Union Health Secretary Shri Apurva Chandra has advised States and municipalities to be vigilant for timely containing of any outbreak of Dengue. “It is important for relevant stakeholders including the Urban Development Ministry, States, Municipal Corporations and local self-government bodies to cooperate and work in tandem to prevent and manage dengue cases in the country,” he stated while chairing a high-level inter-ministerial meeting (conducted in hybrid mode) to review the dengue situation in nine high-burden states and assess the preparedness of the public health system for the prevention, containment, and management of dengue, given the onset of the monsoon and the rise in dengue cases. The meeting, held today, included participation from the Ministry of Housing and Urban Affairs (MoHUA) as well as Secretaries and high-level officials from the nine states of Delhi, Gujarat, Karnataka, Maharashtra, Rajasthan, Tamil Nadu, Telangana, Uttar Pradesh, and West Bengal. Total of 18 municipal corporations including Ahmedabad, Bengaluru, Chennai, Delhi, Hyderabad, and Mumbai virtually participated in the meeting. The highest number of cases have been reported from Karnataka, Kerala, Tamil Nadu, and Maharashtra.

Shri Apurva Chandra highlighted the need for pre-emptive steps and public health measures ahead of the monsoon season, when dengue cases typically peak around August, September, October, and November. He emphasised that cases have been increasing over the past four years, year after year. Although dengue cases generally peak in October, this year’s trend shows that, as of July 31, 2024, the number of cases is already almost 50% higher than at the same time last year, he pointed out.

The Health Secretary urged the States to ensure that they are prepared for the upcoming peak. While the number of cases has been rising over the past four years, the Dengue Case Fatality Rate has decreased from 3.3% in 1996 to 0.17% in 2023 due to focused, timely and collaborative efforts, the Health Secretary stated.

Shri Apurva Chandra advised the States to be prepared with effective hospital management of the dengue patients. Secretary also advised for identification of the hot spots, increased vector surveillance, geotagging of the cases for taking preventive actions etc. He stated, “We need to ensure the availability of platelets and hospital resources in the health departments to bring down the fatality rate.” He assured all support to the states in combatting dengue and encouraged the states to submit their proposals to the Ministry regarding the support they require.

To enhance prevention and control efforts, Union Health Secretary called for increased collaboration between the Health Ministry and Ministry of Housing and Urban Affairs by developing Joint Action Plan to have a greater impact. He highlighted the need for support from the Urban Development Ministry in the form of cleanliness drives, particularly during the peak period of dengue cases, which spans from the onset of the monsoon season to November.

Shri S.P. Singh, Additional Secretary, MoHUA enlisted various steps taken to prevent and control the spread of dengue.  He mentioned the "Safai Apnao, Beemari Bhagao Campaign" and the Swachh Bharat portal. These initiatives focus on monitoring activities related to the elimination of stagnant water and preventing waterlogging, he stated.

Various strategies and public health measures have been implemented for the Prevention and Control of Dengue and Chikungunya by the Health Ministry, such as:

1. Surveillance- Disease & Entomological Surveillance

2. Case management- Lab diagnosis & Clinical management

3. Vector management- Environmental management, Source Reduction, Chemical control, Personal Protection and Legislation

4. Outbreak response- Epidemic preparedness/ Response and Media management

5. Capacity building- Training, Strengthening and Operational research

6. Behavior Change Communication- Social mobilization and IEC

7. Inter-sectoral coordination- Different Ministries (Urban Development, Rural Development, Panchayati Raj, Education Ministry, Tribal Affairs, Water Supply and Sanitation)

8. Monitoring and Supervision- Analysis of reports, reviews, field visits, and feedback

In addition to enhancing the prevention, control, and management of dengue nationwide, the other  key initiatives implemented are as follows:

• For free diagnosis and disease surveillance, Sentinel Surveillance Hospitals increased from 110 in 2007 to 848 in 2024
• Updated National Guidelines of Case Management released on 10.8.2023 and shared with the states
• Master trainers from medical colleges and district hospitals trained in four national level trainings on updated guidelines for improving clinical management and avert deaths due to Dengue

Smt. Aradhana Patnaik, Addl. Secretary and MD (NHM), Smt. Vandana Jain, Joint Secretary (VBD); Dr. Tanu Jain, Director National Center for Vector Borne Diseases Control  (NCVBDC)  and senior officials of the Union Health Ministry were present in the meeting. Officials from states and their Municipal Corporations joined the meeting virtually.

Background

Dengue is a fast emerging, outbreak-prone, and mosquito-borne viral fever. Over the years, dengue has largely transitioned as an epidemic in urban centres due to relatively higher temperature (Urban Heat Island), higher concentration of population, rapid construction, inadequate solid waste management and improper water storage practices contributing to increased density of the vector Aedes mosquito.

In 2022, a total 2.33 lakh cases and 303 deaths and in 2023 total of 2.89 lakh cases and 485 deaths due to Dengue were reported.  The urban areas have been contributing 55-58 % of the total cases for last few years, however in 2023 it has increased to around 68%.

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MV

HFW/ Dengue Review/2 August 2024/6