LAHORE, July 31: A recently-compiled study has revealed that Punjab had witnessed a new dengue virus serotype DENV-4 that emerged in last year’s outbreak with 5,693 total reported cases which were 50 times higher than 113 cases reported in the first dengue outbreak in 2006.

“A comparison of data during outbreak of dengue fever from 2006 to 2010 shows a shift from mild illness towards a large and more severe manifestation of the disease,” the research revealed.

The researchers who compiled the study are expecting a big and large-scale dengue virus outbreak next year. They have strongly recommended immediate rigorous vector control measures and vaccine development to prevent a huge population of the province against the disease.

The report also gives a gloomy picture of the traditional ways adopted by the health department authorities to control the vector which resulted in the emergence of dengue hemorrhagic fever. It is evident from the analysis of the report which says, “The complications of the disease also show a rapid increase, with 63 admissions in 2006, 293 in 2008 and over 2,210 during 2010 outbreak of the dengue virus.”

The study was finalised on the basis of the data collected primarily from the Punjab Health Department’s Dengue Control Cell and the administrations of the government health facilities.

The data of last three outbreaks from 2006 to 2010 in Punjab was reviewed and the parameters like number of cases, disease severity and complications were collected.

The medical experts, who prepared the research report, are: AIMC/Jinnah Hospital Special Dengue Control and Surveillance Unit Coordinator Dr Mudassir Razzaq Khan, in-charge Dr Malik Asif Humayoun and Dr Muhammad Irfan of Royal Bournemouth Hospital, UK.

The research report has also been sent for presentation in the 7th European Congress on Tropical Medicine and Internal Health to be held on Oct 3 to 6 in Barcelona, Spain this year.

The researchers highlighted the comparison of clinical and pathological data of dengue patients during last three outbreaks in Punjab and discussed the changing epidemiology during successive outbreaks.

The report said: “Serologic and virologic conditions are now highly indicative of a further locally acquired outbreak of DHF of a larger magnitude in the future.”

It recommended that the education of clinicians and primary-care physicians was crucial for early recognition of DHF, especially in patients with a prior history of DF.

According to the report, the first confirmed outbreak of DHF in Pakistan was reported in Karachi in 1994 and in the following year an epidemic of DF occurred in Balochistan. Later, large outbreaks occurred in Pakistan in 2006, 2008 and then in 2010.

It said the number of dengue fever cases officially confirmed in 2006 outbreak was 113; it increased to 232 in 2007, 1,407 in 2008 and 5,693 in 2010.

In the outbreak of 2006, for the first time two different dengue serotypes i.e., DENV 2 & 3 were reported while during 2008 and 2010 outbreaks, three different serotypes including DENV 2, 3 & 4 were isolated.

Punjab Health Department Dengue Control Cell Coordinator Dr Mubashar Ahmad told Dawn that the provincial capital (Lahore) was under immense threat of outbreak of dengue virus compared to other districts.

He said out of 5,693 cases reported in 2010, around 4,494 were diagnosed in Lahore alone.

Surprisingly, he said no dengue case was reported in Rajanpur and Lodhran, the most affected districts in recent massive floods, in the 2010 outbreak perhaps owing to rising temperature or any other reason which is yet to be established.

“Some 44 dengue fever cases have been reported from January 2011 to July so far throughout the province,” said Dr Mubashar who added that 34 of them were confirmed in Lahore. He said two dengue cases were reported last week in Baghbanpura area.

He predicted that the province might enter the high-risk season for dengue fever which would start in October and last for two months as warm and wet weather provided an “ideal environment” for mosquitoes to flourish in water-filled spots. The current rainy season might help massive breeding of the mosquitoes which required extraordinary vigilance, he said.

Dr Mubashar said the health department had launched the anti-mosquito spray drive from July 15 throughout the province.