The State could be in for the long haul this year too, as dengue and leptospirosis cases continue to surge in all districts.
In Kerala, dengue cases usually begin to spike in April-May and the epidemic peaks in July. The pattern seems to be the same this year too.
The fact that monsoon has not set in fully in the State and rains are intermittent, means that the vector breeding will surge several fold, leading to a longer, sustained epidemic.
According to the Health department’s data provided through Integrated Disease Surveillance Project, till June 17, 7,388 suspected cases of dengue and 17 suspected deaths due to dengue have been reported. Confirmed dengue cases number 2,566, as on Saturday.
On average, every year, 1,000-1,500 confirmed cases of leptospirosis are reported. The tally of confirmed leptospirosis cases has already crossed 500, with 27 confirmed deaths too.
In the case of leptospirosis, though it is a disease that is easily preventable and curable when detected and treated early, poor compliance with health advisories issued by the Health department has been leading to unnecessary loss of lives.
According to doctors, Doxycycline prophylaxis, as advised by the Health department (to those whose occupation may put them at risk of contracting leptospirosis such as agricultural labourers, cleaning staff) has been found to be over 70% efficient even when one has been exposed to the infectious agent. But the drug has to be consumed as per the guidelines.
Laboratory diagnosis even in the acute phase continues to be a challenge in the case of leptospirosis. Though the Health department has introduced RT PCR tests for leptospirosis which can confirm the disease in the early phase , it is yet to be made widely available.
Pre-monsoon cleaning activities and vector control drives across the State do not seem to have had the desired effect. The Health department points to public apathy and lack of public cooperation as the main reason why vector control activities and surveillance never seem to have the desired effect.
Vector control activities like source reduction have to be a sustained affair for the mosquito population to remain below a certain threshold.
A.aegypti is a species that prefers to be indoors—dark, cool corners, underneath tables or cots—and rarely moves away from its resting places if it finds breeding facilities also. Hence it is important to ensure that homes are free of breeding sources like potted plants.
Techniques such as indoor residual spraying on the lower part of walls and indoor space spraying in homes and workplaces are being advocated by experts but the Health department is yet to explore these options.
According to a senior Health official, the fact that the new Kerala Public Health Bill 2023, passed by the Assembly is yet to become law of the land (Kerala Public Health Bill 2023 is still awaiting the Governor’s signature) is one reason why Health officials are not able to take action against those who keeps their premises unkempt, allowing vector breeding circumstances.
“Under the new Act, an offence which could imperil public health could invite a fine of ₹10,000. Such a regulatory approach is very important for effective public health action. But at present, though the local bodies can take action for improper waste management, neither the Municipal Act nor Panchayati Raj Act has any provision for imposing fines for breeding mosquitoes in one’s surrounding,” he said.
