Dengue remains perilous with over 2,000 cases in 15 days of January

• Dengue cases rise from 8,931 in 2002 to 183,235 in 2017
• Most number of cases filed in Colombo while least number of cases filed in Ampara
• 2,387 dengue patients admitted within the course of two weeks
• Early identification and management can reduce morbidity and mortality

By Shannon Jayawardena

The killer disease dengue, which has claimed many lives in Sri Lanka during past years, is once again on the rise with over 2,000 cases filed within a short period of two months, with most of the cases being reported in the Western Province.

According to National Dengue Control Unit (NDCU) statistics, approximately 2,387 dengue patients have been admitted during the first two weeks of this year. 

A total of 532 cases this month marked Colombo as the highest district to harbour dengue while 316 singled out Gampaha as second and Kandy came third with 253. With just six cases filed, Ampara District denoted the least amount of dengue cases.

NDCU statistics also show that 183,235 cases prevailed last year and 7,983 patients received treatment during the month of December. While 8,931 cases were filed in 2002, numbers increased rapidly thereafter, with 29,777 in 2015 and 55,150 in 2016.

While dengue is a viral infection transmitted by the bite of an infected mosquito, there are four closely related but anti-genially different serotypes of the virus that can cause dengue which are DEN1, DEN 2, DEN 3 and DEN 4.

Dengue has a wide spectrum of infection outcome (asymptomatic to symptomatic). Hence symptomatic illness can vary from undifferentiated fever (viral syndrome), dengue fever (DF), dengue haemorrhagic fever (DHF) and dengue with unusual manifestations.

Severe vomiting, abdominal pain, increased thirst, drowsiness and excessive sleepiness, loss of appetite, abnormal bleeding manifestations, cold clammy skin and extremities, restlessness and irritability, skin mottling, decreased or no urine input and behaviour changes such as confusion or use of foul language are the main symptoms and if present should sought immediate medical attention. 

However, early identification and management of dengue can help reduce morbidity and mortality. In the present hyper-endemic setting in Sri Lanka, dengue is considered in the differential diagnosis of patients presenting acute onset of fever with headache, retro-orbital pain, myalgia, arthralgia, rash (diffuse, erythematous, macular), haemorrhagic manifestation, Leukopenia (<5000/mm3), platelet count ≤150,000/mm3 and rising haematocrit of 5-10%.

According to the Sri Lanka Epidemiology Unit (EU) the highest dengue prone areas are Colombo, Gampaha, Kalutara, Kurunegala, Ratnapura and Jaffna Districts. EU statistics highlight that around 41.53% of dengue cases were reported from the Western Province last year.