Health Ministry-Sri Lanka

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Integrated vector management

Prevention and control of dengue virus transmission depends entirely on control of the mosquito vectors or interruption of human – vector contact. 

Environmental Management

Environmental management is a key element of IVM. Environmental management can include environmental modification, environmental manipulation, and strategies that reduce contacts between vectors and humans.

In the case of mosquitoes, the larvae are easier to control than adults because they are confined to water bodies. Therefore, whatever practicable, removing water called “source Reduction” should be a primary consideration in mosquito control.

Environmental manipulation 

Strategies involve recurrent activities such as measures that have a temporary effect on vector habitat and need to be repeated Eg. Covering of water storage containers or tanks with tight lids, screens or net covers

Removal of water with scrubbing and cleaning of the inner surfaces of water storage containers, refrigerator trays, ant traps, tanks or flower vases to remove mosquito eggs.

 

•    Changing water salinity and PH in ant traps, refrigerator trays etc. By adding salt or soap
•    Puncturing blocked flower pots to produce a drain hole
•    Keeping machinery parts and scrap material of factories in a sheltered place to prevent the collection of rain water. Proper tire management, storing un-used tires under a shelter in bus depots and other places

Environmental modifications
 Usually involves capital-intensive investments in permanent infrastructures,

1.    new buildings without roof gutters  
2.    Proper discarded receptacles (burying, crushing, burning)
3.    Mosquito proofing of overhead tanks rainwater harvesting tanks, underground storage tanks, domestic wells
4.    Proper drainage of cement lined or concrete drains
5.    Permanent removal of Roof gutters, and construction of new buildings without roof gutters  
6.    Proper discarded receptacles (burying, crushing, burning)

Permanent removal of Roof gutters, and introduced as a policy as a policy in the code of practice.

Removal of unnecessary water collecting plants like Bromelia

Reduce Human – vector contacts

A third type of environmental management strategy aims to reduce human–vector contacts through the strategic placement of settlements and housing, or better use of window screening. Originally, such included effective use of mosquito nets, wearing protective clothing      

Enforcement of law against offenders 

Enforcement of law against the offenders who are keeping dengue mosquito breeding places in his/her premises which will endanger the lives of others

 

 

Ae. aegypti and Ae. albopictus breed in a wide variety of container habitats. Dengue mosquito breeding places can be categorize as follows

  1. Discarded non biodegradable items
  2. Discarded biodegradable items
  3. Places where rain water can be accumulated
  4. Uncovered water storage tanks, containers
  5. Ornamental & fancy items where water can be collected
  6. Special home appliances
  7. Water containing small containers inside and outside of the house 
  8. Plants/ parts of plants, tree holes
  9. Others

1.Discarded non biodegradable items
Eg. Tires, Plastic wrappers, Polithine, clay pots, discarded bottles, Rigiform boxes, Plastic cups, discarded toys and other items, tin (salmon & Biscuit), wooden boxes

 

 

Large discarded containers (tires, damaged appliances) and small discarded containers (paint cans)

2.Discarded biodegradable items
Eg. Coconut shells,   King Coconut shells, bamboo stumps  (and other fruit shells which can hold water, egg shells – hardly breed mosquitoes in these places)

3. Places where rain water can be accumulated
Eg.Concrete slabs, Blocked roof gutters, 

4. Uncovered / unprotected water storage tanks, barrels and other containers, rain water harvesting tanks


5. Ornamental & fancy items where water can be collected
Bird baths, statutes, abandoned ponds, flower vases, flower pots and sauces, abandoned fish tanks, fountains

 

6. Home appliances
Eg.Refrigerator trays and air conditioner trays

 

7. Water containing small containers inside and outside of the house  
Eg. Ant traps , Animal feeding trays    

8. Plants/ parts of plants, tree holes , leaf axiles, bamboo stumps

9. Others

  • Non use “Cisterns”
  • Cemented shallow well
  • Non use boats
  • Water leaking   cement floor
  • Water dispenser’s tray
  • Fence poles
  • At the construction sites
  • Inside the grinding stones
  • Tube Wells
  • Earth pipe hole
  • Water meter

 

2013


2012

2011

Q. What is dengue?

Dengue is flu like illness caused by any of four closely related antigenically different dengue viruses (DEN 1, DEN 2, DEN 3 or DEN 4). The virus is transmitted to humans by the bite of an infected female mosquito. The incubation period of dengue fever normally ranges from between 3 to 14 days.

