Deadlier than ever

With the city hospitals struggling to accommodate a growing number of dengue patients, deaths from the viral fever are increasing at a higher rate compared to the previous years.

Experts and doctors have attributed this year's rising death rate to late hospitalisation and second-time infection of the mosquito-borne virus.

Hospital sources say almost two-thirds of the total dengue patients this year are male. However, among the dead, the number of females is higher than the males.

In the last 24 hours till yesterday morning, only one dengue patient died in Dhaka while at least 896 were hospitalised. With this, a total of 156 people died this year. Of them, 89 are female and 67 male, according to the Directorate General of Health Services.

On the other hand, of the total 28,443 dengue patients this year, 18,056 are men and 10,387 women.

In 2019, the country saw the highest number of dengue cases -- 101,354, with a death rate of 0.17 percent. The death rate is highest this year -- 0.54 percent.

"When number of patients increases, deaths also increase. Second-time dengue infection with two different dengue variants is one of the reasons for the increasing number of deaths this year," said Tahmina Shirin, director at Institute of Epidemiology, Disease Control and Research.

According to experts, the dengue virus has four variants: Den 1-4, also known as serotypes 1-4. All the four variants have been found in Bangladesh at different times. This year Den 1 and 3 are active in Bangladesh.

Mortality risks become higher if a previously infected dengue patient is attacked a second time by a different variant. However, early detection and immediate hospitalisation can help lower death risks significantly, Shirin said.

HM Nazmul Ahsan, associate professor at Shaheed Suhrawardy Medical College Hospital, said delayed admission to the hospital is the main cause for higher dengue deaths this year.

Many patients are rushing to city hospitals in a critical condition after being treated in local hospitals outside the capital, as they did not get the necessary treatment there.

The chances of death are high for this kind of patients, said Nazmul.

Many private hospitals do not follow the national guidelines which are made mandatory to treat dengue patients, Nazmul added.

Proper management is very important to treat the critical dengue patients. If the patient is hospitalised immediately when they show early signs of the viral fever, the patients do not deteriorate into a critical stage, he said.

"People should get admitted to the hospital as soon as they show signs like severe stomachache, difficulty breathing, severe weakness, bleeding from gums or nose, vomiting, or blood in stools, urine or vomit," he added.

About the higher rate of female deaths, Nazmul said many female patients who have comorbidity are susceptible to dengue infection.

There are some female patients who are pregnant. They are usually from special groups who need special attention. Then there are women whose condition may become critical if they are infected with dengue during the time of their menstruation, Nazmul pointed out.

Another reason may be attributed to the patriarchal social norm -- women's health conditions are often neglected and, in many cases, they are taken to the hospital late, he explained.

About handling the pressure of dengue patients at the Suhrawardy hospital, Nazmul said they have around 450 medicine beds, of which they have kept four wards dedicated for the dengue patients. They are also treating dengue patients at the general wards due to the huge number of patients.

He said they have prepared a guideline with three categories: A, B and C. The patients who are infected with dengue but stable and have no complications belong to group A. They send them back home and the rest belonging to the other two categories are admitted to the hospital, Nazmul said.