BackVector borne diseases to strain health systems more as India braces for monsoon
Government has admitted that there are challenging times ahead with monsoon coming and mercury risingIndia is also likely to miss the deadline for elimination of neglected tropical diseases (NTDs) such as kala-azar in December and lymphatic filariasis by 2021
PremiumNEW DELHI: Its double whammy for India amid the covid-19 outbreak as the upcoming monsoon season may trigger a surge in vector borne diseases such as dengue, malaria and chikungunya.
Government’s concern is clear with Prime Minister Narendra Modi raising the issue in his meeting with state chief ministers on Sunday. “With the onset of monsoon, there will be proliferation of many non-covid-19 diseases, for which we must prepare and strengthen our medical and health systems," Modi had said.
With India under a lockdown to contain coronavirus spread, the union health ministry has said states can postpone activities such as distribution of insecticide treated nets (ITN) till the lockdown is lifted. Use of long-lasting insecticidal nets (LLIN) provided in high malaria endemic areas should be promoted. However, if dengue cases rise, fogging operation on vehicle mounted machines can be undertaken immediately in affected areas.
Government has admitted that there are challenging times ahead with monsoon coming and mercury rising. “Managing vector borne diseases will be a challenging task with monsoon. This time during lockdown there is likelihood of more people staying put at home coupled with increasing temperature and humidity are likely to increase the incidence of these seasonal diseases," Harsh Vardhan, union health minister told Mint.
These diseases have a cyclical trend and the years 2020 and 2021 are considered important for monitoring these diseases. States had been asked to undertake an enhanced surveillance for any rise in fever cases or any of the vector borne diseases" he said. Covid-19 has fever as one of the symptoms, as do the vector borne diseases, and testing will have to be scaled up for all diseases, he added.
“The country is in a full lockdown due to covid-19, which has also hampered regular activities for other health programs," said Sanjeev Gaikwad, country director, Malaria No More, a non-profit organization.
“The approaching monsoon season that starts in June, also carries with it a risk of emergence of other life-threatening diseases such as malaria. It is critical to maintain the decline in malaria cases in the country with a proactive approach as soon as the lockdown is lifted so that a surge in malaria cases is not seen during the monsoon," he said.
India is also likely to miss the deadline for elimination of neglected tropical diseases (NTDs) such as kala-azar in December and lymphatic filariasis by 2021.
Still, 33 districts in Bihar, four in Jharkhand, 11 in West Bengal and six in Uttar Pradesh remain endemic to kala-azar with 80% of the cases being reported from Bihar alone.
Indoor residual spraying (IRS), which is the only successful measure to prevent build-up of sand-flies -- kala-azar spreading vector --was scheduled to be undertaken in the last week of March. However, only Bihar restarted the program, and there has been no such indication from other endemic states which might lead to resurgence of cases, government sources said.
“The current covid-19 situation has had a profound impact on NTDs and program for control and elimination of Soil Transmitted Helminths. The deworming activities have been affected across several states," said Nirmal K Ganguly, president, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry and former Director General at Indian Council of Medical Research.
For lymphatic filariasis, vector borne disease transmitted by mosquitoes, the mass drug administration (MDA) round was scheduled in Jharkhand and Bihar in the last week of March and in April, but have been postponed. The lockdown due to covid-19 is making it difficult for people with lymphoedema (swelling in limbs) and hydrocele (swelling in scrotal sac) to access the services they need that can lead to progression to more advanced stages.
“In such times carefully identified critical health services that are part of government elimination programs must be continued to protect people at risk from existing endemic diseases while at the same time protecting them from newer challenges like covid-19," said Ganguly.
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