Sunday, September 05, 2010

Games construction spurs Delhi dengue outbreak

Commonwealth Games must battle spread of deadly fever.

By Jason Overdorf
September 5, 2010

NEW DELHI, India — With about a month to go before the opening ceremony of the already controversial 29th Commonwealth Games [2], Delhi bears the look of a mammoth construction site, as plucky migrant laborers scurry to build — and rebuild — roads and stadiums as they melt under the concrete- and asphalt-withering rains of the monsoon. But the worst news is yet to come.

Delhi's big dig has left stagnant water all over the city, breeding a huge swarm of aedes mosquitoes just in time for dengue fever season. As a result, Delhi is suffering a major epidemic at the absolute worst possible time. Already more than a thousand "official" cases of dengue fever have been reported, while independent reports suggest that the reality could be almost double that number. Malaysia and Australia have issued travel advisories and expressed concerns about their athletes, according to press reports [3], and at least 20 countries have written to Indian officials for reassurance. Worse still, Indian health officials say that the disease is set to peak just in time for the opening ceremony.

"This year, due to the construction activities for the Commonwealth Games, and the monsoon, which was a little bit delayed, there are innumerable breeding places for the aedes mosquito," said Dr. Kalpana Baruah, an official with India's National Vector Borne Disease Control Program. "Mosquito density has gone very high, and [because] we are having this virus circulating already in the area, immediately the dengue cases started pouring in. Now every day we are getting almost 60 to 70 new cases."

Even at those numbers, Municipal Corporation of Delhi officials say people's fears are exaggerated. "If you see the incidence of this disease in Thailand, it's much higher, and there has been no problem of visitors in Thailand," said Dr. N.K. Yadav, chief medical officer of the MCD health department. "Moreover, we are more proactive, and we are taking all preventive measures in the Games area and all over Delhi. I don't see any reason for alarm."

Nevertheless, alarm there is. And that's bad news for the games' planners, who oversold the event's ability to attract tourists — claiming they'd recoup most of the costs from travelers — before spending spiraled to $4.6 billion, or nine times the original estimate. So far, England's Queen Elizabeth and a host of top athletes have said they have prior commitments, and just 16,000 of the 170,000 tickets allotted for sale abroad have found takers. Mounting fears about dengue won't make selling the rest any easier.

Commonwealth Games Federation chief executive Mike Hooper downplayed the threat last week, saying that not a single member country had approached him with worries about dengue.

Meanwhile, in damage control mode at a press conference, Suresh Kalmadi, chairman of the organizing committee, told reporters that 1,800 doctors will be on call to deal with dengue cases, and, separately, MCD officials announced they plan to fog the games venues with heavy duty insecticide.

Dengue results in extremely high fevers, and can be deadly, though the mortality rate has dropped considerably since 1996, when Delhi's worst outbreak saw more than 10,000 people infected and more than 400 killed. Transmitted by the aedes mosquito, the disease is endemic to India, along with virtually all of south and southeast Asia, but serious outbreaks are cyclical, waxing and waning with the monsoon and government enthusiasm for control programs. Even a mild case is misery. And there is no vaccine, and no real treatment, apart from paracetamol and fluids.

So far, around a thousand official cases of dengue have been reported in and around Delhi.

But because of a disagreement over testing methods and other factors, many cases go unregistered in the government tally. A recent television station survey [4], for example, found nearly 1,500 cases in just two area hospitals.

To fight back, local schools have told students to wear winter uniforms — with long-sleeved shirts and long pants. And there has been a run on mosquito repellent as local residents seek to protect themselves from the insects that carry the disease. Sales of mosquito-repelling sprays and lotions have doubled, according to local pharmacists, and supplies are beginning to run short.

The good news is that so far the death rate is low, with only three confirmed fatalities so far, according to the health department of the Municipal Corporation of Delhi. But that's hardly inspiring to residents who can now add a deadly outbreak of disease to a list of games-related woes that includes the improper diversion of funds from programs for the historically oppressed Dalit caste, the expulsion of beggars and street vendors, and a day-and-night battle against colossal traffic jams.

Now, according to a poll conducted by the Times of India newspaper, a whopping 76 percent of residents say the whole exercise was a waste of money, while nearly half believe the fiasco and corruption of the preparations for the great showcase of India's rise has already damaged the country's image abroad.

With that in mind, and dengue-toting mosquitoes in the air, maybe it's just as well the queen won't be coming.

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