Dengue turns deadlier in October

90 deaths, 28,820 hospitalisations in just 16 days

At least 90 dengue patients died and 28,820 were hospitalised in the first 16 days of October, raising concerns over the worsening outbreak.

According to the Directorate General of Health Services, dengue claimed 148 lives in September, 43 in August, 36 in July, 13 in June and one in May. Hospitalisations stood at 43,774 in September, 20,536 in August, 9,206 in July, 20,907 in June and 714 in May.

Health experts blamed delayed hospitalisation, inadequate early diagnosis, the absence of an effective three-tier dengue management system and rising infections for the increasing death toll.

A recent death review by the Institute of Epidemiology, Disease Control and Research, led by its Director Prof Quazi Ahmed Zaki, found that more than one-third of the 119 patients reviewed died within a day of hospital admission.

The review found that 62.5 percent died from dengue shock syndrome, 31.2 percent from expanded dengue syndrome and 16.1 percent from dengue with bleeding, while 12.5 percent died from other causes. Many patients also experienced diagnostic delays of at least three days.

Medicine specialist Dr ABM Abdullah said repeated infections and delays in diagnosis and treatment were major factors behind dengue deaths.

Patients infected for a second, third or fourth time may develop severe complications, increasing their risk of death, he said.

Prof Abdullah urged people, particularly children and those with underlying conditions such as diabetes, hypertension, heart, liver and kidney diseases, and cancer, not to ignore even mild symptoms.

People experiencing fever, body aches, vomiting, diarrhoea, sore throat or loss of appetite should seek medical advice and undergo testing when necessary, he said.

He warned against taking painkillers or other medicines without medical advice, as certain drugs could worsen complications.

Prof HM Nazmul Ahsan, associate professor at Shaheed Suhrawardy Medical College Hospital, expressed concern over inconsistent application of national dengue treatment guidelines.

He said treatment should depend on a patient’s clinical condition, as a low platelet count alone did not necessarily warrant a transfusion.

“Unnecessary platelet transfusions, inappropriate fluid administration and excessive fluid loading can themselves contribute to complications and, in severe cases, death,” he said.

Prof Nazmul also called for more accessible dengue testing, particularly for low-income communities in urban and rural areas.

Public health expert Mushtuq Husain stressed the need for a three-tier dengue management system involving primary, secondary and tertiary healthcare facilities to reduce deaths and ease pressure on major hospitals.

Under the proposed system, primary healthcare facilities would offer dengue detection and initial testing free or at low cost. Patients requiring closer monitoring would be referred to upazila health complexes and district hospitals, while medical colleges and specialised hospitals would handle severe cases.

In Dhaka, hospitals run by city corporations, the railway, banks and autonomous organisations could provide secondary care, he suggested. Primary healthcare centres should also have additional beds and necessary treatment facilities.

Such a system would reduce pressure on tertiary hospitals and ensure specialised care for critically ill patients, he said.

Prof Kabirul Bashar, an entomologist at Jahangirnagar University, said dengue cases might decline slightly in November, but a noticeable fall was unlikely before December.

Continued rainfall could prolong the outbreak, he warned.

Citing a forecasting model, he said cases could continue rising for up to six weeks after the last rainfall.