Fogging has limited (success) scope

Vector-borne diseases like dengue cannot be eradicated by just fogging operations of the municipalities, we will have to do our bit by following hygienic practices Archana Misra Rains bring life to even ‘dead’ roots, and food aplenty for every being living— be it human or animal! It is the season of plenty. But it also brings to life some dangerous viruses, bacteria as well as their carriers! Dengue, chikungunya, malaria being some such vector-borne diseases where the main carrier is the small ‘Dracula’—the mosquito. It thus becomes imperative to get rid of this pest and much of the strength & finances of the municipal bodies go in doing just that. Fogging is the main, and so far the most tried, method of killing ‘community mosquitoes’. By this we mean the mosquitoes in public places, markets, near garbage collection/disposal points, near water bodies as well as residential colonies. “The aim of the mosquito fogging operations is to kill, or ‘knock-down’, any adult mosquitoes that may be carrying a deadly virus. The mosquitoes become infected with the virus after biting and taking blood from someone who is sick with a disease caused by that virus (like malaria, chikungunya) and the effort is to try and prevent the infected mosquito from biting another (healthy) person and thus passing on the disease,” informs Dr PK Singh, Chief Medical Officer. “Fogging is done during the evening or early morning hours because most adult mosquitoes are active during that time. But, this is not very effective in controlling dengue cases. This viral disease is transmitted from one infected person to another healthy person by Aedes aegypti & Aedes albopuctus species of Aedes genus of mosquito. The female type of Aedes mosquito are fearless biters that bite chiefly during the day and stay confined indoors. They do not get inside the fogging range and hence are spared. But, the outdoor dengue vector that is hit by the pesticide droplet is killed,” he informs. “The data to suggest that fogging actually decreases number of mosquitoes is not very strong. Fumigation is not a preventive measure but only a containment measure. It is a high-risk formula with only psychological effects. It makes people feel safer. Fumigation is not foolproof. Dengue has to be controlled at the larval stage,” agrees Dr Randeep Guleria, head of department of pulmonary medicine at the All India Institute of Medical Sciences (AIIMS). Aedes species of mosquitoes are comparatively larger than the other species of mosquitoes. They are easily distinguished by white stripes on a black body for that reason this type of mosquito also called ‘Tiger mosquito’. What chemical is used? This brings us to the next question: What chemical is being used in the fogging machine? We use an insecticide, Malathion, tells the CMO. However, he also hastened to add that the fogging operation has its limitations. “The adult mosquitoes that come in the contact of the droplets are killed, others are merely dispersed and hide in leaves etc. Also, fogging does not kill mosquito eggs and larvae that may soon result in another army of mosquitoes.” Fogging is also an expensive and limited exercise. It would be better if we follow the traditional methods of keeping our surroundings clean, clutter free and not let water stagnate in pots, tyres garbage etc. “Even if a small wrapper has some water droplets on it, the mosquito can lat its eggs. Thus, when we say, practice precaution, the public should take us seriously. At public places too, the keepers should ensure there is no lapse on this front. As dengue mosquito lays eggs in clean water, it becomes even more dangerous as it would be most likely to be found in your kitchen, bathroom or even the dining room,” he advises. Thus, fogging is not the answer. Source reduction is. It needs to begin in the community. Nothing high tech – just common sense – keeping clean, disposing of all items that can collect water. How to slay them then? The most effective method to reduce the mosquito population remains that of eliminating potential breeding habitats. They have evolved to be able to reproduce very fast in houses, outside of houses and they are very effective in detecting stagnant water that one might have in the garden or the house, or some hidden crevice in a tree. They are very good at finding these spots for breeding and once they are able to find the spot, they are able to lay hundreds of eggs and the females have been effective at finding people to bite. That is why it is so hard to control them - because a few mosquitoes are able to make the most of the very few breeding habitats and maintain a population that is enough to continue having dengue or Zika. Over the past two years, the top five breeding habitats in homes have not changed. They are domestic containers, such as pails; flower pot plates; ornamental containers such