September deadliest, Oct peak looms

Dengue infections and fatalities continue to rise at an alarming rate, with the death toll reaching 200 and total reported cases climbing to 47,832 as of yesterday.

Experts warned that the outbreak may worsen in October, when cases are expected to peak, before beginning to decline gradually from November. However, they cautioned that infections and deaths are likely to persist well into December and January.

According to the Directorate General of Health Services (DGHS), in September alone, 76 people died from the disease and 15,866 patients were hospitalised -- the highest monthly toll this year.

The number of deaths stood at 39 in August, 41 in July, and 19 in June. Reported hospitalisations were 10,684 in August, 10,684 in July, and 5,951 in June.

Health experts blame intermittent rainfall, favourable weather conditions, and poor mosquito control measures for creating ideal breeding grounds for Aedes mosquitoes, which transmit dengue, chikungunya, and Zika viruses.

Prof Kabirul Bashar, an entomologist at Jahangirnagar University, said, "Dengue comes in waves. When mosquito density is high alongside rising cases, it becomes very difficult to stop. Our forecasting model shows that cases will peak in October, start to decline in November, but continue significantly until January. Stopping it completely now is almost impossible."

Bashar stressed that while city corporations must intensify source reduction, breeding-site management, hotspot control, and other measures, everyone must act from their own position.

"Without active community participation in eliminating breeding grounds, controlling this outbreak will be extremely difficult," he said.

GM Saifur Rahman, an entomologist at National University, urged intensified mosquito-control drives in hotspots, including targeted breeding-zone eradication, adult mosquito elimination, and sustained nationwide action.

He also called for community mobilisation through awareness campaigns.

"If the authorities truly want to save lives, they must take steps to control mosquitoes systematically, and address the existing shortcomings." Entomologist

— Prof GM Saifur Rahman

WHY DEATHS ARE RISING

DGHS data show that 81 percent of dengue patients who died this year were admitted to hospitals only after suffering fever for three or more days, highlighting delayed hospitalisation as the leading cause of fatalities.

While disclosing the data at a press conference on September 22, DGHS Director General Prof Md Abu Jafor said early testing and timely hospitalisation are therefore crucial.

Of the deaths, 74 percent occurred within 48 hours of admission; 50 percent of patients died from Dengue Shock Syndrome (DSS); and 43 percent of the deceased had comorbidities.

HM Nazmul Ahsan, associate professor at Shaheed Suhrawardy Medical College Hospital, noted that four viral infections -- influenza, dengue, chikungunya, and Covid-19 -- are circulating simultaneously, leading to negligence in seeking medical care and late testing.

"Many patients fail to recognise warning signs such as severe abdominal pain, breathing difficulties, bleeding, extreme fatigue, or a sharp fall in urination . By the time they arrive at hospitals, their condition is often critical," he said.

He added that many critically ill patients are referred to Dhaka hospitals from districts, but delays in referral are also driving up fatalities. He urged district-level hospitals to strictly follow national treatment guidelines and treat patients locally.

Public health expert Mohammad Mushtuq Husain echoed the call for early treatment and stronger healthcare capacity outside Dhaka.

He stressed the need to strengthen secondary care hospitals to better manage vulnerable groups, including infants, the elderly, and patients with comorbidities, so that they can be stabilised before referral to tertiary centres.