LAHORE The countrys biggest province, Punjab, has been hit hard by the menace of dengue fever as compared to any other federating unit, affecting around 2,000 people and more than 90 per cent of them are from the provincial metropolis. The dengue fever has so far claimed seven lives in Lahore alone. Sindh is the second most affected province. However, the situation in Khyber Pakhtunkhwa and Balochistan is under control. Dengue cases have also been reported in twin cities of Islamabad and Rawalpindi. With the dengue not sparing the rich and the poor, the provincial health administration is visibly failing not only in treating the affected, but also no plan seems to be on ground for eliminating the mosquito. Due to ever increasing inflow of patients in the public sector hospitals, the dengue afflicted are being denied admission on one pretext or the other. The provincial dispensation, instead of taking concrete steps to eradicate the menace, continued to mislead the masses by giving wrong figures regarding the number of dengue patients. According to private hospitals and medical practitioners, the dengue fever has reached epidemic proportions and affected persons are far greater in numbers than the official figures. Meanwhile, at last alarm bells have rung at the highest level since Punjab Chief Minister Shahbaz Sharif has chaired yet another meeting of his team to fight the menace of dengue fever. Refusal of admission in public sector hospitals on the plea that treatment was possible at home, people left with no option except to see the dear one in pain or to take him/her to private clinic for better care. Though medication for dengue fever is only Paracetamol, majority could not afford high expenses of room rent at clinics, fee of visiting doctors and nursing care. Moreover, transfusion of platelets at private clinics is beyond the reach of common man. One mega unit of platelets, provided free at the public sector hospitals, costs Rs 15,000 to Rs 20,000 at private clinics. Transfusion of more than one unit further increases the expenses of a private patient. Treatment of a dengue patient at a private hospital costs from Rs 50,000 to Rs 1 million depending upon the number of platelets kits. Yes, we send patients home after prescribing paracetamol at the outpatients departments. The reason is the hospital is packed and no bed is available for new patient. At this stage, 2-3 patients are using one bed. People can look after dengue patients at home better than at the hospital, said a doctor at OPD of Services Hospital on the condition of anonymity. We are giving admission to only those whose platelets are less than 20,000. Such patients require transfusion of white cells and this facility is being provided at the hospital, he stated. The provincial metropolis is leading in dengue fever cases, leaving far behind other cities in the province as far as the numbers of affected persons are concerned. Though Lahore is having far better healthcare infrastructure than any other area in the province and a specialised wing and trained manpower to carryout fumigation and insecticide spray, it is not reflecting in statistics as around 90 per cent of the total dengue fever in the province are so far reported from the metropolis alone. The menace has even reached epidemic proportions in the City due to ineffective insecticide spray and fumigation and influx of patients from other parts of the province in search of better treatment. Giving reasons behind far more cases in Lahore than other cities, the experts say that movement of patients toward the metropolis for treatment has put the Lahorites at greater risk than the citizens in other areas. Mosquitoes get virus after biting affected persons and then transmit to other persons through bite. Presence of more affected persons in Lahore has put the Lahorites at a greater risk of getting dengue. The prevailing situation needs extra care and precautionary measures to save from the menace, the experts stated. Instead of taking concrete measures, the government functionaries continued to issue advisory regarding precautionary measures to avoid dengue fever and its symptoms. Dengue fever is caused by a mosquito which grows in clean water. Avoiding accumulation of water and proper insecticide spray in houses is important in getting rid of the menace. High fever, shivering, pain in back, eyes and bones are symptoms of dengue fever, also known as broken bone fever. Delay in treatment could cause rapid decrease in white blood cells that further weakens immunity of a patient. In case the white blood cells decreases considerably, bleeding can start from gums, eyes and other parts of the body, making treatment of dengue patients more difficult. Meanwhile, Punjab Chief Minister Shahbaz Sharif has directed that steps should be taken on war-footing for coping with the challenge of dengue virus and departments concerned should evolve a coordinated strategy for this purpose. Chairing a meeting to review the steps taken for eradication of dengue virus, he said every life was dearer to him and all available resources should be utilized for eradication of dengue virus and no negligence would be tolerated. Provincial Minister for Education Mian Mujtaba Shuja-ur-Rehman, Senator Pervaiz Rashid, Members Assembly Hamza Shahbaz Sharif, Afzal Khokhar, Dr Saeed Elahi, Dr Tahir Ali Javed, Secretaries of Health, Local Government, Information, Director General Health Services, District Coordination Officer