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Although it has been about two months since Kathmandu began reporting its first dengue fever cases this season, the Kathmandu Health Bureau has no plans yet to launch a campaign to contain the infections. Experts say a search-and-destroy campaign is an effective way to eliminate mosquito breeding sites, the vector, and raise awareness about protective measures. “Dengue fever cases have been on the rise, mainly in the metropolitan city of Kathmandu,” said Basanta Adhikari, head of the Kathmandu health bureau. “But a plan to launch a search-and-destroy campaign for dengue virus has yet to be worked out.” Like the Kathmandu Health Bureau, most local units have taken no action, as hospitals see large numbers of dengue patients daily, citing a lack of budget. Officials from the Division of Epidemiology and Disease Control said they can only ask local units and cannot enforce the decision, as provincial governments and local units can make their own decisions independently. The Epidemiology and Disease Control Division (EDCD) is an agency under the Ministry of Health and Population, which is responsible for dealing with all kinds of epidemics and epidemics in the country. The division deals with neglected tropical diseases, vector-borne diseases, and zoonotic and communicable diseases. It is also responsible for developing necessary policies and conducting research in the country. The division, however, is not an enforcement agency, unlike other countries like the United States where the Centers for Disease Control and Prevention plays a key role in epidemic control and advises the government on issues. health. “While the focus is on the coronavirus, there are other deadly diseases like dengue fever, scrub typhus, cholera and kala-azar, among others, circulating in the country,” said Dr Prabhat Adhikari, an infectious disease expert. “The problem is that we don’t have a central agency, which can make quick decisions and enforce them.” Experts say delay in making and implementing decisions multiplies the risks and by the time agencies spring into action, the disease has already penetrated society, affecting large numbers of people. Dengue fever is a mosquito-borne disease transmitted by female Aedes aegypti and Aedes albopictus mosquitoes. The same vector also transmits chikungunya, yellow fever and Zika viruses, according to the World Health Organization. Cases of dengue infection have increased exponentially due to the apathy of affected agencies to take measures to control infections. So far this year, 2,108 cases of dengue infection have been reported in 69 districts. In 2019, at least six people died and more than 16,000 were hospitalized after dengue fever spread in 68 districts. Meanwhile, 69 people have tested positive for cholera since June 21. The threat of the coronavirus is not over either, with active cases rising to 3,612 on Saturday. On Saturday, 173 people tested positive for Covid-65 in 643 polymerase chain reaction tests and 108 in 2,196 antigen tests. Experts say a lackadaisical approach to containing the spread of infections can add to the burden on the country. “Thousands of people are dying from Covid infections and thousands are infected with dengue virus,” Adhikari said. “But our response to control the spread of infection is not effective.” The government had formed the Covid-19 Crisis Management Coordination Center for coordination among agencies concerned with the prevention and control of coronavirus infection. However, questions have been raised about the success of the High-Level Center in coordinating between agencies tasked with preventing the spread of infections. Many local governments across the country have even refused to conduct contact tracing, placing suspects in quarantine and those infected in isolation centers. The infection spread rampantly across the