THE new sunday express MAGAZINE Voices Pushpesh Pant Ravi Shankar Ajai Sahni Anu Aggarwal Debashis Chatterjee Swami Sukhabodhananda Buffet People Wellness Books Food Art & Culture Entertainment AUGUST 25 2024 SUNDAY PAGES 12 The annual Dengue outbreak is now spreading at an alarming rate not only in India but across the world, putting billions at risk. So are other insect-borne and animal-borne diseases like Nipah, Mpox and Zika Bitten by the Bug By Sneha Mahale S anjana Salunkhe and her family moved from Mumbai’s crowded Andheri suburb to an upscale ground-floor apartment in Richmond Town, Bengaluru, shortly after the Covid-19 pandemic. The 30-year-old freelance content strategist was drawn to their new domicile’s open spaces and gardens, which she thought would be an ideal place for her four-year-old son, Armaan, to grow up in. However, when the monsoons hit, their home was swarming with mosquitoes. Despite all efforts to prevent breeding such as removing stagnant water, maintaining cleanliness around the house and staying indoors most of the time, Armaan developed a 102°F fever. He was diagnosed with dengue. “He was sick for 10 days, and although he recovered, he fell ill again soon after returning to school. The doctor explained that dengue had compromised his immune system, making him more vulnerable to other illnesses,” she says. With the mosquito problem persisting in the locality and no fumigation or intervention from local authorities, Salunkhe and her family have decided to move to another area of Bengaluru with fewer dengue cases. Their experience is part of a larger dengue issue in Karnataka. On August 3, the southern state had recorded 19,313 dengue cases and 10 deaths, surpassing the total number of cases reported last year; and it is only August. The State Health Department’s data revealed that among the afflicted are some of the most vulnerable: 360 infants aged under one and 6,863 children under 18. In India’s bustling IT capital, the number of cases skyrocketed nearly six-fold in a month, surging from 1,563 on July 1 to a staggering 8,800 by August 3. The city usually , synonymous with innovation and progress, found itself at the epicentre of a public health crisis, with neighbourhoods turning into breeding grounds for mosquitoes and hospitals filling with dengue patients. The situation was serious enough to prompt the Union Health Ministry to convene a high-level review meeting, chaired by Union Health Secretary Apurva Chandra, with representatives from nine states and 18 municipalities, all facing high dengue numbers. Mosquitoes do not differentiate between their victims; last week Tribal Affairs Union minister Jual Oram’s 58-year-old wife Jhingia died of dengue. In Delhi, Haryana, Odisha, Maharashtra, Kerala, Telangana Maharashtra, Tamil Nadu, Andhra Pradesh and Punjab, dengue has arrived with the rains. Not just dengue: symptoms of chikungunya and Zika have been detected in some patients. As the world shrinks because of easier travel, insect-borne and animal-borne diseases are here to stay as the , deadly disaster of Covid-19 showed. A month ago, Kerala issued a Nipah virus alert; health experts believe 40-75 per cent of people infected with Nipah will die from the virus. PEST SEASON IS FAST AND FURIOUS A single infected mosquito can transmit the dengue virus to up to eight people, leading to clusters of illness within communities. Although many cases are asymptomatic, those who do exhibit symptoms often suffer from a debilitating combination of high fever, severe headache, intense body aches, nausea and a rash. Most patients recover within 1-2 weeks, but severe cases can necessitate hospitalisation and, in extreme situations, may be fatal. All four types of the dengue virus, DENV-1, DENV-2, DENV-3, and DENV-4, share similar symptoms and follow the same line of treatment. Of these, DENV-2 is considered the most severe and deadly It is, . however, yet to be ascertained as to which strain spreads faster. The most alarming aspect of these diseases is their infection speed. Over half of current dengue cases were reported in just two weeks, from July 20 to August 3. India enters the most dangerous part of the year for dengue: August to November, when the monsoon’s aftermath leaves behind pools of stagnant water, which make fecund breeding grounds for mosquitoes. Although dengue cases generally peak in October, this year’s trend shows that, as of July 31, the number of cases is already almost 50 per cent higher than at the same time last year. Dr B Reddya Naik, a professor of zoology