AN INCREASING number of death from dengue infection may have been the result, as experts believe, of mutation in both the dengue virus and its vector — primarily, Aedes aegypti. As dengue virus has its genome based on ribonucleic acid which can mutate fast to adapt to adverse conditions, experts say that such mutations would make dengue treatment protocol, preventive measures against infection and vector management plans difficult. Citing the example of Covid virus, SARS-CoV-2, which had more than 50 mutations in different countries, they fear that dengue virus may have already had such mutation. At least 271 people have been reported dead from the infection, along with 55,663 cases of hospital admission, as Directorate General of Health Services statistics show, this year. The infection left 1,705 people dead, as the conservative public estimate shows, in 2023. The figure of death was 281 in 2022, 105 in 2021, 7 in 2020 and 276 in 2019. In such a situation, the government has no update on information on whether mutations have already taken place, or are taking place, in the genes of the dengue virus. The Directorate General of Health Services, which earlier said that it was serotyping the virus to identify the dominating variant of the four serotypes, says that it has plans to sequence the genome of the dengue virus.
Physicians observe that the symptoms of dengue patients that they treat now are different from the symptoms of the patients that they have treated in the past. Physicians also report that dengue has been diagnosed in many patients who show no typical symptoms of fever, pain or vomiting. The death rate of the patients in hospital has also increased. An entomologist working at the National Institute of Preventive and Social Medicine observes that the mosquito that acts as dengue vector is also likely to have mutated. The use of insecticide has, as he thinks, may have caused the change in the cellular functions of the mosquito. As any data on such suspected changes are still missing, the vector management would also turn challenging. If the mutations have already taken place in the dengue virus genes, its control mechanism and treatment protocols need to be changed accordingly. An effective mosquito control, patient management and vaccination need to be based on accurate data and evidence about such mutations. In the past two years, chikungunya and dengue have not broken out at a time at a place, but physicians have received patients with symptoms of chikungunya, which also suggests a change pattern in the spread of the two infections caused by different viruses.
For a better fight against the outbreak of dengue infection, especially at a time when experts believe that there have been mutations in the gene of the virus and its vector, the government should do more research on dengue infection, which should include the sequencing of the dengue virus genome, to arm up the health services agencies better.
