.It was steadily rising from 1992 when only 656 infections were reported.

Colombo’s Chief Medical Officer Dr. Pradeep Kariyawasam said: "The real situation is worse. Many cases go unreported and wrong diagnosis is common.”

Children are the most affected, though doctors say, the day feeding dengue virus carriers do not target them. Children play near mosquito breeding grounds and are more available to the mosquitoes during their feeding time in the morning and afternoon. Their immune system is also weak.

Consultant epidemiologist Ananda Amarasinghe says, "dengue virus is transmitted when mosquitoes that bite infected persons bite others. The virus enters the blood with mosquito’s saliva, replicates in body tissues, spreads through blood and infects white blood cells. Dengue can be diagnosed by blood test. There is no vaccine for dengue."

“Dengue is the easiest mosquito borne diseases to control,” Dr. Regie Perera said, “because dengue virus carrier mosquitoes Aedes Aegipti and Aedes Albopictus breed in fresh water that collects in container. Our battle is targeted to get rid of these containers.”

During June 22- 23 weekend teachers, parents and old students of almost all of the country’s 10,000 schools were active collecting and burying or burning every type of containers that could hold water.

“From schools the message is spreading to homes. We are winning the war,” Health Minister Dayaratma said.

If that war had been declared a fortnight earlier little six-year old Anjana Sandeepani would be alive and kicking today. Her playground was near a garbage dump. She developed high fever, severe headache and abdominal pain. But she went to school and fainted there. She was rushed to Sri Lanka’s top children hospital, Lady Ridgeway. Her blood count was low. She collapsed.