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Dengue outbreak in India: Symptoms, treatment, precautions and a vaccine

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Dengue outbreak in India: Symptoms, treatment, precautions and a vaccine

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The recent spurt of dengue cases can be blamed on unseasonal rains, leading to water-logging. The Indian Council of Medical Research (ICMR) directly blamed climate change for the increasing case numbers.

Dengue outbreak in India: Symptoms, treatment, precautions and a vaccine
India is seeing one of its worst outbreaks of dengue in years, with a high number of cases being reported from Haryana, Punjab, Kerala, Rajasthan, Tamil Nadu, Uttar Pradesh, Uttarakhand, Delhi and Jammu and Kashmir.
Local authorities have launched inspection programmes to locate and destroy mosquito breeding grounds and expert teams, including officials from the National Centre for Disease Control (NCDC) and National Vector Borne Disease Control Programme, have been sent to affected areas.
The deadly viral disease is spread by the female Aedes aegypti and Aedes albopictus mosquito species, of which the former is more prevalent in India. The same mosquito species is also responsible for spreading chikungunya, yellow fever and Zika viruses.
According to data from the US Centers for Disease Control and Prevention (CDC), around 400 million individuals are infected with dengue every year. With one out of four individuals falling sick, 100 million individuals show symptoms and nearly 22,000 die each year from the disease. The disease is prevalent in areas with a large population of mosquitoes, mainly in the tropics and subtropical regions, which covers almost the whole of India.
Symptoms 
The symptoms of dengue last 2-7 days in most cases. Common symptoms of a mild infection include fever, aches and pains, or a rash. Other symptoms of the disease are nausea, vomiting, eye pain, muscle, joint, or bone pain, the reason why the disease is also known as bone-break fever.
In cases of severe infections, symptoms like belly pain, tenderness, excessive vomiting (at least three times in 24 hours), bleeding from the nose or gums, vomiting blood, or blood in the stool can show up 24-48 hours after the fever has receded. In such cases, the patient must be given immediate medical attention. Pregnant women, children and past patients of dengue are most likely to suffer from severe infections. Severe infections can be deadly as they lead to shock, internal bleeding, and death.
It is advisable to get the dengue blood tests done as soon as individuals report symptoms associated with the virus. There is ‘no standard protocol’ for the treatment of patients who have contracted a double infection of COVID-19 and dengue.
Currently, there's one available dengue vaccine called Dengvaxia® (CYD-TDV) developed by Sanofi Pasteur, the French pharmaceutical giant. The vaccine is administered in the 9-45 age group in several countries, including India, but it can only provide immunity to those already infected by dengue.
Safeguards 
Clearing out the breeding grounds for mosquitoes is the best preventive measure. Removal of stagnant water, emptying vessels and preventing water from pooling in areas are important community-wide measures that can be taken. But it may not be feasible to get rid of water-filled containers, especially in places of erratic water supply.
In such cases, insecticides can be a viable option. While chemical insecticides can be effective in significantly eradicating mosquito populations, they also carry significant downsides and can be toxic to other organisms.
Bioinsecticides provide a safer yet effective option for treating water to kill mosquito larvae. They are usually a combination of biological agents along with certain stabilisers that are designed to only affect mosquitoes.
The most-effective bioinsecticide for mosquitoes is Bacillus thuringiensis israelensis (Bti), a naturally occurring bacteria in the soil that can kill mosquito larvae. Bti is available in various forms, solid ‘dunks,’ pastes, powders, solutions and more, and can be directly introduced to water in specified amounts to kill the mosquito larvae present.
Bti is a green label pesticide that does not harm any mammal, and Bti-treated water remains non-toxic for humans and other animals alike. Bioinsecticides like methoprene can also help.
Other measures like using mosquito nets, especially around infants, wearing full-sleeve garments, and limiting outdoor exposure in areas with stagnant water are effective preventive techniques as well.
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