Sting operation

The country is suddenly looking at the Aedes aegypti mosquito a little more closely than it has in a long, long while. If we had kept our eye on the ball, we may have been spared the present outbreak of dengue and chikungunya and the mass panic that has followed in its wake. Disease control is ultimately all about disease surveillance.

One of the central vector control initiatives that Singapore launched with great success involved extensive number crunching. Areas which had a high incidence of the Aedes vector were carefully defined. The basic idea was simple: since mosquito breeding precedes disease transmission, it was vital to control the vector population before the disease manifested itself. Achieving this was, of course, not easy. This was where public involvement in terms of maintaining hygiene and keeping stored water well covered came in. Things are indubitably far more complicated in the Indian scenario, given the numbers and distances involved, but there is in the dengue prevention protocol adopted by Singapore, important clues on how this country should tailor its own vector control programme 8212; and this includes the meticulous collection of epidemiologic data.

There was, incidentally, considerable evidence of the rise of chikungunya and dengue in the country over the last few months. Earlier this year, Andhra Pradesh had reported both a high density of the Aedes aegypti in some regions, and the outbreak of chikungunya with the sporadic emergence of dengue. In February-March, Orissa saw a clear rise in the incidence of a fever that was accompanied by muscular pains and headaches. Early data of this kind should have alerted the health authorities to the inexorable progress of these diseases, but they failed to translate the evidence they had into effective and concerted, pan-Indian public health interventions. The present crisis is both challenge and opportunity 8212; a challenge to India8217;s health authorities to evolve their own protocol of disease prevention and an opportunity for ordinary Indians to work towards ensuring a cleaner living environment.