In the 2011 monsoon season, dengue fever, a deadly mosquito-borne disease, struck Pakistan with unexpected force. It was the largest such outbreak in the country's history infecting 27 000 people and causing 322 fatalities, and exhausting the capacities of the hospitals in the affected areas.
The 2011 monsoon outbreak was first reported in Lahore, the capital city of the Punjab province in mid-August 2011. The virus spread rapidly to the entire province and then at its peak, by October 2011, dengue infections were being reported throughout the rest of the country. National health authorities had to address the situation as a matter of utmost urgency. The country quickly needed to marshal the experts, the know-how and the capacity to contain the disease.
Combatting dengue fever requires pooling together technical expertise from a range of disciplines: epidemiology, public health, entomology, insect pest control, and field sampling and quality assurance, among others. Responding to a request from Pakistan, the IAEA brought together - at short notice - national and international experts from very diverse fields for a workshop on the integrated control of Aedes aegypti mosquito, the carrier of the dengue virus.
At the five-day workshop from 7 to 11 November 2011, the experts shared their experience and discussed an action plan for combatting and containing dengue in Pakistan. They also visited the FAO/IAEA Agriculture and Biotechnology laboratories, where research is on-going to develop methods to mass-rear pest insects in order to assess the feasibility of applying the sterile insect technique as part of an area-wide integrated vector management approach.
"This meeting gave Pakistani health officials the opportunity to gain access to the best technical advice in dealing with Dengue fever," said Mr. Jorge Hendrichs, Head of the Insect Pest Control Section of the Joint IAEA-FAO Division.
"Because Pakistan needs to have the necessary experience and procedures in place, it can benefit a lot by learning from other experts in the region, where dengue is a common occurrence," Mr. Hendrichs said.
As a result of their discussions, the experts pinpointed two key priorities that needed immediate attention: collection of essential baseline data through field sampling and training for local and national health authorities.
"It is important to establish basic data," said Dr. Hervé Bossin, an entomology expert from the L'Institut Louis Malardé in French Polynesia. "The Pakistani authorities need to know which of the mosquito species is involved, their breeding areas and other indispensable information. This is something we can do in the field as part of the data sampling."
With the IAEA's support, the experts plan to hold two training courses in Pakistan in 2012. These will focus on basic surveillance and disease epidemiology, biology and ecology of dengue vectors in the country. The aim will be to strengthen Pakistan's capacity to implement surveillance networks before the next monsoon season.
Background
Pakistan first reported an epidemic of dengue fever in 1994. Dengue fever is a mosquito-borne infection, transmitted through the bites of female Aedes mosquitoes. About 2.5% of the patients who develop dengue hemorrhagic fever, a complication of the disease, die.
The WHO reports that dengue fever is most common in tropical and sub-tropical regions, but it has grown exponentially in the past decades, spreading to other regions as well. There is no specific treatment for dengue fever, but appropriate and prompt medical care increases the survival rate considerably. The only way to contain the virus is by combatting the disease carrying mosquitoes, Aedes aegypti.