Communicable and Non-communicable diseases – HIV, Malaria, Cancer, Mental Health, etc.

[op-ed snap] Taking a holistic approach to dengue


From UPSC perspective, the following things are important :

Prelims level : Dengue vaccine

Mains level : Paper 2-Dealing with Dengue, stategies, suggestion, and holistic approach.


The advent of a new tetravalent vaccine against the dengue virus has thrown new light into the evidence-based management of dengue.

Why the holistic approach is needed

  • Apart from promoting the use of the vaccine, gaining control over dengue will also require a holistic approach that has to include within its ambit vector control and proper case management.
  • Tetravalent vaccine: The vaccine is tetravalent i.e. it provides protection against all the four types of dengue viruses.
    • The vaccine confers about 80% protection to children vaccinated between 4 and 16 years of age without any major side effects.
  • Climatic factors: It is essentially a tropical disease that occurs in the countries around the Equator; hot weather and intermittent rainfall favour the sustenance of Aedes aegypti.
    • Aedes eggs can remain dormant for more than a year and will hatch once they come in contact with water.
  • Risk factors: Urbanisation, poor town planning, and improper sanitation are the major risk factors for the multiplication of such mosquitoes.
    • Aedes eggs can remain dormant for more than a year and will hatch once they come in contact with water.
    • Aedes mosquitoes cannot fly beyond a hundred meters. Hence, keeping the ambiance clean can help prevent their breeding.
    • Further, these mosquitoes bite during the daytime, so keeping the windows shut in the day hours is also useful.

What needs to be done?

  • Source reduction activities: Activities like preventing water stagnation and using chemical larvicides and adulticides.
    • These chemicals need to be applied in periodic cycles to kill the larvae that remain even after the first spray.
  • Dealing with the manpower shortage: The number of skilled workers available for such measures is low; many posts in government departments remain vacant despite there being a dire public health need.
    • Due to this deficiency of manpower, active surveillance is not being done in India, says the National Vector Borne Disease Control Program.
  • Ending the Under-reporting: Dengue cases are often under-reported due to political reasons and also to avoid spreading panic among the common people. Under-reporting needs to be dealt with.
  • Increasing coordination: There is a lack of coordination between the local bodies and health departments in the delivery of public health measures.
    • A comprehensive mechanism is required to address these issues.
  • Need for epidemiological measures: Any communicable disease needs the epidemiological approach. Singapore uses one successful model of mapping and analysing data on dengue, using Geographical Information System (GIS).
    • The use of GIS involves mapping the streets with dengue cases for vector densities.
  • Emphasis on the WHO guidelines: Fluid management in the body is the cornerstone in the management of severe diseases like dengue hemorrhagic fever and dengue shock syndrome.
    • According to the guidelines, coagulation abnormalities are not due to a reduction in the number of platelets alone.
    • This is why the WHO recommends fresh whole blood or packed cell transfusion in the event of bleeding.
  • Caution in using alternative medicine drugs: Modern medicine is not against any complementary medicine; when such a medicine is approved after rigorous testing.
    • However, in the absence of evidence, the efficacy of such medicines remains in the realm of belief instead of science.
    • So, medicines like Nilavembu kudineer and papaya leaf extract are only belief based.


The communicable nature of Dengue and its asymptomatic nature requires the holistic approach to successfully tackle the disease.


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