Dechen Tshomo 

More than three months after the dengue outbreak in Phuentsholing, health ministry is yet to declare the outbreak as contained.

While the number of dengue fever cases in Phuentsholing hospital dropped drastically, the hospital continues to see about three to five cases daily. Until last month, the hospital recorded more than 20 positive cases almost every day.

Since the July 5 outbreak in Phuentsholing, 4,300 dengue positive cases were reported as of yesterday. This includes two maternal deaths and six more deaths.

Except for Lhuentse, all dzongkhags reported dengue cases.

The health ministry’s chief programme officer with communicable disease division, Rixin Jamtsho, said the cases reported from other districts were imported from Phuentsholing and other endemic places because the patients reported having travelled to these places before getting ill.

About 77 percent of the total cases were reported from Phuentsholing hospital. This excludes the tests conducted by a few private diagnostic centres in the drungkhag.

With intervention from the Dzongkhag Health Rapid Response Team (DHRRT) with support from drungkhag, institutions, and communities in Phuentsholing, he said the outbreak was brought under control much ahead of the end of dengue season which is towards the end of November.

The DHRRT was inactivated from mid-October after the number of cases significantly reduced.

The cross-border contamination was one of the main challenges the team and the health ministry faced. He said about 32 percent of the reported cases were from the Indian border town, Jaigaon.

While the ministry and DHRRT continued to create awareness, there was poor support and compliance by the public.

“Public’s poor response for awareness and self-protection, and the limited manpower capacity and human resources at the hospitals were the other challenges,” Rixin Jamtsho said.

The ministry’s surveillance report showed that 56 percent of the respondents have empty containers, barrels, and tyres with stagnant water in their surroundings.

About 53 percent responded that they do not use mosquito nets, while 88 percent said they wear short pants and shirts with short sleeves.

He said that more than 50 percent of the respondents with flower pots in their balcony was unaware that it was important to inspect the pots for mosquito larvae.

About 35 percent of the dengue mosquitoes were seen breeding in the domestic refrigerator and barrel drums. About 58 and 16 percent of the dengue breeding places were tyres and flower pots respectively.

To prevent such massive outbreak in future, the ministry has come up with numerous measures.

Rixin Jamtsho said almost half of them are in place and many are underway.

Measures include developing structured advocacy and risk communication plan, activating National Health Rapid Response Team, development of dengue operational plan for source reduction and destruction much ahead of rainy seasons, strengthening the cross-border collaboration, allocation of a separate budget for dengue management, and dengue outbreak response.

Capacity building of health workers in dengue management and outbreak response are the other measures because poor reporting of dengue challenged preventing, controlling and containing the outbreak this year.