WHO says no need for travel restrictions on Sri Lanka

The World Health Organisation (WHO) today said that it does not recommend that any general travel or trade restrictions be applied on Sri Lanka as a result of the dengue fever outbreak.

From 1 January to 7 July 2017, the Epidemiology Unit of the Ministry of Health (MoH) Sri Lanka reported 80,732 dengue fever cases, including 215 deaths. This is a 4.3 fold higher than the average number of cases for the same period between 2010 and 2016, and the monthly number of cases exceeds the mean plus three standard deviations for each of the past six months. Based on sentinel site surveillance for the past seven years the expected peak months of May to July coincides with the south-western monsoon which commences in late April.

Approximately 43% of the dengue fever cases were reported from the Western Province and the most affected area with the highest number of reported cases is Colombo District (18 186) followed by Gampaha (12 121), Kurunegala (4889), Kalutara (4589), Batticaloa (3946), Ratnapura (3898), and Kandy (3853). Preliminary laboratory results have identified Dengue virus serotype 2 (DENV-2) as the circulating strain in this outbreak. Although all four DENV have been co-circulating in Sri Lanka for more than 30 years and DENV-2 has been infrequently detected since 2009.

The current dengue fever outbreak occurs in a context of massive heavy rains and flooding and is currently affecting 15 out of 25 districts in Sri Lanka where almost 600 000 people have been affected. Heavy monsoon rains, public failure to clear rain-soaked garbage, standing water pools and other potential breeding grounds for mosquito larvae attribute to the higher number of cases reported in urban and suburban areas.

The World Health Organization is supporting the MoH Sri Lanka to ensure an efficient and comprehensive health response.

The MoH launched an emergency response including vector control activities that is also supported by the mobilization of defense forces. The army, police and civil defense forces have been mobilized to conduct house-to-house visits in the high-risk areas with health staff. In addition, they are involved in mobilizing the community for garbage disposal, cleaning of vector breeding sites, and in health education.

The Regional Office for South-East Asia (SEARO) has constituted a Task Force to guide the response.

WHO/ SEARO deployed an epidemiologist, an entomologist and two dengue management experts from the WHO Collaborating Center for case management of Dengue/Dengue Haemorrhagic Fever (Queen Sirikit National Institute of Child Health, Thailand) and Ministry of Public health (MoPH) Thailand. The triage protocol was updated in June 2017 to assist with better management of the patients in the health facilities.

The WHO Sri Lanka country office has purchased 50 fogging machines to support vector control activities. The MOH and WHO have worked together to prepare a strategic and operational plan for intensive measures to control dengue outbreak in next few weeks.

WHO says the current dengue epidemic is likely to have repercussions on public health in Sri Lanka. (Colombo Gazette)