Chapter 5: Dengue Prevention and Control

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We know that, Dengue is an arthropod borne viral disease. Dengue viruses are transmitted to humans through the bites of infective female Aedes mosquitoes. Aedes aegypti is a confirmed vector and Aedes albopictus is a secondary vector of this disease in Bangladesh. Dengue is predominantly an urban disease occurring mostly in the rainy season. Mosquitoes generally acquire the virus while feeding on the blood of a dengue infective person. After an incubation period of 8 to 10 days, an infective mosquito is capable of transmitting the virus throughout its life time.

This mosquito is a small insect with black and white stripes on its legs and back. For the control, the distribution and seasonal density of the vector should be known for the area. Other important information includes the biology, bionomics and breeding habitats. Such information can be collected through vector surveillance.

Integrated vector management (IVM)

Following approaches are to be taken for IVM:

  • Larval source reduction is the main tool for vector control. Effective control requires a concerted effort among the government agencies, NGOs and communities.
  • Community understanding and involvement remains the key for implementation of preventive and control activities. The control measures should be implemented at personal, community and institutional levels.

Household level actions

  • Wearing protective clothing such as full sleeved shirts and full pants during day time.
  • Use of mosquito coils, aerosols, mats etc.
  • Use of mosquito net (preferably insecticide-treated) even during day time.
  • Use of repellents and creams during the day.
  • Placing screens/wire mesh/net on windows.
  • Water in containers (earthen jars, cement tanks, plastic drums etc.) should not be allowed to be stored for more than three days uncovered.

Community level actions

  • Raising awareness regarding community involvement and participation about prevention and control of dengue.
  • Involving community in source reduction for prevention and control of dengue.
  • Cleaning and covering water storage, keeping surroundings clean, improving basic sanitation measures
  • Promoting use of insecticide treated nets and curtains.

Institutional level action

  • Keeping Hospitalized patients under mosquito net during febrile phase even during day time
  • Cleaning of larval habitats like overhead tanks, ground water storage tanks, air coolers, planters, flower vases etc. every five days
  • Carrying out indoor and outdoor space spraying (fogging, ULV etc.)
  • Promoting personal protection measures
  • Reporting of fever cases to health authorities

Outbreak Response for Dengue/DHF

For Dengue/DHF prevention and control Aedes aegypti mosquito control through multisectoral involvement is the mainstay. Dengue epidemics and outbreaks occur in the monsoon and the control program should start preparedness and containment measures well ahead of the rainy season. The major activities for prevention and containment of outbreaks are:

  • Rapid assessment of the existence of outbreak; magnitude of the problem and ensuring containment measures
  • Community awareness through mass media campaign (including print and electronic media)
  • Community drive for Aedes aegypti control (eliminating breeding sources; appropriate vector control measures; personal protection; and microenvironmental management)
  • Strengthening of the public health infrastructure, intersectoral collaboration and community participation
  • Establishing a responsive health care system for appropriate care of the patients in hospitals (including trained doctors, paramedics and nurses; and provision of logistic)
  • National Dengue/DHF Control Program should have appropriate policy to undertake suitable and effective control activities during the inter-epidemic period
  • Dengue outbreaks receive considerable adverse publicity and coverage in the media (both in the case of real epidemics or rumors) which impacts negatively on tourism and other sectors that inflicts heavy economic losses to the country affected by the disease. Measures should be taken to address this issue.

Care provider’s role in educating the patients and attendants during clinical management has an important value for increasing awareness for Dengue/DHF control.