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Dengue is raging in Pakistan and elsewhere in the world. We look at various aspects of this epidemic in these posts. It appears that in 2021, Pakistan is seeing a significant increase as compared to 2020.

A French report by F. Rodhain published in 1996 and cited in [The situation of dengue in the world] – PubMed ( summarized the dengue situation as follows. Do remember it was 25 years ago.

[Quote] The situation of dengue in the world can be summarized as follows: 2.5 billion persons at risk, 60 millions cases per year, and 30 000 deaths per year. The four dengue serotypes, DEN-1, DEN-2, DEN-3 and DEN-4 are nearly human-specific. Clinical symptoms of dengue vary from unapparent infection, mild febrile manifestations to hemorrhagic forms with or without shock syndrome. Dengue viruses are transmitted by Aedes mosquitoes, the most important vectors being Aedes aegypti and Aedes albopictus. The epidemiology of the disease can be divided into endemo-epidemic situations occurring in South-East Asia, and epidemic situations found in Pacific islands, Africa and Tropical America. Maintenance of dengue is supported by an increasing demography, uncontrolled urbanization and climatic conditions favorable to the vectors. Spread of dengue is primarily caused by modern transportation means, especially the aircraft. The geographical distribution of dengue is pantropical, except for Madagascar and some african regions. Because no vaccine and no specific treatment actually exist against dengue viruses, mosquito control is the only way to reduce the incidence of dengue around the world. However, the evolution of the dengue situation is not satisfactory. [Unquote]

I may remind again that these concerns were raised 25 years ago. The situation now may be seen in the following paragraphs.

Situation Update – ECDC

European Center for Disease Prevention and Control report as on 29th October 2021 shows 1,316,518 cases. Majority of these were reported from Brazil (845,720), India (60,112), Vietnam (53,489), Peru (37,728) and Philippines (32,555). Since the publication of last report, 133, 797 cases were added: India (46,068), Brazil (31,839), Pakistan (22,603), Colombia (5,710), and Vietnam (5,233). Underreporting is integral to system in all these countries.

It may be noted with interest that only one locally acquired case has been reported in 2021 so far in continental Europe. However, it is feared that environmental conditions are favorable at present for the growth of mosquito populations and virus replication.

In Pakistan, over 22,000 cases were added in two months from August to October 2021. Dengue is already endemic to Pakistan, but this increase is of epidemic proportions. Cases are being reported mainly from Lahore, Rawalpindi, and Islamabad. It may be so that the other cities are not reporting yet.

Situation Update – World Health Organization

Update of November 04, 2021 is summarized below.

Cambodia – 1,257 cases reported. Number of cases reported is lower than the last five years trends. Shows reasonably good control.

China – only 4 cases in September. The trend is below usual seasonal trend of previous years.

Malaysia – 21,308 cases reported. A very significant decrease of 74% compared to same period last year. During 2021 only 16 deaths have been reported as compared to 133 deaths in corresponding period in 2020. This is commendable achievement.

Singapore – 4,720 cases reported, which are within expected seasonal levels.

Vietnam – 57,499 cases and 21 deaths have been reported in 2021 so far. During the same period in 2020, 88,444 cases were reported. It shows that Vietnam is also doing well in control, with a 42% decrease.

Situation Update – Pakistan

Statistics are somewhat unclear even when taken from multiple sources. It is understood that the number of cases this year is around 16,000 and it is rising. 34 deaths have been reported. Both stats are probably underreported. Majority of cases have been reported from Punjab, followed by KPK.

Pakistan saw a major epidemic of dengue in 2019 with 53,498 reported cases and 95 deaths. Cases dropped sharply in 2020 when only 6,016 were reported with No Deaths. 2021 is seeing a sharp surge so far.

To be Continued……

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