and head of the medical entomology laboratory at Osmania University Hyderabad, reveals a , critical reason behind this alarming trend. “Over the past decade, India has seen a significant increase in its mosquito population, particularly species like Aedes aegypti, a primary vector for dengue, Zika virus and chikungunya. This surge is directly linked to the more frequent and severe dengue outbreaks we’re witnessing,” he says. This brings into sharp focus the main antagonist in this unfolding health crisis, the mosquito. The rapid rise and global spread of the blood-sucking species, particularly in India, is increasingly concerning. WHY BLOODSUCKERS ARE THRIVING Dengue is primarily spread by the Aedes aegypti mosquitoes, notorious for their day-biting habits. Aedes albopictus also contributes to the spread, though to a lesser extent. These mosquitoes are typically associated with hot, humid climates, thriving in environments where stagnant water is abundant. However, new research published in 2018 by NIH uncovered a surprisingly alarmist twist: even dry conditions can fuel mosquito breeding now. In dry weather, mosquitoes become desperate for moisture and are driven to feed on blood more frequently This . means that even in arid conditions, the threat of dengue can persist or even worsen. India’s status as the world’s most populous country makes it mosquito heaven. “Over recent decades, population growth, particularly in highly urbanised cities and towns, has intensified. As human populations expand, so do the habitats for mosquitoes that thrive around people. This close association has led to a significant increase in dengue cases, as mosquitoes track and exploit the growing urban environments,” says Cameron Simmons, executive director delivery at the World Mosquito Program (WMP), a not-for-profit group that works to protect the global community from mosquito-borne diseases such as dengue, Zika, yellow fever and chikungunya. As a result, dengue, once limited to tropical and subtropical regions, has now become endemic in over 100 countries. Naturally then, the global incidence of dengue has skyrocketed over the past two decades. From 2000 to 2019, the World Health Organization (WHO) recorded a staggering 10-fold increase in reported cases, soaring from 5,00,000 to 5.2 million. The year 2019 was particularly alarming, with dengue cases reaching a record high across 129 countries. While the Covid-19 pandemic led to a temporary dip in reported cases between 2020 and 2022, dengue made a dramatic resurgence in 2023. The frequency and scale of outbreaks surged, reaching regions previously untouched. CRITTERS SPREAD THEIR WINGS This year, by May 2024, the European Centre for Disease Prevention and Control has reported another chilling statistic: over 10 million dengue cases and more than 5,000 deaths across 80 countries and territories. In Brazil alone, the virus spread like wildfire, with over a million cases reported in just the first two months of the year—a staggering record for this period (cases normally peak from March to May). Peru’s situation was equally dire; with more than 34,000 cases reported early in 2024, the country was forced to declare a health emergency The infection’s . relentless march hasn’t spared even countries previously considered low-risk. Croatia, France, Italy, Portugal (Madeira) and Spain are now grappling with outbreaks, marking a disturbing shift in the disease’s geographical spread. In Africa and Asia, where data collection is often sparse, the true burden remains unknown. “Cases are also being reported from parts of Latin America, southeast Asia, Argentina, southern China and southern Europe,” says Simmons. India’s dengue crisis mirrors global trends. The Indian Council of Medical Research (ICMR) in 2023 reported an 11-fold increase in dengue cases over the past two decades, with recurrent outbreaks now a troubling norm. What was once a disease confined to just eight states in 2001 has now spread its tentacles to all states and Union Territories. Remarkably, it has even reached Ladakh, with two cases reported in 2022—a stark indication of how far the virus has travelled. The reasons behind the spread is the usual suspect: man’s disregard for Nature’s balance. Climate change: According to the Intergovernmental Panel on Climate Change (IPCC), dengue’s escalation is being fuelled by rising global temperatures and increased rainfall, which create ideal conditions for dengue-carrying mosquitoes to thrive. “Climate change is lengthening mosquito breeding seasons, Turn to page 2