With one more patient succumbing to dengue fever, the recent outbreak of dengue has claimed two lives while the number of affected are increasing.

A 30-year-old man died yesterday at the intensive care unit of the Thimphu national referral hospital. The deceased is a resident of Phuentsholing where 1,239 confirmed dengue cases were reported as of Tuesday, August 20. The other victim was a 25-year-old woman from Tading, Samtse. She died on August 11.

Meanwhile, a severe dengue outbreak has stricken residents of Phuentsholing. Phuentsholing general hospital reported 33 positive cases in one day, on August 19.

There are four types of dengue fever. The most common in Phuentsholing and other affected parts in the country is “the cerotype 2,” which is also the most threatening.

Dengue fever symptoms appear three to 14 days after a mosquito bite. Mild and high fever, severe headache, pain behind the eyes, joint pains, and rashes are some of the symptoms.

Phuentsholing general hospital has become crowded with patients waiting in queue everyday for the reports and treatment since the last 10 days. With the emergency room packed, the hospital had for many days adjusted trollies along the corridors.

On August 12, the hospital received more than 700 people and most had come complaining of dengue symptoms.

Nothing had changed as of yesterday.

Some sat with on the staircase with their heads down on their relatives’ shoulder, while some just laid down on the benches. A hospital staff said that more than 20 hospital staffs were affected by the fever. From government officials to private offices and corporations and students, people from all organisastions have been hit by the fever.

A woman who was headed to Thimphu had to stay longer in Phuentsholing when two of her friends were diagnosed with dengue. She was with her friends at the hospital waiting for the reports yesterday.

“I will have to stay here now,” she said. “I have brought both to the hospital.”

A government official said that the fever has gone beyond control now. He said it was also “disturbing” that somebody had died.

“We are educated and we at least know how to take care, but I am worried for those who come from villages,” he said, adding that the government has to do something before it is too late. “I am recovering from a painful experience.”

People who come from other districts are also reported of getting the fever. Chogyal, a businessman said he had no idea when the dengue mosquito had bitten him.

“I was on tour for several days in Thimphu,” he said. “Symptoms started to show right after I came to Phuentsholing.”

Chogyal said his blood platelets had decreased to 91. Dengue fever reduces blood platelets below the required standard count of 150.

Kuensel learned that there are just two fogging machines to control mosquitoes by spraying. Owing to the severity of the situation, a rapid response team comprising of the health, sub-district, and thromde (municipal)  are now getting five more fogging machines from Samtse and Gelephu. The team is also working on the way forward.

Sub-district health officer Passang Tshering said they are going to conduct a mass cleaning campaign on August 24 to eradicate the mosquito breeding sources in the town.

“Most cases are being reported of those people living across the border,” he said.

The response team member Tenzin said that “the improper storage of water” has caused more mosquito breeding grounds in Phuentsholing. “People store water because of the shortage of water supply here,” he said.

Tenzin said that dengue is a viral disease spread by Aedes mosquitoes. The disease can manifest as simple febrile illness or severe hemorrhagic forms.

“Though it is the mosquito that is responsible for the transmission of dengue, our behavior, mainly improper management of waste is directly responsible for maintaining the mosquito population, thereby increasing the risk of it spreading,” he said.

The number of positive dengue fever cases could be higher than the hospital record considering hundreds of people who visited the private clinics for blood tests. Most visit private clinics because of the rush with increased number of patients at the hospital.

Three main private diagnostic centres in the town recorded about 579 blood samples collected for dengue fever. Out of this, about 267 cases were reported positive as of yesterday. Phuentsholing diagnostic centre alone tested 100 positive cases from 250 blood samples. However, these include both Bhutanese and those from across the border. Some people who are tested positive also do not report to the hospital, which otherwise would mean more were affected.

Dr Lethro of Phuentsholing general hospital also said the numbers of positive cases could be higher than the current records maintained.

“Sometimes the rapid kit test does not give 100 percent accuracy on dengue results,” he said, adding that it was rare incidences though.

In some cases, although the result showed “negative” the clinical picture of the fever was similar to dengue’s.

Prevention, better than cure Dr Lethro said dengue fever prevention strategies have two components, which people should be mindful of.

“First is personal protection such as wearing light colored long sleeve clothes, applying mosquito repellants, using nets and coils,” he said.

The second one, he said was to prevent mosquito breeding through proper disposal of tyres, pet bottles, coconut shells, buckets, and other containers that can collect rainwater and allow mosquito to breed.

The panic among the pub- lic has also increased, which actually, has helped people to be more cautious.

In the town, the Namsay Pharmaceuticals medical shop owner said that the shop ran out of Odomos, a mosquito repellent,.

“We are the Odomos distributor but we have found the company has no Odomos at present,” he said. “Yesterday, we called company to ask if they can manage. They said there is no production in the company.”

The proprietor said that they recently sent about five tubes of Odomos to Bangladesh, where dengue fever outbreak is severe. Namsay’s stock of Odomos exhausted on August 18.

Across the border, a medical shop owner said that Odomos production has stopped about a month ago. However, few shops across the border have Odomos, Kuensel found yesterday.

The first dengue fever was reported in the first week of July in Phuentsholing hospital. The number had increased to about 100 cases by July 19. In total, 468 dengue fever tested positive in July alone. More than 771 cases have been confirmed this month until now.

Phuentsholing has consistently seen dengue fever cases in the last five years. In 2016, the hospital recorded 857 positive cases but no casualties were reported. It was the year Phuentsholing received the heaviest rainfall. This year it has rained more with more intervals. The temperature also has soared this year.

The situation is similar across the border in Jaigaon, India.