'Chikungunya is major threat'

While malaria and dengue continue to affect the Capital, Dr Rakesh Kumar from the Centre of Community Medicine at All India Institute of Medical Sciences also identifies chikungunya as a major concern. Excerpts from an interview with Jyotsna Singh

How important are vector-borne diseases in public health?

There are two angles to the issue. Firstly, we see the burden in terms of morbidity and mortality of different diseases. Malaria has a high rate of infection. The situation in Delhi is better than the rest of India. However, dengue affects the city badly and there is an outbreak every four years in Delhi. In 2009-10 there were close to 10,000 cases of dengue. But non-communicable diseases like diabetes and hypertension are more important because of high rate of morbidity as well as mortality. Secondly, we have to see the economic burden – cost of health system, and impact on productivity and finances of the affected family. In India we have had more than one million cases of vector-borne diseases since 2009.

In an urban setting like Delhi, what are the main challenges and how to deal with them?

It begins with anti-larvae and anti-adult operations. When stagnated water does not get treated in time, fogging and indoor spraying of insecticides has to be carried out. Beyond this, unplanned urbanisation is the main cause in cities like Delhi. There are spots where the number of cases is much higher than the rest of the city. In 2009-10, the number of cases shot up primarily because of large-scale construction. Whenever there is urbanisation, we come across high levels of vector-borne diseases.We have to ensure that construction is planned and does not lead to such outbreaks.

Which of the vector-borne diseases impact Delhi the most?

There are five such communicable diseases – malaria, dengue, kalajar, Japanese encephalitis and chikungunya. JE and kalajar are not heard much in the city. Dengue affects badly once in four years, and has a high rate compared to the rest of the country. Malaria is fairly common, but better than the Indian average. Chikungunya is the major concern now. It was earlier found in the southern

states, mainly Karnataka and Kerala. Cases were also detected in Gujarat.  But now it has come as far as Delhi. It has become common here also now. The only good part is that it is a non-fatal disease.