NEW DELHI, Oct 19, (AP): At dusk, the foggers come out to spray their sticky-sweet clouds of diesel smoke and insecticide across the Indian capital. Mothers scold their children for wearing short sleeves. Posters glued to signposts warn about the perils of neighborhood puddles. Such efforts to stop mosquitoes from spreading dengue fever in New Delhi have failed to keep the city from its biggest outbreak in almost two decades: more than 10,190 registered cases, including 32 deaths.
Experts say it didn’t need to be this way, and blame health officials for being slow on both prevention work and medical response. They say, for example, that the Delhi municipal government should have started much sooner and anticipated a longer-than-usual mosquito-breeding season months ago, when weather forecasters predicted this year’s monsoon would extend beyond September. “If they clean up in time, if they have those anti-mosquito, anti-larval measures on time, they can contain dengue,” general physician Devendra Jain said in the small single room, crammed with patients, where he operates his private practice in south Delhi.
Some officials reject the idea that the high numbers are a result of neglect, and instead say they prove the city is simply conducting more tests. Some infections go unreported every year because some people with dengue fever don’t seek medical treatment, and others visit doctors who don’t report cases
Health officials also note that while the number of cases this year has almost surpassed the 1996 high of 10,252, the death toll is far lower than the 423 who died from dengue 19 years ago. There are no statistics on dengue for years before 1996. Three weeks into October, new cases were still being reported. The Holy Family Hospital alone said it was still detecting about 27 cases a day on average, down from a September peak of 75 cases a day.
Dengue leaves its victims exhausted and in great pain, though it is rarely fatal, claiming less than 1 percent of those infected. There is no cure; patients need rest and to be monitored and treated for symptoms, including high fever, dehydration, skin rash, exhaustion and a low blood platelet count. “It is not rocket science,” said Manish Kakkar, a researcher at the Public Health Foundation of India, a research and consulting group. “We know what we have to do, but what happens in India is that the public health measures are not adequate both in terms of quantity and quality.” The dengue outbreak has highlighted India’s striking health-care inequalities.
It is home to a $4 billion medical tourism industry – offering everything from bargain tummy tucks to experimental stem-cell treatments – and to hundreds of millions of impoverished Indians who still have no access to trained doctors or basic medicine. When two young boys died last month after their parents said they were denied treatment at private hospitals, India’s Health Minister warned the government would yank licenses from any hospitals who turned patients away.
State-run hospitals canceled doctors’ vacations, ordering them back to work. Delhi capped the cost of lab tests at 600 rupees ($10) and set up 55 “fever and dengue clinics” to handle the throngs of patients crowding into hospital foyers. Just one of those clinics, near Jamia Millia Islamia university on the southern outskirts of New Delhi, reported screening 800 patients a day.
Some doctors complain that many people seeking medical attention don’t need it, and blame the media for hyping the outbreak. “Basically there is a panic and patients are very scared,” said Dr. Sonika Bali, the medical officer in charge at one government clinic, whose own 12-year-old daughter was among those infected. “We can’t have every patient come in and ask for a blood test. It is becoming very difficult to convince patients that their symptoms are not that of dengue.” Some who truly have dengue, meanwhile, wait before seeking treatment, worsening their symptoms.