Lahore and senior doctors attended the meeting. Shahbaz Sharif said he would personally visit affected areas daily and would hold meetings to review the steps taken for eradication of virus in these areas in which elected representatives, civil society, local people and officers of departments concerned would also participate. He also directed further improvement in the process of purchasing medicines for eradication of dengue virus. He said a comprehensive action plan should be evolved for protecting people from dengue virus and all resources should be utilised for this purpose and spray should be carried out in houses as well as streets. He said committees headed by elected representatives should be constituted at mohallah level and members of the civil society and local people should also be included. He said an effective awareness campaign with regard to adopting preventive measures for protecting people from this virus should be launched and besides special discussion and seminars, corner meetings should also be held at mohallah level. He said all elected representatives should supervise the ongoing campaign for eradication of dengue virus in their respective areas and submit daily report regarding steps taken for elimination of dengue virus. He said that planning should be made before hand for eradication of dengue virus in future and a comprehensive strategy should also be adopted in consultation with the experts. He directed to immediately provide the cell separator machines to Mayo Hospital and provincial ministers and elected representatives should visit the hospitals regularly and personally review the treatment facilities being provided to the dengue fever patients. He also directed to further improve the process of purchasing quality medicines for eradication of dengue virus. Earlier, Secretary Health Jehanzeb Khan gave a detailed briefing regarding the prevailing situation and the steps taken for eradicating the menace. DCO Lahore Ahad Cheema informed the meeting that spray campaign was going on for eradication of mosquitoes and the third phase would also be completed by September 13. He said the city district government was distributing pamphlets from door to door for raising public awareness about precautionary measures to get saved from dengue fever. Syed Jafar Askari adds from KARACHI: As many as 173 Dengue suspects were brought to various hospitals in Sindh during the current year including 154 from the provincial metropolis. The Provincial Dengue Surveillance Cell of Sindh Health Department reveals that 144 were hospitalised while 29 were treated at OPDs. As per a report, out of 154 suspects reported in the port city, 125 were hospitalized while 29 were sent home after giving necessary medicine at OPDs of various hospitals. Report says that 168 out of 173 suspects in the province were tested positive after laboratory analysis. Dengue largely hit Karachi as 149 out of 154 suspects have been tested positive for the deadly disease. Seven new cases have been reported this week while six are still under treatment at different hospitals in the city. As per WHO, Dengue fever is a severe, flu-like illness that affects infants, young children and adults, but seldom causes death. The clinical features of dengue fever vary according to the age of the patient. Infants and young children may have a fever with rash. Older children and adults may have either a mild fever or the classical incapacitating disease with abrupt onset and high fever, severe headache, pain behind the eyes, muscle and joint pains, and rash. On the other hand, health experts have warned the authorities concerned that dengue and malaria may be spread in the metropolis during the ongoing rainy season, as the city government has failed to carry out cleanliness activities properly in the city. The ongoing rains have created new breeding pools. As per health experts, the month of August is conducive for the spread of dengue fever in the city. Dr Rafique Khanani of Dow University of Health Sciences (DUHS), and Infection Control Society of Pakistan (ICSP) said that dengue starts in August and get force in September and October. He warned the citizens to take precautionary measures against the fatal illness. Dr Syed Aijaz Hussain Zaidi, a physician, has advised the citizens to protect themselves from mosquito bite. Said Alam Khan adds from PESHAWAR: No fresh Dengue case has been reported in Khyber Pakhtunkhwa while five suspects have already been discharged from different hospitals before Eid-ul-Fitr. Fearing that the dengue fever could affect areas adjacent to Punjab, provincial dispensation has asked health authorities in all 25 districts to take precautionary measures. Talking to TheNation, Focal Person Dr Ziaul Hasnain informed that at the moment, luckily, no fresh Dengue case has been reported across the province. And, those five Dengue fever suspect persons-one among them was from Battagram and two each from Haripur and Peshawar have been sent home. He, however, informed that one-month back, a Dengue affected person, who was actually belonging to Nowshera district, but working in Rawalpindi died at a hospital. Health authorities, he said, had intimated the EDOs health to take preventive measures to avoid dengue fever. This mosquitoes-borne disease spreads through the bite of an infected Aedes Aegypti mosquito that rests indoor, in closets and other dark places, he maintained. The EDOs had also been asked to raise public awareness