The existing facilities are abysmally inadequate and unfamiliar to tackle emergency situations created by unending stream of patients although there are about 50,000 beds in nearly a thousad hospitals and clinics in Delhi of which 38 are Governmet hospitals, figures much higher than the national average. More medical staff are being recruited and the blood tests have been highly subsidised with a ceiling of Rs 600 in order to fight the mosquitoe-borne infection.

With various breeds of politicians vying to take advantage of the calamity, and the unaccounted number of authorities fighting among themselves over fixing responsibilities and laying claim to achievements, the situation is almost going out of hand, especially as the epidemic has already broken the previous records of several years and the worst is yet to come next month, October being the ideal month for the vector to breed. Dengue cases shoot up following the monsoon season and is reported at its maximum in the month of October.

SYMPTOMS, TESTS & TREATMENT: The diagnosis is typically based on physical examination. The earliest change detectable on laboratory investigations is a low white blood cell count. The first symptoms of the febrile stage are high fever (104 deg F) and headache, muscle/joint pain (therefore called 'breakbone fever') which start five days after infected msquito's (aedes aegypti) bite. But the incubation period can also go up to 14 days. Fever will continue for over a week. Thereafter there can be bleeding from the nose, ears and gums, blood in stool, in what is called dengue hemorrhagic fever. Rashes too may be seen. Breathing can become difficult. There is internal bleeding and blood platelet count goes down (a count of 1,50,000 platelets and above is the normal parameter), leading to shock syndrome and death. In the initial stages, paracetamol (in non-reactive cases) and lots of fluids will be helpful. Treatments are supportive, not curative.

PREVENTION: Avoid msquito bites. Dengue mosquitoes bite during daytime. Covering whole limbs with full sleeves and trousers will help. Caped outfits, if one can, may be useful. Use mosquito repellants. No vaccine is available.

TRAVEL ADVISORY: It is advised to avoid travelling in areas where dengue is in endemic form, especially in September-October in any part of India. Take precautions against msquito bites.

A International Anti-Dengue Day is observed on June 15. Dengue virus infection first surfaced in India in 1981. We were the first to report the incidence in the media in Delhi.