country, especially during the second, third and fourth waves of the pandemic. And experts say that even if the high-level committee worked effectively in a particular incident, it is not always possible to form such a committee. “It is not possible to form a high-level committee to contain the spread of all diseases,” said epidemiologist Dr Biraj Karmacharya, who is also the community program manager at Dhulikhel Hospital. “We need a powerful body that includes experts from various sectors – public health, epidemiology, infectious diseases, communication, animal health, among others. Such a mechanism should have the power to take quick decisions and enforce them. In the United States, the Centers for Disease Control and Prevention (CDC) is the federal agency responsible for protecting the health of Americans. It is among the most important health agencies in the world and plays a crucial role in protecting public health and safety through the control and prevention of disease, injury and disability in the United States and around the world. The CDC has a broad mandate to address health, safety, and security threats both at home and abroad. It has a particular focus on infectious diseases, foodborne pathogens, environmental health, occupational safety and health, health promotion, injury prevention, and educational activities designed to improve the health of American citizens. In India, there is National Center for Disease Control, which plays a leading role in conducting nationwide outbreak investigation using epidemiological and diagnostic tools. The agency organizes meetings for the formulation of guidelines for the surveillance, management, prevention and control of various communicable and non-communicable diseases. The meetings are attended by experts in the respective fields, senior administrators from state health departments, program managers from medical, veterinary, agricultural and animal husbandry departments. The doctors also stress the need for a strong disease control mechanism in Nepal with representation from all three levels of government. The Ministry of Health and Population said it was working to set up a powerful center for disease control, which will deal with all existing and emerging infectious diseases. For this, the ministry had prepared a draft law, which has already been approved by the seven provinces. The ministry sent the bill to the Ministry of Finance for suggestions. “We are working to form a strong body, something like the CDC, to meet the challenge of existing and emerging diseases that threaten human health,” said Dr Roshan Pokhrel, secretary at the Ministry of Health. Pokhrel, however, said he cannot say how long it will take for such an agency to come into being. Ministry officials said the bill will be forwarded to the Ministry of Law, Justice and Parliamentary Affairs once the Ministry of Finance makes its suggestions. The bill must be approved by the Cabinet and both Houses of Parliament to enter into force. Officials said the new bill will replace the Infectious Diseases Act of 1964, and through the act, a powerful CDC-like body will be formed. “Agencies at all three levels of government – local, provincial and federal – will have to follow the decisions made by the powerful new body,” said Dr Guna Nidhi Sharma, an official with the Ministry of Health and Population. “All agencies under the Department of Health Services and other ministries, tasked with dealing with disease outbreaks will report to the powerful agency.” Doctors say most countries have dedicated agencies like the CDC to control existing and emerging diseases and Nepal also needs a similar mechanism to fight the ongoing Covid pandemic and outbreaks of dengue fever, cholera and scrub typhus, among other diseases. “The existing mechanism of government cannot deal with all the health problems we face,” said Karmacharya, who is also a member of an expert group formed by the Ministry of Health to prepare a health bill. the CDCs. “We shouldn’t take a long time to set up a CDC-like body.”
