By- Amritanshu Raj
With the close of every South West monsoon in September, the dengue menace has become a deadly season that the Indian subcontinent has to brace for.
As monsoon rains taper off, leaving behind stagnant water in urban and rural landscapes, mosquito populations surge, bringing with them a renewed threat of dengue outbreaks. South Asia, particularly countries like India, Nepal, and Bangladesh, continues to struggle with containing this fast-spreading viral disease, which infects tens of thousands annually and claims hundreds of lives.
Despite efforts to curb the spread, the region is still grappling with the untamable nature of dengue.
Monsoon’s Aftermath: A Breeding Ground for Disease
With the monsoon rains come floods, landslides, and destruction—but perhaps even more concerning is the uptick in water- and vector-borne diseases that follow.
In Nepal, officials from the Ministry of Health and Population are bracing for tough days ahead, as the season’s end heralds the beginning of another dengue outbreak. The contaminated water and flooded environments serve as prime breeding grounds for mosquitoes, intensifying the risk of viral infections such as dengue, chikungunya, and Zika.
Dr. Yadu Chandra Ghimire, Director at the Epidemiology and Disease Control Division of Nepal, paints a grim picture of the country’s health situation.
“Over 2,000 people from 73 districts have already tested positive for the dengue virus, and several districts have witnessed outbreaks of waterborne diseases, including cholera,” he noted, stressing that the country is preparing for a significant surge in dengue cases as the post-monsoon period begins.
Kathmandu, Jhapa, and Chitwan are among the hardest-hit regions, with Kathmandu reporting 249 cases. While the infection rates have not surpassed those of previous years, the country is on high alert as monsoon-related infections spread rapidly.
South Asia’s Growing Dengue Crisis: India and Bangladesh on High Alert
Nepal is not alone in its struggle against dengue. Across the border in India, the dengue season has taken on alarming proportions. India has seen a dramatic increase in dengue cases, especially in states like Uttar Pradesh, Maharashtra, and Kerala. In 2023 alone, India reported over 110,473 dengue cases, with more than 300 deaths attributed to the disease. The pattern is repetitive: the end of monsoon brings a sharp rise in mosquito populations, leading to widespread outbreaks.
Bangladesh, too, has been hit hard. Last year, the country experienced one of its worst dengue outbreaks in history. In 2023, the number of reported dengue cases exceeded 190,000, and the death toll crossed 1,000—a staggering number for a country of its size. Health experts blame a combination of urbanization, stagnant water, and poor waste management for creating ideal conditions for mosquito breeding.
Bangladesh’s health officials sounded the alarm early, but the rapid spread of dengue overwhelmed hospitals. Urban centers like Dhaka were especially hard hit, with hospitals overrun with patients suffering from the disease’s severe symptoms, including hemorrhagic fever and organ failure. This marked a grim escalation of a trend seen throughout South Asia—dengue’s transformation from a seasonal nuisance to a lethal epidemic.
The Dengue Cycle: Why the Disease Remains Untamable
One of the main reasons dengue remains untamable is the resilience of the Aedes aegypti and Aedes albopictus mosquitoes, the primary vectors responsible for spreading the virus. These mosquitoes thrive in tropical and subtropical regions, breeding in stagnant water left behind after heavy rains. Even a small puddle or discarded container can become a breeding ground, making it difficult to eliminate mosquito populations entirely.
Moreover, the rapid urbanization and population growth in South Asia exacerbate the problem. Cities like Delhi, Mumbai, Dhaka, and Kathmandu struggle with poor waste management, inadequate drainage systems, and overcrowding—factors that create ideal conditions for mosquito proliferation.
Public health experts warn that the scale of urbanization in the region, combined with a lack of infrastructure to manage waste and stagnant water, has turned cities into hotbeds for dengue transmission.
A further challenge is the asymptomatic nature of most dengue infections. According to health officials, around 80% of those infected with dengue do not show symptoms, allowing the virus to spread unnoticed. This means that reported cases likely represent only a fraction of the actual number of infections, making it difficult for authorities to gauge the true scope of outbreaks.
A Regional Perspective: Death Toll Rising Across South Asia
The death toll from dengue across South Asia paints a troubling picture. In 2023, India reported over 330 dengue-related deaths, while Bangladesh faced an unprecedented 1,096 fatalities due to the virus. Nepal, though smaller in population, also grapples with a high number of cases. Since the start of the 2024 monsoon, over 2,000 people have tested positive for dengue, though officials hope to keep the death toll under control.
The escalating crisis is not limited to these countries. Sri Lanka, Pakistan, and Thailand have also reported sharp increases in dengue cases, with health officials expressing concern that the region is facing a dengue epidemic.
In Sri Lanka, more than 70,000 cases were reported last year, with 48 deaths. Experts believe that climate change, which leads to erratic weather patterns, is making dengue seasons longer and more intense, contributing to the worsening situation.
The Human Toll: Overwhelmed Health Systems
The human toll of dengue in South Asia is immense, not only in terms of lives lost but also in the strain on health systems. Hospitals and clinics across the region are frequently overwhelmed during peak dengue seasons, struggling to accommodate the influx of patients.
In Nepal, for example, health facilities have been grappling with a surge in not only dengue cases but also other waterborne diseases such as cholera, dysentery, and diarrhoea.
Health experts in India have also warned that the country’s healthcare system is ill-equipped to handle the scale of dengue outbreaks, especially in rural areas where medical infrastructure is limited. In many cases, patients are forced to travel long distances to reach hospitals with adequate treatment facilities, leading to delays in care and higher mortality rates.
In Bangladesh, last year’s outbreak pushed hospitals to the brink, with healthcare workers battling not only a shortage of beds and medical supplies but also a significant rise in severe dengue cases. The spread of dengue haemorrhagic fever—a more severe form of the disease—contributed to the high death toll, particularly among children and the elderly.
Fighting Dengue: What South Asia Needs to Do
Efforts to combat dengue have been widespread, but the disease continues to outpace prevention strategies. Public health experts emphasize that a multi-faceted approach is required to control dengue in South Asia.
This includes widespread public awareness campaigns about how to eliminate breeding sites, regular community cleanup efforts, and improved sanitation and waste management practices.
Nepal, for example, has urged provincial and local health authorities not to grant leave to health workers during the monsoon season, stepping up vigilance and encouraging the stockpiling of essential medicines.
Health officials have also been raising awareness through all available means to inform people of the risks and encourage precautionary measures.
In India, large-scale fumigation campaigns and mosquito control efforts are common, but these methods alone are not enough to curb the disease’s spread. Experts argue that more sustainable urban planning, along with better waste management and water drainage systems, is essential to tackle the root causes of dengue outbreaks.
The introduction of vaccines, such as Dengvaxia, has also provided a glimmer of hope, but challenges remain in distributing the vaccine widely, particularly in rural areas. Moreover, concerns about vaccine safety have limited its use in some regions.
The fight against dengue in South Asia is far from over. As the monsoon rains continue to fuel mosquito populations, countries like India, Nepal, and Bangladesh must brace themselves for the recurring threat.
The rising death tolls and overwhelmed health systems underscore the urgent need for better infrastructure, public health strategies, and long-term solutions to control this deadly disease. Without a concerted effort to address the root causes of dengue’s spread, South Asia will continue to grapple with one of its most persistent and deadly health crises.
