INSUBCONTINENT EXCLUSIVE:

Kathmandu, September 14 For Prabina Maharjan, it started with a headache, which then turned into fever and body pain. When she finally

turned up at the Sukraraj Tropical and Infectious Disease Hospital a week ago, tests showed something odd for this high-elevation city:

dengue fever, a scourge more associated with Nepallow-lying tropics. But as climate change brings hotter temperature, disease threats are

shifting & and this year Kathmandu, Nepal capital in the Himalayan foothills, is seeing an unprecedented surge of dengue patients. In just

the first week of September, more than 1,000 cases of the fever were diagnosed at the city Sukraraj Tropical and Infectious Disease

Hospital, a quarter of them contracted dengue in the Kathmandu area, said Anup Bastola, the hospital chief tropical medicine consultant. In

previous years, the hospital mainly witnesssed cases of the painful and occasionally fatal disease in people coming from Nepal southern low

lands, he said

&But this year we saw many cases from the Kathmandu Valley itself,& he added. In a city that has never faced such a large local outbreak,

fear of dengueis so rife that people are flooding to hospitals for testing, even ifthey turn out to have a simple headache or seasonal flu,

the doctor said. &The flow of patient is so high that the staff are busy testing blood samples upuntil late in the night,& Bastola

said. Those in the testing lines included 39-year-old Maharjan mother and son, who also turned out to have caught the mosquito-carried

illness, though weren&t hospitalised for a week as she was

&We were astonished to be infected by a disease that is generally considered a disease of the Tarai,& said Maharjan, referring to a southern

tropical region of Nepal. Like many, she is puzzled why the disease is now taking off in hilly Kathmandu, which lies at 1,400 metres (4,600

feet). &There were mosquitoes in the valley in past years too, but we never heard about the outbreak of this disease in such a large scale,&

Maharjan said. As climate change brings hotter conditions in many countries, health threats are rapidly changing, with many authorities

under prepared, international public health officials warn. According to data published by Nepal disease control division, more than 250

cases of locally contracted dengue were detected in the Kathmandu Valley between mid-July and early September, two of them fatal

Last year, the valley saw only six cases, according to the agency&sfigures. Meghnath Dhimal, chief research officer at the government Nepal

Health Research Council, said rising temperature associated with climate change are the major driver of the new threat. &In Nepal, the first

outbreak of this disease occurred in 2006, when only five districts were affected

But this year the disease was found in 56 out of 77 districts,& he said. Warmer conditions help spread the disease both by making it easier

for mosquitoes to reproduce, and by spurring the virus itself to replicate faster. &Migration of infected mosquitoes and human cases from

the tropicalparts (of Nepal) plays a role in seeding the disease in new areas,& he said. Because there is no vaccine or particular medicine

to treat dengue,reducing the number of mosquitoes is the main way to reduce its spread, Dhimal said. But Nepal government, confronted with a

fast-rising threat, so far has not put in place enough programs to do that, he said. &As the highlands were rarely previously affected by

dengue, people and government official are not well-prepared to prevent and control thedisease& he said. &In most cases, efforts to battle

the problem start only after it has gained ground,& he said. &The insects that are not eliminated this year will (lay eggs and) surge again

next year after it starts getting to a favourable temperature,& Dhimal said. Another obstacle in controlling the disease is simplythe lack

of awareness among many people about the emerging threat. For example, residents may protect themselves against mosquito bites atnight, but

the dengue-carrying mosquito bites during the day, something few people in Kathmandu know, he said. A study he led in 2012 found people in

lowland Nepal were five times more likely than people in highland areas to understand dengue risks. &If highland Nepal is to successfully

fight back against dengue awareness of people and control of the vector by effective governmentaction and community mobilisation can be the

only effective step,& Dhimal said. The post Kathmandu battles dengue threat as temperature rises appeared first on The Himalayan Times.