Bringing Dengue Fever Out of the Closet

Dengue fever is transmitted by mosquitos (albeit a different species of mosquito than transmits malaria) and thrives in areas that are also home to malaria. It is not as fatal as malaria, but it can be debilitating, and it can be controlled--if it is out in the open where people can talk about it and do something about it. A story in today's New York Times suggests that India is a major problem in this respect.

India has become the focal point for a mosquito-borne plague that is sweeping the globe. Reported in just a handful of countries in the 1950s, dengue (pronounced DEN-gay) is now endemic in half the world’s nations. 

“The global dengue problem is far worse than most people know, and it keeps getting worse,” said Dr. Raman Velayudhan, the World Health Organization’s lead dengue coordinator.

A senior Indian government health official, who agreed to speak about the matter only on the condition of anonymity, acknowledged that official figures represent a mere sliver of dengue’s actual toll.

The problem with that policy, said Dr. Manish Kakkar, a specialist at the Public Health Foundation of India, is that India’s “massive underreporting of cases” has contributed to the disease’s spread. Experts from around the world said that India’s failure to construct an adequate dengue surveillance system has impeded awareness of the illness’s vast reach, discouraged efforts to clean up the sources of the disease and slowed the search for a vaccine.

This affects everyone in the world because there a huge volume of international travel, including for business and tourism.

“I would say that anybody over the age of 20 in India has been infected with dengue,” said Dr. Timothy Endy, chief of infectious disease at Upstate Medical University in Syracuse.

For those who arrive in India as adults, “you have a reasonable expectation of getting dengue after a few months,” said Dr. Joseph M. Vinetz, a professor at the University of California at San Diego. “If you stay for a longer period, it’s a certainty.”