as vases; hardened soil in plants, toilet bowls and water tanks. Experts say construction waste is a major source of stagnant water which is often ignored in anti-mosquito activities. Potholes in roads where water collects is also an often ignored source. “While the fogging operations will have some success in killing adult mosquitoes in the areas that are treated, the people must understand that this activity alone is not enough to protect everyone or prevent all dengue infections. To reduce and control dengue outbreaks a number of actions need to be taken not only by public authorities but also by residents. These include making sure there are no dengue mosquitoes breeding in your yard, such as in tyres, drums, buckets and any water storage containers, and that you also protect your family from mosquito bites inside and outside the house during the day and in the early morning and early evening. The best methods of personal protection are to apply insect repellent and/or to wear long sleeves and long pants,” suggests Arvind Kumar Rao, chief maternity officer and joint director, urban local bodies, LMC. “The dengue mosquito typically attacks during the day and the favourite spots are below the elbow and below the knee. They are generally active between the time period of August-October and do not breed when the temperature falls. Reduce the mosquito habitat by removing standing water around your house. You could turn to natural repellents like Lemon Eucalyptus Oil, Lavender, Neem Oil and Cinnamon Oil to protect yourself against mosquito bites. There are a number of plants that have mosquito repellent properties like feverfew, citronella, catnip and lavender. Place them around your house to keep mosquitoes away. Even herbs like garlic, lemongrass, basil, peppermint, rosemary may help,” advises senior gynaecologist, Dr Seema Dev. Is fogging harmful? “Not really. Fogging is mostly done outside the houses which can be effective only for 15 minutes and then it gets mixed in the air and hence there will be no impact on the human health,” says Dr PK Singh. “Very low concentration is used and Malathion is not known to cause any serious reactions in humans or even animals or birds. But of-course, those with sensitive skin or asthma should avoid exposure to its fumes. If exposed, wash your face and gurgle with lukewarm water. Allergic reactions are possible but they subside quickly,” he explained. Then there are the usual precautions that can be exercised like don’t let your pet out during fogging, bring indoors all edibles, wash fruits from the garden if exposed to fumes. However, according to some environment experts, when we fog, we kill not just the mosquitoes, we also kill the predators such as dragonflies. And dragonflies are nature’s air force. The dragonflies can eat as much as 100 mosquitoes a day. Mosquitoes, if there are breeding sites, will recover within days. Within a week, the larvae will be flying around. But the dragonfly will take 3 to 6 months to recover. So during that period, there will be no predator to control the mosquito. The Stats that Scare Dengue, which hits hundreds of people in India every year, sometimes fatally, may be spreading its tentacles beyond the rainy season. It has thus become ‘endemic’. This term is used when a virus, disease circulates throughout the year as is the case with dengue in northern, central and eastern India. That being said, conditions like stagnant water and damp weather, seen during and after the monsoon are ideal for the virus to grow and proliferate. The vector mosquitoes grow in numbers in these conditions. So, dengue cases see a sharp spike in the months immediately after the monsoons, like, late August and September. According to the Directorate of National Vector Borne Disease Control Programme (NVBDCP), this year the nation has seen 11,832 more cases of dengue compared to last year (2016), and the number of deaths from the vector-borne disease has been recorded at 46, eleven more than 2016. The report further said till July 30, 2016, the dengue cases reported were 16,870, while this year in the same time period the number rose to 28,702. Last week especially proved to be rather critical one, with 2,536 cases with 10 deaths. Kerala reported the maximum dengue cases with 13,913 cases, followed by Tamil Nadu with 5,474 cases, Karnataka with 4,186 cases, Andhra Pradesh with 798 cases, West Bengal with 571 cases and Maharashtra with 460 cases. Delhi registered 237 cases out of which, 118 are from the national capital while 119 cases are from adjoining states. UP recorded 89 cases. Lucknow has topped the chart with 15 cases reported in the city alone. The state has also seen two dengue deaths till now, one each in Maharajganj and Sitapur. Lucknow is followed by seven cases each in Allahabad, Kanpur Nagar and Hardoi. Sitapur reported six cases of dengue and Lakhimpur