To slow the spread of COVID-19, governments issued lockdowns to keep people at home. They curtailed activities that affected services like trash collection. They tried to shield hospitals from a surge of patients.
However, the cascading effects of these restrictions are also hampering efforts to cope with seasonal outbreaks of dengue fever, an incurable, mosquito-borne disease that is also known as “breakbone fever” for its severely painful symptoms.
Southeast Asian countries like Singapore and Indonesia have dealt with concurrent outbreaks of dengue fever and COVID-19.
In Brazil, with more than 1.6 million COVID-19 cases, at least 1.1 million cases of dengue fever have been reported, with nearly 400 deaths, according to the Pan American Health Organization.
Cases are likely to rise further with the start of seasonal rains in Latin America and Asia.
Dengue fever is typically not fatal, but severe cases might require hospitalization. Prevention efforts targeted at destroying mosquito breeding sites, like removing trash or old tires and other objects containing standing water, are still the best ways to curb the spread of the disease.
COVID-19-related lockdowns have meant that these efforts have been reduced or stopped altogether in many countries.
In Pakistan, plans to disinfect shops and markets that had dengue fever outbreaks last year were shelved due to COVID-19, Pakistani Young Doctor’s Association president Rizwan Kundi said.
Having to identify thousands of COVID-19 cases has meant that dengue fever surveillance has suffered in many Latin American countries, International Federation of Red Cross and Red Crescent Societies Health Director for the Americas Maria Franca Tallarico said.
Experts say that disrupting such prevention efforts is ominous for the global battle against dengue fever.
Last year was the worst year on record for dengue fever cases, with every region affected, and some countries hit for the first time, according to the WHO.
Experts say that while reduced travel means fewer opportunities for mosquitoes to infect people with dengue fever to become carriers themselves, COVID-19 has introduced other variables.
Staying home ?— one way to slow COVID-19 outbreaks — poses greater risks for spreading dengue fever due to higher mosquito populations at people’s homes, said Singapore’s National Environment Agency (NEA).
The impact is already visible. Singapore recorded a five-fold increase in the mosquito larvae detected in homes and common corridors of residential areas during the two-month COVID-19 lockdown period, compared with the previous two months. By July 6, the total of dengue fever cases in Singapore was more than 15,500 and is expected to exceed the 22,170 cases reported in 2013, which at the time was the largest dengue fever outbreak in Singapore’s history, according to the NEA.
Working with communities in Latin America to stop mosquitoes from breeding had been the most successful strategy in the past few years, Tallarico said, adding that with strict limitations on movement, she doesn’t know whether these measures were still happening, and “this is the big concern.”
A shortage of protective equipment due toe COVID-19 also means limiting the number of first responders to dengue fever, she said.
Dengue fever patients need acute care, and this could lead to a “double whammy” that overwhelms health care systems, said Scott O’Neill, director of the World Mosquito Program, a non-governmental organization that focuses on mosquito-borne disease prevention.
At the Tahija Foundation Research Laboratory in Yogyakarta, Indonesia, which has been studying dengue fever, “it became too difficult to enroll patients with the social-distancing measures,” O’Neill said, adding that the facility is now being used for COVID-19 testing.
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