Need to strengthen India's disease surveillance network: WHO

The WHO today called for strengthening India's disease surveillance network by engaging private healthcare sector more for reliable counts of cases of dengue and chikungunya, which have claimed over 80 lives and affected more than 50,000 people across the country.
Terming engagement with private healthcare sector as "critical", WHO said that even probable dengue cases during outbreaks need to be reported to get more effective estimates while noting that strong surveillance, vector control, early diagnosis and case management and public awareness are key to control these vector-borne diseases.
The World Health Organisation said that in recent years, globalisation of travel and trade, unplanned urbanisation and environmental challenges including climate change has had a "significant" impact on transmission of vector-borne diseases.

"Surveillance for dengue and chikungunya in India presently captures only those patients that are laboratory confirmed at government identified sentinel hospitals, most of these are in the public sector.
"Given that substantial population visits the private sector for seeking health care in India, it is important that information from private hospitals and facilities is captured and well-represented for better understanding and estimation of the national disease burden of these infections," said Henk Bekedam, WHO Representative to India.
Observing that in addition to lab verified cases, probable cases of dengue, especially during outbreaks need to be reported for a more effective estimate of the numbers, WHO also called for continued investment in enhancing surveillance and laboratory capacities.

According to the National Vector Borne Disease Control Programme (NVBDCP) under the Health Ministry, dengue has affected 36,110 people across the country and has claimed 70 lives, the maximum 24 in West Bengal and ten each in Odisha and Kerela.

The death toll due to dengue in the national capital today rose to 18 while the number of cases crossed 1,100.
Similarly according to NVBDCP, 14,656 cases of chikungunya have been reported across the country with 9,427 alone in Karnataka. In the national capital, 12 people have reportedly died from Chikungunya.
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Bekedam said that aedes mosquitoes carrying Wolbachia bacteria (a bacterium that can stop viruses such as dengue and Zika from growing inside the mosquito) have been released as part of trial tests in several places beginning in 2011, including Australia, Brazil, Indonesia and Vietnam, to help control dengue and has a potential to suppress mosquito populations.

"Using genetically modified mosquitoes is another promising technique. In genetically modified mosquitoes, the genes of male mosquitoes are modified.
"Because of these changes, when they mate with female mosquitoes, their larval offspring cannot survive. This practice is designed to control and significantly reduce the mosquito population," Bekedam said.
Noting that preventing dengue or chikungunya virus' transmission depends entirely on controlling the mosquito vectors or interruption of human-vector contact, WHO India said that it promoted an Integrated Vector Management (IVM) to control mosquito vectors, including those of dengue.
"Transmission control activities should target vector in its immature (egg, larva, and pupa) and adult stages in the household and immediate vicinity.

"Schools, hospitals and workplaces need to work towards making their premises mosquito free by reducing any sources where vector breeding can happen," Bekedam said.
He said that till date, no vaccine is available to prevent dengue and Chikungunya infection, although research is ongoing and the only effective preventive measure is protection against mosquito bites and vector control.
Noting that not everyone needs hospitalisation, WHO said that it is good to know early warning symptoms to seek referral care and very young children and elderly with underlying comorbidities are at greater risk of severe disease and need to be monitored carefully.

"Everyone has a role to play in the control of dengue and chikungunya. More awareness is the key. Communities, resident associations, schools and other educational institutions, workplaces must come together to reduce vector breeding at source.
"WHO supports Health Ministry's long-term strategy for control and prevention of vector-borne diseases," he added.