Dengue’s risk is rising at an alarming rate globally. As per the World Health Organisation (WHO), almost half of the world’s population is now at risk of dengue. Similarly, WHO estimates that 100 to 400 million people are infected with dengue every year.

In the context of Nepal, the Epidemiology and Disease Control Division (EDCD) under the Ministry of Health and Population reported that 51,243 dengue infections were confirmed in the country in 2023 – one the highest recorded number of dengue infections. According to the department’s statistics, 20 people died in Nepal last year alone as the infection spread to all 77 districts.

Cases of dengue continue to vary annually – for example, in 2022, Nepal had recorded 54,784 infections – the highest ever recorded in Nepal. 62 deaths were attributed to dengue in 2022. Similarly in 2020 and 2021, Nepal recorded 530 and 540 cases respectively. In 2019, one of the first major spikes was reported when Nepal recorded 17,992 cases. According to the EDCD, dengue first entered Nepal in 2004 when the infection was confirmed in one person. By 2023, 133,541 people had been confirmed with dengue. According to the division’s statistics, there is no record of confirmed dengue in 2005. As per a report published in the Journal of Travel Medicine, “the scale of the outbreak in Nepal was unprecedented; however it was not unforeseen”. According to the report, “climate change, urbanization and increasing transportation networks with other endemic regions have created increasingly favourable conditions for the mosquito vectors of dengue, Aedes aegypti and Aedes albopictus, and for the transmission of the disease in Nepal”.

This year, as of 14^th July, 2024, 1,544 cases of dengue infection have been confirmed. The infection has been confirmed in 73 districts of Nepal, however, no fatality has been recorded owing to dengue in 2024 yet. The highest number of infections confirmed in 2024 is in Bagmati Province with 390 cases, and the lowest in Karnali Province with 16 cases. The data might suggest a low incidence of dengue infections in Nepal in 2024, however, if the past is any indicator, it is not a telling sign that the infection can be treated lightly, and instead calls for further vigilance and preparedness. Health experts and authorities too have been warning of a potential rise in incidence of dengue as the monsoon rain batters the nation.

“In the last few days, it is difficult to provide the exact data as the provinces and other municipalities have not sent their reports yet,” Director of EDCD Dr. Yadu Chandra Ghimire told Aaawaaj News. He said that the situation will not be as severe as last year due to the recent increase in public awareness, and the department playing its role.

“We are coordinating with all the local levels and provincial governments as well. They are also doing their work. It is not possible to say that the infection will not spread or that there is no problem, but it is within our control at the moment” he said.

He added, “1,400 patients in 73 districts are not something to panic about. In addition, we are well-prepared. But everyone should remain cautious in their respective places.”

Similarly, the Epidemiology and Disease Control Division informed that they have allocated around 80 million to all local levels in view of the risk situation. Along with this, Ghimire has also sent two lakh rupees to each municipality for dengue disease control. He also mentioned that some local levels, including the Kathmandu Metropolitan City, have started dengue prevention and control research, larvae destruction, and awareness activities.

Ghimire said that he has sent all the concerned personnel for the implementation of the dengue control and prevention action plan. He expects that the provincial government and local governments will be able to work efficiently for the control and management of dengue infection.

However, health experts say that the government has not done as much as it should have.

Sher Bahadur Pun, an infectious disease specialist at Shukraraj Tropical and Communicable Disease Hospital, said that “the tendency to start programs only after dengue has appeared or spread continues”. According to him, this approach will likely cause problems in the future, and suggests the government be proactive towards such issues.

Pun also mentions that despite the government developing an action plan for the control of diseases like dengue, its effective implementation remains a problem. He said that to control dengue, the active participation of the state and the general public is necessary. Pun emphasized the need to work in coordination with all three levels of government: federal, provincial, and local.

He suggests being alert to symptoms such as sudden headache, high fever, muscle pain, back and joint pain, body aches, nausea, pain in the eyeballs and back of the eyes, and bleeding from the nose and gums. He also suggested keeping the area around the house clean to avoid dengue.