 

Q. What is dengue heamorrhagic fever (DHF)?

Dengue haemorrhagic fever is a more severe form of dengue illness and can be fatal if unrecognized and not properly treated in a timely manner. DHF is caused by infection with the same viruses that cause dengue fever and plasma leaking is a main feature of the illness.

 

Q. How are the dengue and dengue heamorragic fever (DHF) spread?

Dengue is transmitted to human by the bite of an infected Aedes mosquitoe. The mosquito becomes infected when it bites a person who has dengue virus in their blood. After about a week, the mosquito can transmit the virus while biting a healthy person. There is no person to person transmission

 

Q. what are the symptoms of dengue

The common symptoms of dengue fever includes high grade fever, severe headache, severe pain behind the eyes, joint pain, muscle pain, bone pain, nausea, vomiting, rash, sometimes mild bleeding,

Dengue heamorrhagic fever is more severe form of dengue illness characterized by fever that lasts from 2 to 7 days, in addition to the symptoms of simple dengue fever; they may have persistent vomiting, severe abdominal pain, difficulty in breathing, dizziness, bleeding etc. In Dengue heamorrhagic fever patient may enter in to the critical phase of the illness where the small blood vessels become leaky allowing the fluid component of the blood to leak to chest and abdominal cavity.

This can lead to reduction in blood volume and therefore poor blood supply to vital organs, such as brain, kidneys & liver. This may lead to failure of the circulatory system and shock, followed by death if circulatory failure is not corrected.

 

Q. What are the treatments for dengue?

If a person is having symptoms suggestive of dengue it is advice to take paracetamol in recommended doses to alleviate fever and pain. They should avoid taking other pain relieving drugs and need to rest without doing strenuous exercises and any other tiring activities. Early diagnosis & supportive care with intravenous fluids and frequent blood test monitoring reduces complications of the disease.

They have to drink adequate fluid and consult a doctor if symptoms persist more than 2 days. If they develop vomiting, severe abdominal pain, dizziness, difficulty in breathing, or any other significant symptoms any time during the course of illness (Even after fever declines), it is advised to go immediately to the hospital for evaluation.

 

Q. Where to complain?

If a person needs to complain regarding a possible dengue mosquito breeding place, it is always encouraged to have a discussion with the owner or responsible person regarding the problem. If it is not satisfactory informing the relevant Public Health Inspector and Medical Officer of Health of the particular area and Local government institution (i.e Municipal council/Town council / Pradeshiya sabha ,ec) should be the 1st step.

If Fever is present, always suspect as having dengue

1. Give a good/adequate rest

  • Never allow to do hard work or to be tired by any means

2. Give adequate liquids to drink

  • Milk, Fruit juice , Orange juice, Jeewani ,conjee, soup are suitable
  • Do not give only water all the time
  • Allow the patient to take usual solid foods if possible
  • Never give red/brown coloured foods/drinks or beverages

3. Keep eye on the number of times of passing urine

  • If the number of times of passing urine less than usual take the pa-tient to a hospital

4. If a child has fever,

  • Wet the body with normal water
  • Give Paracetamol recommended dose (for the age/weight) and 6hrly
  • Never give other drugs to reduce fever

Eg: Diclofinac/ Ibuprofen/Mefenamic Acid – Tablets / Syrups

5. If the fever continues for more than 2 days,

  • Take the patient to a hospital on the 3rd day and do a blood test (FBC)

6. Take the patient immediately to a hospital, if you notice these symptoms,

  • Inability to tolerate oral fluids (Repeated vomiting)
  • Refuse to eat /drink
  • Feeing extreme thirsty
  • Reduced number of times of passing urine/not passing urine more than 6 hrs
  • Abdominal pain
  • Drowsiness
  • Behavioral changes
  • Vomiting reddish or blackish stained vomits
  • Bleeding manifestation – Gum bleeding, red color urine
  • Dizziness /Giddiness( vertigo)
  • Pale looking
  • Cold limbs (arms and legs)

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