There has been an exponential rise in dengue cases in the country in recent years. Currently, Punjab is the worst hit and the highest toll is borne by Lahore. This is an omen that the coming years may see escalation in number, severity and death toll.

The authorities are totally clueless and people have started pondering whether it is because of carelessness, negligence and inefficiency or is an outcome of biological infringement jump-started by some aliens. Belated surge in various steps taken by the authorities concerned like spraying, importing medicines, establishment of help-centers, provision of help-lines, use of media etc, clearly betrays a knee-jerk reaction. It is understandable that the High Court has taken notice lately and is expected to award exemplary punishment to the government functionaries responsible. On the other hand, the epidemic is spreading southward where floods are wreaking havoc, complicating the situation further.

One thing is quite clear; the dengue horror is not Pakistan-specific. Nearly 40 per cent of the world’s population is in the grip of the epidemic. According to WHO, over 100 countries are affected; mainly South America, north-eastern Africa, Middle East, Indian sub-continent and a large part of eastern Asia are badly hit. Malaria was an endemic some decades back in Pakistan but has been fairly under control. The current swelling of dengue cases raises alarm regarding malarial recurrence.

Furthermore, the mosquito which spreads dengue virus, i.e., Aedes Aegypti, is also responsible for spreading Yellow fever. Under normal conditions, the law of uncertainty and chaos theory increase the probability of multiplying the miseries! Pakistan already is in the grip of multi-dimensional problems. Bad governance, ill-preparedness, inconsideration and corruption have all added up to torment the people.

There is a difference of opinion in categorising the patients; many cases including a few deaths caused by dengue have vehemently been denied and labeled otherwise. This has unwittingly exacerbated the situation and panic-stricken authorities have resorted to fiddling with the record, as observed by patients and their relatives. The course taken by the fever varies from patient to patient which adds uncertainty, although the pattern is more or less the same. Temperature stays between 100 and 102 degF and rarely comes to normal for at least a week. In some cases it continues for another four to five days. Patient grows very weak day by day with diminishing platelets in cases where the attack is severe or the immunity is poor. Vomiting and headache cause loss of fluid and patient tends to lose appetite. In such a situation, the patient’s platelets drop so fast that some times doctors are unable to stop the downslide. Platelets falling below 40,000 are extremely dangerous and may result in death (due to hemorrhage) but quite a few hospitals have brought the figure to dangerously low level of 20,000 (and even 10,000) as a condition for indoor treatment relying on the increased gluing efficiency of platelets as the number goes down.

In view of the poor statistical picture of this grossly under-estimated menace, it is felt necessary to share the concern especially for the coming years through this article. Futuristically, it is important to reduce the ratio of patients who have suffered because of wrong treatment, inattention, panic or lack of information. Moreover, the situation turns grave for patients not being able to control vomiting causing acute dehydration. It is to be emphatically explained that in case of a viral disease, the fever has to be kept low with the help of Paracetamol; primarily, it is to be fought through diet, fluid intake and rest.

Many viruses have a tendency to lay dormant in small colonies within the human body replicating at low rate depending on the subject’s immunity. Malaria is one of them which stays in liver for years together waiting for the individual’s immunity to go down a certain level. Although it has been claimed that dengue spreads through Aedes-bite only, yet there is a need to study from the above aspect. The present virus is detectable only after about six days of incubation period (range is between 3 to 14 days). In nearly 80 per cent of cases, patients could only guess that they suffered a dengue attack. Even hospital authorities are not sure and fever pattern and symptoms are the leading indicators to suggest that patient is suffering from dengue. There are basically four known types of dengue virus but the information lacks perspicuity.

Personally, I believe that this virus may not be originally dengue but mutates very quickly based on individual immunity level and its depletion-gradient after the virus starts appearing stronger and stronger through its growing number, in some cases it has even been lying dormant (although a study does lead to negative findings and is attributed to environmental variations). There is therefore a need to study in detail what form of various strings of this particular virus in the country appear in the chain, what are their isolated effects viz a viz the individual’s immunity level and how could a common man possibly be educated on a preventive basis in our variegated demographic milieu. The subcontinent’s weather pattern is definitely changing and the study must also include this impact on mutation taking place in the virus at all stages.

Proper information regarding relapsing, in the true sense, is not available even on the internet; that can also be included in the research by medical experts and students although it has been opined that the period may vary between 3 months to one year. Herbal treatment such as extract of papaya leaves has been recommended; dengue-specific home-grown medicines can be tested and suggested.

Thus, besides all the necessary measures being taken according to local “Prevention and Control of Dengue Fever and Dengue Hemorrhage Fever” and WHO instructions, it is an opportunity for our researchers and multi-national companies to turn the tide in the next rainy season and manage a steep decline in dengue cases. Underlying commonality of human experience requires that all these efforts should also appear on internet; it is a wellspring of information and would assist the authorities and the common man alike to fight this menace.