about preventive measures including wearing full-sleeve clothes, use of repellents, mosquito coils and electric vapor mats to avoid mosquito bites, use of insecticide treated nets (ITNs) to protect young children, pregnant women, old people, use of insecticide treated curtains at windows or doorways, to repel or kill mosquitoes. Fogging, insecticidal and larvicidal sprays in the outskirts of the affected areas should be conducted. The official said that the KP had recorded 43 cases and seven deaths from Dengue fever in 2009 which meant that the virus was prevalent and could pose serious threats if timely measures werent taken immediately. Overall 58 deaths had been recorded of the total 2,098 confirmed cases in the country in 2009, officials concluded. Bari Baloch adds from QUETTA: No Dengue case has been reported in the provincial capital recently, officials said on Monday. Dr Tahir Khan Badini told this scribe that the atmosphere of Balochistan particularly that of Quetta was not favorable for Dengue-virus. However, he said that due to movement of people from Punjab and Sindh could affect people of Balochistan. Dengue patients immediately go to Lahore and Karachi for treatment because they are not satisfied with the facilities in Balochistan. Therefore cases of dengue virus are not being registered in Quetta or other parts of the province, he said. Monis Ali, a resident of Turbat said that recently his younger brother fell ill. His condition was serious. He said one of his elder brothers admitted him to Civil Hospital of Pasni where doctors could not diagnose the disease and adding that after three days he was admitted in the Civil Hospital of Gwadar where doctors were unable to treat him there too. He said that eventually his brother took him to Karachi where the doctors diagnosed his disease as dengue fever. Asma Ghani adds from ISLAMABAD: Unlike Lahore and other cities of the country, dengue fever cases are far less in number. Only few cases have so far been reported with no death. Though, the Capital Development Authority (CDA) has directed the Health Services Directorate to carryout fumigation, rural areas and suburbs of the Capital city have not been covered. According to National Institute of Health (NIH), 12 dengue fever cases have been reported in Islamabad. A meeting was held at Pakistan Institute of Medical Sciences (PIMS) on Monday to review treatment facilities for the dengue fever patients at the healthcare centre. Seven-member committee has been constituted for monitoring treatment and collection of data. The officials feared that people coming to the capital after spending Eid holidays in hometowns especially Lahore could bring dengue virus. The management of Federal Government Services Hospital and Polyclinic also informed that a special medical team has been constituted to deal with the situation and two rooms have been reserved for the dengue fever patients. Israr Ahmed adds from RAWALPINDI: As many as 15 dengue suspects have been reported at three government teaching hospitals in the City. According to District Officer Health and government focal person on Dengue Fever Dr Khalid Randhawa, 11 persons have been admitted to Holy Family Hospital, three to Benazir Bhutto Hospital (BBH) and one to the DHQ Hospital. According to the data provided by District Health Department (DHD) officials, one patient each was brought to HFH with dengue fever symptoms from Kohinoor Mill, Gharibabad, Dhoke Hassu, Kallar Syedan and Doltala on Chakwal Road. Earlier, doctors said five patients have already been admitted at the HFH Isolation Ward, three at DHQ and one at BBH. So far, 35 suspects have been admitted to three teaching hospitals while the authorities had received reports of 21 persons from NIH. The reports of all the suspected patients were negative. However, one patient who was brought from Nowshehra died on August 13 at HFH. Medical Superintendent (MS) HFH Dr Fayyaz said all dengue patients are being provided necessary medicines. DO Health Dr Khalid Randhawa claimed that DHD along with Town Municipal Administrations have launched a comprehensive fogging campaign at all the places where dengue cases were reported. Meanwhile, a seminar on Dengue Fever-preventive measures was organized by Pakistan Aman Party (PAP) in collaboration with Global Peace Foundation at Peshawar Road in which the speakers demanded the federal and provincial governments to activate civic bodies with regard to start spray on urgent basis to reduce the reproduction of deadly mosquitoes as the number of dengue patients were at rapid rise. They also laid emphasis on initiating urgent campaign on advocacy, social mobilization and legislation to ensure the safety of public health, public health bodies and communities should be made strengthen and their capacity be built up to the requirements to ensure an adequate response to the situation. Experts further said that dengue fever, also known as break-bone fever, was an infectious tropical disease caused by the dengue virus. Its symptoms include fever, headache (especially behind the eyes), vomiting, swollen lymph nodes, nausea, fatigue, muscle and joint pains and a characteristic skin rash that is similar to measles. In a small proportion of cases the disease develops into the life-threatening dengue hemorrhagic fever, resulting in bleeding, low levels of blood platelets and blood plasma leakage, or into dengue shock syndrome where dangerously low blood pressure occurs, they mentioned.