[Salon] The spread of dengue

[Chas Freeman <cwfresidence@gmail.com>]

https://www.bloomberg.com/news/newsletters/2023-11-20/india-cricket-star-s-sickness-shows-dengue-s-rising-danger-prognosis?cmpid=BBD112023_prognosis

November 20, 2023

Shubman’s sickness

Shubman Gill was well on course to score a converted century, or 100 runs, during the men’s Cricket World Cup semi-final against New Zealand this month when the Indian opening batter suddenly seized up and hobbled off the field.

During a post-match press briefing, Gill blamed his cramping on Mumbai’s humidity and the “after-effects of dengue.” A mosquito-borne infection had left the 24-year-old hospitalized in Chennai and shedding muscle mass. He missed India’s first two games in the tournament before he was discharged.

“The reserve that I used to have before the dengue has decreased a little bit,” he said.

Gill’s struggle with the disease is a high-profile warning over dengue’s rapid spread. Climate change and record temperatures are providing increasingly ideal conditions for the mosquitoes that pass on as many as 400 million infections each year, mostly in urban areas in tropical and sub-tropical regions, according to the World Health Organization. While most people who contract the virus display little to no symptoms, it can be wrenchingly severe for some, taking weeks for recovery and even resulting in death. 

“It’s like being wiped off the face of the earth,” Ellen Barry, a New York Times journalist, wrote four years ago. She described how it began with a penetrating shoulder ache. “Then, as I sweated through the hotel sheets, hallucinations. My senses were altered. When I drank water from the tap, it tasted like a mouthful of tin.”

A worker fumigates against the dengue virus in Dhaka, Bangladesh, on Sunday, July 9, 2023. Photographer: Anik Rahman/Bloomberg

We are all the more likely to experience those feverish conditions going forward. Our warming planet, increasing urbanization and the flux of human movement has helped dengue cases double every decade since 1990. Once restricted to just a few Southeast Asian nations, now about half the world’s population is at risk. Dengue’s transmission potential is expected to rise by as much as 37% by the middle of this century, according to a study published in The Lancet journal this month.

“The increasing magnitude of these outbreaks has led many countries in Asia to declare dengue among their top public health priorities and how countries respond to these increasingly complex epidemics can have significant political implications” says Oliver Brady, an associate professor at the London School of Hygiene and Tropical Medicine. He pointed to the resignation of Peru’s health minister in June after the country struggled to contain its worst ever outbreak.

Asia represents around 70% of the global disease burden, and here in Mumbai dengue cases have rocketed to nearly 4,400 since January — up from less than 750 in the same period in 2022. That mirrors spikes across the country that prompted India’s health minister to sound the alarm in September. Hospitals in neighboring Bangladesh are on their knees following a record outbreak.

Currently there’s little treatment available and only one vaccine that the WHO hasn’t prequalified for wide use. That may change soon as new inoculations clear final stage efficacy trials. Takeda’s two-shot regime recently received approval from regulators in Brazil, Europe and Indonesia in people 4 years of age and older. The Serum Institute of India, the world’s largest producers of vaccines, wants to start manufacturing vaccines for travelers in the next three years.

As for Gill, while he was fit enough to play in Sunday's World Cup final, the batter cried out in frustration after he was caught out for just four runs. His anguish was shared by his team and the rest of India as Australia cruised to victory hours later. — Chris Kay and Bhuma Shrivastava