There is a need to raise public awareness taking precautions

Hyderabad : Tropical vector-borne diseases pose a unique challenge to planetary health. Approximately 80% of the world population remains vulnerable to one or more of the vector-borne diseases. Vectors are insects or rodents, ranging from rats, mosquitos, mites to ticks and can transmit several tropical infections like dengue, malaria, chikungunya, leptospirosis and scrub typhus. The tropical Indian subcontinent, with its rising temperatures and longer transmission seasons, carries a heavy burden of vector-borne diseases, like malaria, chikungunya, and dengue.

The arboviruses dengue and chikungunya’s primary vector, Aedes aegypti mosquito, is found in abundance in India. The malarial vector Anopheles accounted for more than 10 million global cases of malaria in 2017, of which 63.38% were caused by the deadly malarial parasite Plasmodium falciparum. The Zika virus disease, currently emerging in India, is also transmitted by the Aedes group of mosquitos. The zoonotic life-threatening rickettsial scrub typhus, transmitted by chigger mites, accounts for 25.3% of all acute fevers in India. Leptospirosis is another disease of significant magnitude in India. Itis caused by rat vector-borne gram-negative bacteria that spreads either through direct contact or contaminated water sources. Prolonged monsoons and flooding can amplify transmission of leptospirosis in India and contribute to a huge public health burden.

Speaking about this, Dr.Gifty Immanuel who deals with tropical infections said ‘’Concurrent outbreaks with overlapping symptoms, significant mortality rates and increasing disease drivers all exacerbate the problem of vector-borne diseases in India. It represents a clinical conundrum. Few of the tropical diseases have effective vaccines. In the absence of immune-prophylaxis (vaccines), antimicrobials remain the mainstay for potentially fatal vector-borne diseases. Certain antibiotics are used as a therapeutic tool against susceptible vector-borne diseases. Tetracyclines have a long history of use and could reduce mortality in scrub typhus if used early. It could also serve as an efficacious prophylactic and therapeutic agent in all forms of malaria and leptospirosis. Arboviral inhibitory properties are also being increasingly recognized in dengue and chikungunya.’’

Meanwhile, antibiotic resistance at the global scale and disruption of human microbiome are a looming crisis. Self-medication should be always avoided Initiatives like the use of insecticide impregnated nets, protective clothing, bite avoidance, vector control,  clearing water logged areas, and improving environmental hygiene are effective preventive measures. And the use of therapeutic options needs to be decided only by clinical judgement. Public awareness and health education plays the most important role in disease prevention and control.