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As dengue becomes more widespread in Rawalpindi, can hospitals cope? – Pakistan



Hospital and laboratory staff remain on duty until late hours, testing blood samples and monitoring patients.

For three continuous days, Asma Bibi was in agony; severe body aches, muscle aches, constant migraines, fatigue and fever. When she entered Benazir Bhutto Hospital (BBH) in Rawalpindi, her test reports revealed that she had contracted a "bone fever", otherwise known as dengue. Given the way the virus affects the human body as it develops and unfolds, its condition is expected to worsen.

The 20-year-old Bibi, who is six months pregnant, spent two days in the BBH High Dependency Ward where critical patients were being treated.

Asma Bibi, who has a dengue fever, sits in a blue mosquito net at BBH in Rawalpindi. ̵
1; Photo by

Sitting on a bed covered in a blue mosquito net, Bibi told Dawn.com: "I suffered from severe headaches, followed by vomiting and body aches. I lost my appetite and stopped eating at all. While Bibi hopes to recover soon if not properly treated, dengue can be fatal.

A mosquito-borne viral infection is found in tropical countries around the world and is transmitted through the bite of infected female mosquitoes that feed indoors as well as outdoors during the day (dawn to dusk). These mosquitoes thrive in stagnant areas, including puddles, water tanks, containers and old tires. Lack of reliable sanitation and regular garbage collection also contribute to the spread of these mosquitoes.

Dengue is quite common in South Asia, mainly occurring during and after the monsoon season from June to September.

According to the Special Assistant to the Prime Minister for Health, Dr. Zafar Mirza, the number of dengue cases in Pakistan has touched the five-digit figure and 10,013 dengue cases have been reported so far this year from across the country.

Read also: Dengue is back . At least 9 deaths have been confirmed in three hospitals in the city in the last few months.

A measure of how widespread the dengue epidemic has occurred in parts of northern Punjab is manifested in the number of patients in the outpatient wards of major hospitals in the region, many of the complaints showing a developing dengue infection. Healthcare infrastructure is struggling to cope.

Hospitals declare a state of emergency

Doctors say that this year the unprecedented influx of dengue has created fear and panic among people and that patients with simple headaches and body aches flood the hospitals.

Overview of the Common Dengue Section for Women at BBH. Doctors say that this year the unprecedented tide of dengue has created fear and panic among people. – Photo by

"We are overloaded and there is no cooperation from private hospitals. Dengue in the Potohar area has become widespread, where routine wards are already turning into dengue wards, resulting in bad effects on other patients, "Dr. Inayat ur Rehman, dengue person at BBH, told Dawn.com

Reman says that the intensity of the virus is about 10 times higher this time than in previous years.

Due to the significant increase in patient flow, hospital and laboratory staff remain on duty until late hours, testing blood samples and regularly monitor critical patients.

Dr Faisal Shahzad, who heads the ward at BBH – which is not usually reserved for dengue patients, says: "We received more than 2000 patients in just a few days and each patient should be monitored every 15 minutes. Our space is filled to the brim with this deadly mosquito epidemic. "

Dr. Faisal Shahzad says the hospital has admitted more than 2000 patients in a few days. – Photo by

Dr. Kutbudin Kakar, National Professional Officer, World Health Organization (WHO) for Pakistan-born diseases He says: "gear jump in dengue due to heavy rains; meteorological conditions were favorable for mosquito breeding aedes aegypti in the Potohar area, and the vector expanded to other dengue-free areas in the past. "

" In addition to meteorological conditions, a high influx of people moving from high-risk areas of dengue was another major reason for the spread of the vector. Thanks to this population movement, dengue is spreading to areas where it has not been present before, ”he says.

Hospital and laboratory staff remain on duty until late hours, testing blood samples and regularly monitoring critical patients. – Author Photo

In a speech before the dawn of the area, Punjab Health Minister Dr Yasmin Rashid said: “The government is dealing with emergency dengue and the situation is improving. We communicate with private hospitals and the Fouji Foundation Hospital also facilitates dengue patients. Smoking is done at larvae and residential areas where dengue cases have been reported, but no smoking should be done as this causes a mutation of the virus. "

Rashid added that" 300 doctors and 200 nurses have only been replaced in Rawalpindi for this purpose. "

After you recover, dengue can hit you again.

Dengue infections are caused by four closely related viruses called DEN-1, DEN-2, DEN-3 and DEN-4. A person suffering from one type of dengue develops immunity from that specific strain of the virus after recovery, and when it comes to the other three species, the individual is only protected against infections that result from them for two to three months after the first dengue infection. as soon as this short period is over, they can be infected with any of the other three strains of dengue.

Researchers have noted that subsequent infections may put people at greater risk of severe mucous membranes than those who have never been previously infected.This severe infection – known as hemorrhagic dengue – can cause organ damage and can also be fatal.

“Hemorrhagic dengue is a danger and affected people in Rawalpindi this season. I fear that it will increase and move to other cities as people travel, "says Dr. Kaiser Sajad, Secretary General of the Pakistan Medical Association.

" There is a need for a permanent strategy to reduce and eliminate the virus and no ad hoc action should be taken. Ongoing action must be developed with all stakeholders, "Sajjad added.

The virus is evolving

A recent study says that the virus changes shape and mutates, which helps it to escape. the impact of vaccines and therapists.

Dr. Shemey Locke, a professor at Duke NUS School of Medicine and the corresponding author of this study, says that different strategies for different types of patients must be taken.

Locke says that in order to prevent disease through vaccines that are administered prior to infection, medics must use a vaccine that is effective against what is known as "smooth surface virus".

"When it comes to patients exhibiting fever symptoms, treatment strategies effective against uneven surface particles should be applied," she adds.

"A little late for fumigation"

Rawalpindi's Doval Cala Khan is filling up with its fumigation blasting machines, which look like blown leaves, with smoke coming across the street and residents rushing to open their gates to allow smoke to reach their homes.

at Dhoke Kala Khan in Rawalpindi – Author's picture

Parven, a resident of the area, says that municipal authorities should have sprayed earlier to avoid the worst of the epidemic.

Read more: Is the risk of change in dengue increasing? 19659003, meanwhile, not far from Doke Cala Khan, in Islamabad's Lohi Bhair lives on Khalid Navid, who works as a security guard in Islamabad. Brought to BBH in critical condition. And although his mother tells him he seems to be recovering relatively well from fever, Naveed has witnessed the rapid onset of dengue in at least eight other people in his neighborhood. All of them, he said, were accepted into the BBH.

Naveed does not say whether the area has been fumigated against dengue, but a member of one of the fumigation teams of the last few years says authorities must have started fumigation "long before the monsoon season began to avoid this situation."


Harun Janjua is an award-winning freelance journalist covering Pakistan and Afghanistan. He Tweets @JanjuaHaroon


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