What explains over 200 dengue cases in Sikkim?

Gangtok: Since 2017, the Singtam-Rangpo belt of Sikkim has been reporting cases of dengue and malaria. In 2017, over 1,500 cases were reported in the area. This year, since August, Singtam has reported over 200 cases of dengue, from the specific market area, including Mandi Line, Jubilee Line and Mandir Line being most affected. The first hospitalisation occurred on August 13.

The foothill areas of Singtam, Rangpo and Jorethang, which are close to the river, have notably been a hub for the spread of dengue and malaria. The cleanliness of these busy towns is also a priority. Sikkim, ideally being a mountainous region, the spread of dengue and malaria are uncommon phenomena. But perhaps the effects of global warming, rapid urbanisation and widespread increase in population had resulted in the spread of dengue and malaria spreading mosquitoes in Sikkim.

Singtam district hospital caters to patients from as far as North and South Sikkim, despite being situated in East Sikkim, some 31 kilometres from Gangtok.

A resident whose 11-year-old son was admitted due to dengue, informed EastMojo, “My son has been showing symptoms since September 1. It was a fever more than anything else. When we were monitoring him at home, the fever rose to 101 degrees Fahrenheit. Then I brought him to Singtam hospital. Within one hour, he was tested. Other ailments like typhoid and others were all negative, but dengue came as NS1 positive. NS1 particularly is tested in the hospital, IGG and IGM are not tested, as it is the only kit supplied. Hence after showing NS1 positive, my child is admitted. His platelets are also low currently, when we see the CBC, it’s been 4 continuous days. His fever is subsiding, if it was 103.9 two days ago since last night, his fever has subsided. He doesn’t like taking food, there is weakness, but treatment is continuous.”

Another resident cited the reason could be that drains in Singtam are very dirty. “It’s a populated place, so littering around is bound to happen. Most places in Singtam Bazaar have cases of dengue being reported but most are from the Mandi line, Jubilee line, Mandir Line, and Lal Bazaar, behind which is my residence. Particularly in Singtam Bazaar, there are a large number of cases,” the resident added.

The same was backed by Chief Medical officer (CMO) Dr Tempo Gyaltsen claiming, “Cases were first detected from the Singtam area, in Jubilee line since July end. When the cases were detected from the Jubilee line, we opted for source reduction which included cleanliness and awareness. Municipal officers and panchayats came and we conducted a cleanliness drive. On two occasions we have conducted fogging.”

EastMojo sat down with the CMO to discuss the outbreak in more detail. Excerpts:

EM: How many patients have been admitted so far?
CMO: Currently in our hospital, there are 7-8 patients admitted for dengue. Of the total tests conducted, over 200 came positive for dengue.

EM: Which age group has been most affected?
CMO: The age group affected has not been accounted for. It is happening to children as well as to adults. The maximum number of cases have been reported among adults. There are fewer cases among the children.

EM: How many patients needed hospitalisation?
CMO: We have had around 25 patients admitted so far for dengue, most of them are adults. It is a viral fever.

EM: How severe are the cases?
CMO: We have only the simple dengue fever. We don’t have dengue haemorrhagic or dengue shock syndrome.

EM: What sort of control measures are being used?
CMO: The mosquito is a specific one for dengue spread. We have to pay heed to its biting habit. It bites in the morning and evening, hence, I appeal to the people that in the evening, please do not wear sleeveless or half pants while venturing outside. Prefer to use full sleeves, it is a way of controlling the spread.

EM: Has the district hospital been overwhelmed by dengue spread on top of COVID 19?
CMO: We cannot say that we are overwhelmed, but the basic infrastructure is the same. The way we are testing people for COVID 19, similarly we are testing people for dengue as well. That is specific to patients coming from Singtam-Rangpo surrounding areas. There have been no cases reported from other places.