2020 May 22
11th of March, 2020 – Sri Lanka detected its first local case of COVID-19, a tour guide returning from Italy. Since then, vigorous actions have been taken by government officials, the Tri forces and medical officers to minimise the spread of the virus. It is notable that Sri Lanka has reported no community cases of infection to date. All confirmed cases in the island have been of nationals returning from overseas and front line navy personnel, which shows the effectiveness of the strategies put in place by local authorities to curb the spread of the virus.
The fight against COVID-19 however, will be a continuous one. To date, there has been no evidence established on the transmission of the disease through asymptomatic patients. However, caution is advised as individuals may show mild symptoms and can be unaware of the infection. Cases as such may unknowingly continue with their everyday activities, increasing the potential spread of COVID-19 in the country.
Sri Lanka’s ill-reputed tropical threat – Dengue
With a global estimate of approximately 390 million annual cases, the infamous dengue virus threatens the quick flattening of the COVID-19 curve, especially in developing countries like Sri Lanka. Moving into the fifth month of the year 2020, the western and southern parts of the island begin to experience the annual May-June monsoon rains. With this, the healthcare system of Sri Lanka has confirmed its annual spike in the number of cases of dengue.
As of January 2020, there have been 19,474 suspected cases of dengue, in contrast to 1,055 active cases of COVID-19 in which 442 cases are currently active. Experts say that the lockdown and the minimal use of public transport may have had a role to play in the slow growth rate of cases reported for Dengue where a total of 485 cases were reported in the month of May 2020 in comparison to 4260 in the previous year.
COVID-19 vs. Dengue
The primary step in the treatment of any disease is its identification. With the Dengue and COVID-19 virus having clinical and laboratory similarities, distinguishing one from the other has not been easy.
Furthermore, both these deadly diseases show similar symptoms of fever and acute flu-like illness in their initial stages. However, in contrast to COVID-19, the dengue virus cannot spread by direct and indirect contact. The only means of transmission is by the bite of a female mosquito that has already fed on an infected individual. Moreover, in spite of the development of novel rapid test kits for COVID-19, diagnosing a potential case of dengue still requires advanced virological or serological tests in a fully equipped laboratory.
Knowing the enemy
A key part in preventing the spread of the dengue virus is understanding the disease’s vector organism. Belonging to the Aedes mosquito species, these carriers have definitive white markings on their black bodies and are active only during the day.
Humorously named in the medical world as the “posh” mosquito, these species are known to breed in small collections of water (as little as 5ml) in shiny receptacles, and not in large murky water reservoirs. Moreover, these mosquitoes have been studied to have a relatively small flight radius. This has been proven with research conducted into past cases, where more often than not, breeding grounds of these mosquitoes have been discovered in the patient’s own house, and not in surrounding areas. Therefore, health officials request the public to dispose of any such potential vessels within the perimeter of their respective property, prior to complaining to their local municipal councils on the collection of stagnant water in nearby drains and other parts of the neighbourhood.
What needs to be done
Signs of dengue are exhibited 4-6 days upon infection, whereas a COVID-19 infection may take up to 14 days for symptoms to show. Patient reports in Singapore have shown a cross-reaction between the two viruses, resulting in multiple false-positive cases for dengue. This complication, together with the high number of dengue cases and jam-packed hospitals as per previous years, poses a large strain on Sri Lanka’s limited medical resources.
Hence, for the containment of either of the two, the Health Promotion Bureau (HPB) of Sri Lanka urges the public not to diagnose themselves and take any signs of illness lightly. They are requested to seek immediate medical advice at the sign of any respiratory ailments or fever by dialling 1999, a 24 hour hotline made available in all English, Sinhala and Tamil. In addition to this, the HPB has made a comprehensive summary and conveys all you need to know about Dengue and COVID-19 on a daily basis via their Facebook page – HPB Sri Lanka. It has also been advised that in addition to the use of face masks, the general public are requested to wear long-sleeved clothing and avoid public transport as much as possible.
All the symptoms and preventive measures that need to be taken to protect oneself from dengue have been described in the video below. Prevention is better than cure, and the first step is always awareness. Stay informed, stay safe!