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काठमाडौं, असाेज ५ः महामारीका रूपमा देशभर डेंगु फैलिरहँदा सरकार भने संक्रमण नियन्त्रणमा उदासीन देखिएको छ । देशभर हालसम्म १७ हजार ५ सय ९४ जनामा डेंगु संक्रमण देखिसकेको अवस्थामा २१ जनाको मृत्यु भइसकेको छ । दैनिक डेंगु संक्रमणसँगै मृत्यु हुने दरसमेत बढिरहेको छ तर सरकारले डेंगुलाई ‘राष्ट्रिय प्रकोप’का रूपमा घोषणा गर्न ढिलाइ गरेको छ । १७५९४ मा संक्रमण, २१ को मृत्यु पछिल्लो समय देशको ७५ जिल्लामा संक्रमण बढ्दै जान थालेपछि इपिडिमियोलोजी तथा रोग नियन्त्रण महाशाखा (ईडीसीडी)ले काठमाडौं उपत्यकालगायत देशभर डेंगी संक्रमण अत्यधिक विस्तार भएको निष्कर्ष निकाल्दै ‘राष्ट्रव्यापी प्रकोप’ घोषणा गर्न स्वास्थ्य मन्त्रालयलाई पत्राचार गरिसकेको छ । सरकारले विज्ञको सुझाव मानेर तत्काल निर्णय गर्नुको साटो अझै पनि स्वास्थ्य मन्त्रालय पर्ख र हेरको रणनीतिमा छ । नियन्त्रणका लागि ¥यापिड एक्सन प्लान बनाउन पनि ईडीसीडीले मन्त्रालयलाई आग्रह गरेको छ । संक्रमणदर दैनिक बढिरह“दासमेत सरकार जनस्वास्थ्यप्रति भन्दा पनि चुनावकेन्द्रित हुँदा डेंगु महामारीको रूप लिने क्रममा छ । ईडीसीडीका कीटजन्य रोग नियन्त्रण शाखा प्रमुख डा गोकर्ण दाहालका अनुसार नेपालमा डेंगु संक्रमणको दर जुलाईमा थोरै मात्रामा देखिए पनि बिस्तारै गति लिँदै जाँदा सेप्टेम्बरमा धेरै बढेको हो । पछिल्लो समय मुलुकमै सबैभन्दा बढी डेंगु संक्रमित काठमाडौंमा देखिएको छ, त्यसमा पनि काठमाडौं महानगरपालिकामा संक्रमण धेरै रहेको छ । इपिडिमियोलोजी तथा रोग नियन्त्रण महाशाखाको तथ्यांकअनुसार हालसम्म ललितपुरमा ४ हजार ८ सय ८७ जना, काठमाडौंमा ४ हजार ६ सय ७४ जनामा डेंगु संक्रमण देखिएको छ । सेप्टेम्बरको तथ्यांक हेर्दा, ललितपुरभन्दा काठमाडौंमा संक्रमणदर बढेको छ । त्यस्तै, मकवानपुरमा १ हजार ६ सय १० जना, दाङमा १ हजार १ सय ४९ जना, भक्तपुरमा ७ सय १३ जना, रूपन्देहीमा ६ सय ७९ जना र चितवनमा ४ सय २९ जनामा डेंगु संक्रमण देखिसकेको छ । ‘राष्ट्रव्यापी प्रकोप’ घोषणा गर्न विज्ञको सुझावमा सरकार उदासीन नेपालमा पहिलोपटक डंगुमा संक्रमण सन् २००४ मा पहिलोपटक चितवनमा फेला परेको थियो । त्यसपछि बर्सेनि नेपालमा डेंगु संक्रमण देखिँदै आएको छ । त्यसपछि सन् २००६ मा ३२ जनामा संक्रमण देखिएको थियो भने २००७ मा २७ जना, सन् २००८ मा १० जनामा संक्रमण देखिएको थियो । त्यसपछि सबैभन्दा बढी सन् २०१९ मा १७ हजार ९ सय ९२ जनामा संक्रमण देखिएको थियो भने सन् २०२० मा ५ सय ३०, सन् २०२१ मा ५ सय ४० जनामा संक्रमण देखिएको थियो । चिकित्सकका अनुसार हल्कादेखि उच्च ज्वरो आउने, मांसपेशीहरू अत्यधिक दुख्ने, टाउको दुख्ने, आँखा वा आँखाका गेडी दुख्ने, वान्ता हुने थकान र बेचैनी हुने, र जोर्नी दुख्ने यो संक्रमणका मुख्य लक्षण हुन् । स्वास्थ्य तथा जनसंख्या मन्त्रालयले यस्ता लक्षण देखिएमा स्वास्थ्य संस्था जान आग्रह गरेको छ । चिकित्सकका अनुसार टोक्ने लामखुट्टेले संक्रमण सारेको भए टोकाइको ५ देखि ७ दिनमा यसको लक्षण देखा पर्न थाल्छ । पोथी लामखुट्टेको टोकाइबाट हुने डेंगु नियन्त्रणका लागि पानी जम्नसक्ने खाल्डो, गमला, पूmलदानी, पुराना टायर आदिजस्ता ठाउँमा पानी जम्न नदिने, घर वरिपरी सरसफाइ राख्ने, शरीर पुरै ढाक्ने कपडा लगाउने, राति सुत्दा झुल वा धुपको प्रयोग गर्ने आदि सुरक्षाका उपाय अपनाउन सकिन्छ । डेंगु भाइरस फैलाउने दुई प्रकारका लामखुट्टेलाई एडिस एजिप्टी वा एडिस अल्बोपिक्टस भनिन्छ । यी लामखुट्टेको टोकाइबाट मानिसमा डेंगुको संक्रमण हुने गरेको छ । यी दुवै प्रकारका लामखुट्टे मानव आवास नजिक पाइन्छ । लामखुट्टेले डेंगु भाइरसबाट संक्रमित व्यक्तिलाई टोक्दा त्यो भाइरस लामखुट्टेमा प्रवेश गर्छ । त्यसपछि संक्रमित लामखुट्टेले अर्को व्यक्तिलाई टोक्दा त्यो व्यक्तिको रगतमा भाइरस पस्छ र संक्रमण गराउँछ । डेंगु ज्वरो चार प्रकारका डेंगु भाइरसमध्ये कुनै एकको कारणले हुन्छ । संक्रमित व्यक्तिको नजिक बसेर डेंगु ज्वरो आउन सक्दैन, बरु लामखुट्टेको टोकाइबाट डेंगु ज्वरो सर्छ । डेंगु ज्वरोबाट निको भएपछि तपाईंलाई संक्रमित गर्ने भाइरसको प्रकारसँग दीर्घकालीन प्रतिरक्षा हुन्छ तर अन्य तीन डेंगु ज्वरो भाइरस प्रकारमा हुँदैन । यसको मतलब तपाईं भविष्यमा अन्य तीन भाइरस प्रकारमध्ये एकद्वारा फेरि संक्रमित हुनसक्ने सम्भावना हुनसक्छ । दोस्रो, तेस्रो वा चौथोपटक डेंगु ज्वरो आएमा गम्भीर डेंगु ज्वरो आउने खतरा बढ्छ । त्यसैले, हामी डेंगु ज्वरोका बारेमा सतर्क रहन जरुरी छ । राजधानी दैनिकबाट