five. Barabanki, Siddharthnagar and Sultanpur have seen three cases each of dengue in the season. The National Vector Borne Disease Control Programme also came out with statistics on chikungunya, another vector-borne disease which saw a steep rise last year in Delhi. Overall, till July 30, 2017, India has seen a total of 18,466 cases of chikungunya - a whopping 45,591 cases less than last year. In 2016, India registered a total of 64,057 cases of chikungunya, with Karnataka topping the list with a total of 15,666 cases of chikungunya, and Delhi in the second highest spot with 12,279 cases. Till July 31, 2017, Delhi has seen a total of 220 cases of chikungunya. Dengue is manifested by a sudden onset of fever, with severe headache and muscle and joint pains. Severe pain gives it the name break-bone fever or bone crusher disease. The dengue rash is characteristically bright red and usually appears first on lower limbs and the chest; in some patients, it spreads to cover most of the body. Prevention is the only cure As there is no specific treatment for dengue, it is better to take measures for prevention of the disease rather than curative treatment. It is the first step in case of prevention to control Aedes mosquito which transmit and thereby spreading the disease. This mosquito can be controlled mainly by methods such as: (a) Environmental Control : The environment should be cleaned up and get rid of water holding containers such as discarded tins, empty pots, broken bottles, coconut shells and similar other collections of water. If water holding is required then water holding container must be covered with various lids. And proper care must be taken so that water accumulation in unwanted places should not last for five days. Municipal authorities should not let the garbage stay rotting at collection centres or public places and sprinkle lime powder near such points wherever possible. (b) Chemical Control : In recent years there are various chemical materials found in the market such as: Malathion etc. The use of such chemicals is very helpful to reduce and control the both adult mosquito and mosquito larva. (c) To protect the human body from the mosquito bite : By the use of various materials such as spray, mat, mosquito net etc. the human body can be protected from mosquito bite. (d) In addition by the use of mosquito net for the Dengue patient is helpful to prevent spreading of Dengue from a diseased a person to healthy person. As Aedes mosquito bite mainly in the morning and late evening. So it is better to use mosquito net during sleep not only at night but also in both morning and late evening to protect the human body from mosquito bite. Some safe, easy & natural home remedies Eating green leafy vegetables can provide the essential vitamins and minerals that can ward off the infection. Chewing two cloves of garlic or drinking hot garlic vegetable soup can decreases the multiplication of viruses. It is good herbal remedy for Dengue. To maintain the water and electrolyte balance of the body, oral rehydration solution should be given. This also helps in flushing out the viruses through the fluids excreted by the body. Eating red rice can quicken the healing process in dengue. Drinking hot soups and herbal teas can generate heat in the body and prevent chills. Roots of amaltas or leaves of coriander can be used as a tonic for reducing the fever. Consuming fenugreek leaves (methi) or basil leaves (tulsi) can soothe and cleanse the system and also eases the symptoms. Orange juice, Amla juice or Amla and grape fruit can promote antibody production. Vitamin C present in these fruits can aid in preventing dengue hemorrhagic fever. Caffeine and alcohol, known for their diuretic properties, are best avoided to prevent dehydration. Avoiding junk food with empty calories, sugar products and fried food is must. Squeeze and pound two pieces of raw papaya leaves with a filter clothes. Do not boil, cook it with hot water. A patient could take two tablespoon per serving daily. This will help control dengue fever. Neem leaves, Neem oil are a great purifying agent. Neem powder should be used in dosages of between 5 to 6 grams 2-3 times daily. Chyavanprash can be taken as it is an immunobooster, blood purifier and increases blood count. Boiled basil leaves (tulsi) served in a warm drink like tea can help prevent an outbreak of dengue. This is one another natural remedy for Dengue. 10-15 basil leaves should be chewed twice a day or these can be boiled in 200ml water on low heat. When half the quantity is left it can be taken 2-3 times a day. This strengthens the body's defense mechanism. Papaya leaves juice is a natural remedy for dengue fever. Use basil leaf 10 pieces and one black pepper. This should be the proportion. Grind it and make pea size pills, use it with warm water. To increase the blood count pomegranate juice/black grape juice should be given.