Dengue or not

Imkong Walling

The COVID-19 pandemic exposed what was apparent to all— derelict government medical infrastructure and deficient resources ignored for decades in Nagaland. The biggest health challenge faced by the state government to date, it was literally a trial by fire for the state medical setup, which managed to see through the storm, while in the process, affecting a semblance of earnestness in the government. 

It seemed like the worst has passed but another virus is shaping out be an emerging health concern. Fairly small in magnitude than the COVID-19 threat, the impact of the mosquito-borne dengue, this time, is becoming too obvious to be merely written off as a seasonal health scare that arrives and goes with the monsoon rains. 

Apparently not as fatal, it is still putting a strain on the medical infrastructure, especially in Dimapur, which has consistently reported the highest number of cases and also handled the most number of cases, since the first dengue case was officially recorded in Nagaland in 2009.  

Over the years, there have been reports of dengue deaths but which have not been officially established. Only one fatality is on official record, till date, which occurred in 2015.

2018 was the year when the state officially recorded  the highest number of cases at 369, to drop to single digit figures the following two years and resurging in 2021 (24 cases) and 2022 (154 cases). The count for the year 2023, as on September 1, per the state chapter of the National Vector Borne Diseases Control (NCVBDC), stood at 227 cases confirmed by the ELISA test. 

Officially, the situation does not seem to be alarming relative to other places in the country. But the situation on the ground is depicting a different picture that not only seems to contradict the NCVBDC data but also baffling. There is no absolute data, yet all the private medical establishments have been reporting unprecedented spike in admissions of patients with dengue-like symptoms over the past month. It includes all the five big private hospitals, including CIHSR, and other smaller hospitals, besides nursing homes with in-patient care. 

Physicians in private hospitals, which are handling the majority of cases, have noted increased severity and requirement for platelets transfusion unlike previous years, further putting unparalleled strain on the only government-run blood bank with blood component separator equipment.  

The inferred incongruity has had physicians in private medical establishments at odds with the standard ELISA confirmatory test procedure prescribed by the ICMR. There are cases when patients displaying dengue symptoms test positive in the Rapid Diagnostic Test, go on to test negative in the confirmatory test. 

While false positives and instances of patients and their attendants opting not to go for the confirmatory test can be assumed as a cause for the inferred clash between official data and high case admissions, the present dengue situation has brought to fore a long held disconnect between the Health Department and the private health establishments. 

It is believed there is ample room for healthier communication and coordination between the two entities, over and above paper directives, paving the way for a coordinated response mechanism that includes the community.

The writer is a Principal Correspondent at The Morung Express. Comments can be sent to