2017 dengue outbreak in Sri Lanka

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2017 dengue outbreak in Sri Lanka
DiseaseDengue fever
Virus strainDengue virus
First outbreakSri Lanka
DatesMay 2017 – Aug 2017
Type
DENV-2
Confirmed cases186,101
Deaths
440
Fatality rate0.24%
Vaccinationsno vaccine available (at time)

In the 2017 dengue epidemic in Sri Lanka, a rise in the number of dengue fever cases was reported on the island country of Sri Lanka. The peak of the outbreak was in the mid-year monsoon rain season, when there was record of over 40,000 cases in July. This figure was far beyond the historical highest number of cases per month in Sri Lanka. Year-end total dengue cases rose to 186,101.

Most cases (43%) were recorded in Western Province urban areas such as the Colombo district (table 1).[1] Most dengue cases were young people and school children. Year-end Sri Lanka's total dengue related deaths was 440.

The Government of Sri Lanka spend more than US$12 million on outbreak control and was supported by NGOs such as the Red Cross.[2][3][4]

Map
Table 1 - Dengue Cases by Three Exemplar Districts (2017)[5]
District January February March April May June July August September October November December Total
Colombo 2,734 1,900 2,467 2,570 3,333 5,372 7,471 3,620 1,251 823 1,131 1,602 34,274
Gampaha 1,635 1,087 1,870 2,072 3,168 4,901 9,039 3,553 1,246 779 1,078 1,219 31,647
Kalutara 581 448 836 739 946 1,248 2,612 1,477 663 337 528 546 10,961

Background

In 2017 Sri Lanka experienced its largest neglected tropical disease outbreak of dengue fever since the first recorded Sri Lankan case in 1962.[6][7][8] This biological hazard, transmitted via female mosquito bites, caused 186,101 dengue cases, significantly higher than in previous years (table 2), and 440 deaths.[3][9][10]

Table 2 - Annual Dengue Case Numbers from 2010 to 2022, Sri Lanka[11]
Year 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022
Annual Dengue Cases 34,188 28,473 44,461 32,063 47,502 29,777 50,592 186,101 51,659 105,049 31,162 25,067 51,005 (Jan-Oct)


Sri Lanka's Ministry of Health (MoH) reported a rise in cases from January, with the highest number of cases reported in July (table 3).[11] Most cases were recorded in the west and north of the country, specifically in the urban Colombo district.[3]

Table 3 - 2017 Monthly Dengue Cases, Sri Lanka[11]
Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Reported Dengue Case Numbers 10,927 8,724 13,540 12,540 15,963 25,319 41,121 22,270 9,519 6,614 8,868 10,753

Causes

Climate

  • Sri Lanka's tropical climate offers prime mosquito breeding conditions.[12]
  • The 2017 monsoon rains (May–August) coincided with the peak of the dengue outbreak (table 2). Triggering floods and disrupting refuse collection, increasing mosquito breeding sites.[8][13]
  • However, annual
    El Nino conditions were lower on average than previous years, suggesting that climate was not completely responsible for the outbreak.[3]

Political

Socio-economic

  • Sri Lanka is a
    middle-income country with a GDP per capita of US $12,600 (2017).[16] This restricts investment in healthcare infrastructure resulting in an overstretched healthcare system.[8]
  • High urban population density in western districts created higher probability of transmission.[3]
  • In 2017, 42% of Sri Lankans were in extreme poverty (below US$5.50 a day) which limits a family's access to healthcare and increases risk of disease.[16][17]
  • Regional disparities, due to the Sri Lankan civil conflict (1983-2009), displaced people to IDP camps and marginalized ethnic groups (Tamils) in north and eastern districts, reducing support and increasing disease risk.[18][19]

Short- and long-term impacts

Short-term impacts

Long-term impacts

  • Today dengue cases are declining in Sri Lanka, with 25,067 total cases in 2021 (table 1).[11]
  • Dengue is still present with new strains (serotypes DENV-3 and DENV-4) becoming more prominent threatening future outbreaks.[15]
  • Combined with the COVID-19 pandemic there is still immense pressures on healthcare and trade networks.[21]
  • 2022 has seen an economic crisis and severe food insecurity in Sri Lanka, the dengue outbreak would be a contributing factor.[22][23]

Futures

Dengvaxia - with five more in development.[21] However, Sri Lanka's current expenditure is US$161 per capita on healthcare (2021), the vaccine is a significant proportion of that budget and in uncertain economic times may not be a priority.[26][27]

See also

External links

References

  1. ^ a b c "WHO | Dengue fever – Sri Lanka". WHO. Archived from the original on July 21, 2017. Retrieved 2020-11-27.
  2. ^ "Sri Lanka: Dengue Outbreak - Jul 2017". ReliefWeb. 21 August 2018. Retrieved 2020-11-27.
  3. ^
    PMID 32186490
    .
  4. ^ "Dengue Fever Outbreak in Sri Lanka Kills Nearly 300 People". Time. Retrieved 2020-11-27.
  5. ^ "Trends". www.epid.gov.lk. Retrieved 2020-11-27.
  6. ^ "CDC - Neglected Tropical Diseases - Diseases". www.cdc.gov. 2022-03-07. Retrieved 2022-10-28.
  7. ^
    S2CID 212629415
    .
  8. ^
    S2CID 80605119
    .
  9. ^ "What is a disaster? | IFRC". www.ifrc.org. Retrieved 2022-10-28.
  10. PMID 26874619
    .
  11. ^ a b c d "Trends". www.epid.gov.lk. Retrieved 2022-10-28.
  12. ^ "Dengue and severe dengue". www.who.int. Retrieved 2022-10-28.
  13. S2CID 14765887
    .
  14. S2CID 5071742
    .
  15. ^
    S2CID 232078010
    .
  16. ^ a b "Gapminder Tools". www.gapminder.org. Retrieved 2022-10-28.
  17. ^ WHO (2017). "World Bank and WHO: Half the world lacks access to essential health services, 100 million still pushed into extreme poverty because of health expenses". www.who.int. Retrieved 2022-10-28.
  18. ^ a b "Sri Lanka - World Directory of Minorities & Indigenous Peoples". Minority Rights Group. 2019-06-19. Retrieved 2022-10-28.
  19. ^ Kapila, Mukesh (2018). "Healthcare in Conflict Settings". World Innovation Summit for Health. Retrieved 2022-10-28.
  20. OCLC 689053662.{{cite book}}: CS1 maint: location missing publisher (link
    )
  21. ^ a b c WHO (2022). "Vaccines and immunization: Dengue". www.who.int. Retrieved 2022-10-28.
  22. ^ Root & Win (2022-08-09). "How Sri Lanka went from topping Lonely Planet's list to almost 30% hunger levels". The New Humanitarian. Retrieved 2022-10-28.
  23. ^ a b Quiggin, John; Mallawaarachchi, Thilak (25 July 2022). "How did Sri Lanka run out of money? 5 graphs that explain its economic crisis". The Conversation. Retrieved 2022-10-28.
  24. PMID 35712272
    .
  25. PMID 19814853
    .
  26. ^ "Current health expenditure (% of GDP) - Sri Lanka | Data". data.worldbank.org. Retrieved 2022-10-28.
  27. PMID 31431184
    .
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