Commissioner & Secretary of Health and Family Welfare, Anoop Khinchi, IAS, convened a meeting with the National Vector Borne Diseases Control Program (NVBDCP) to assess dengue preparedness at his office chamber on 23rd September 2024.
Emphasizing that all precautionary measures must be taken by the public to prevent dengue, Khinchi noted that Nagaland currently has few dengue cases this year. However, for the prevention of any vector-borne diseases, he urged the public to maintain clean surroundings by eliminating stagnant water to reduce mosquito breeding sites, wear long sleeves, and use Long-Lasting Insecticidal Nets (LLINs) and repellents to prevent mosquito bites.
Khinchi specifically pointed out stagnant water in cups used during rubber plantations in Wokha and Dimapur, and directed officials to notify the districts to take precautionary measures. He emphasized the need to reiterate precautionary steps and educate the public about peak mosquito activity times for their safety.
The Commissioner & Secretary also inquired about the status of the dengue helpline, hospital preparedness, and the distribution of LLINs.
State Program Officer and Joint Director of NVBDCP, Dr. Neisakho Kere, reported that while there was a dengue outbreak last year with 4,943 positive cases, only 16 cases have been reported so far this year. He attributed the decrease to effective advocacy and awareness campaigns focused on source reduction.
Dr. Kere informed that NVBDCP teams in the districts are actively conducting awareness programs and checking domestic breeding sites to remove mosquito larvae. He noted that serotypes 1 and 2 were detected during last year’s outbreak. He stated that since many people were affected by these serotypes, some immunity has developed, which may explain the lower number of cases this year. However, he cautioned that the arrival of serotypes 3 and 4 could lead to a spike in cases.
In Dimapur, where the house index was notably high last year, it has decreased this year thanks to mass awareness and intervention efforts. Dr. Kere also mentioned that district hospitals have been informed to set up separate dengue wards.
Turning to Japanese Encephalitis (JE), Dr. Kere expressed concern over the neurological deficits caused by the disease. He reported that this year, there have been 4 cases in Mon, 5 in Dimapur, and 1 in Peren, with no deaths recorded so far. He noted that four districts—Mon, Peren, Phek, and Kiphire—are not covered by the JE routine immunization program. Given the high case fatality rate of JE, he stressed the importance of introducing routine immunization in these districts.
Dr. Kere explained that JE is transmitted by Culex mosquitoes, which can amplify the virus in pigs, allowing it to survive for up to a year. He noted that while human-to-human transmission does not occur, mosquitoes that bite infected pigs can transmit the virus to humans.
Regarding prevention efforts, Dr. Kere highlighted that fogging for adult mosquitoes is being conducted in areas where cases have been detected. However, due to the JE virus’s prevalence in jungle and paddy field areas, fogging in these regions has been challenging. Despite this, he assured that NVBDCP teams are doing their best and that the districts are on high alert, which has helped control the situation so far.
Dr. Kere predicted that dengue cases would decrease by the end of October, as mosquitoes typically do not survive in winter. However, he cautioned that dengue-infected mosquito eggs can survive for up to a year, and mosquitoes lay eggs in any discarded container where water accumulates.
Regarding other diseases, Dr. Kere said that Mpox is not currently a threat in the state, but the Zika virus, which is transmitted by the same Aedes mosquitoes responsible for dengue and chikungunya, remains a concern.
Addressing malaria, Dr. Kere recounted that in 2009, Nagaland recorded its highest number of malaria cases—8,489 positive cases with 35 deaths. Since then, the number of cases has consistently decreased. Last year, there were 4 indigenous cases and 5 imported cases, with “indigenous” meaning the infection originated within the state and “imported” indicating infection from outside the state. So far this year, only 2 malaria cases have been reported. He attributed this decline to changes in weather, noting that malaria vectors do not survive in higher temperatures and tend to move to cooler regions, according to an entomological report.
Dr. Kere also remarked that Aedes mosquitoes, which cause dengue and chikungunya, are more resilient than malaria vectors. Dimapur, once a malaria hotspot, has seen a reduction in cases due to interventions such as the distribution of larvivorous fish and LLINs. He explained that malaria vectors are now mainly found on the outskirts, particularly in jungle areas.
He further noted that Aedes mosquitoes, which transmit dengue, chikungunya, and Zika, bite during dawn and dusk, while Anopheles mosquitoes, which cause malaria, bite at midnight.
Dr. Kere further informed that 8.45 lakh LLINs have been distributed across the state to families, jhum cultivators, migrant laborers, schools, colleges, and hospitals, with usage monitored fortnightly.
Deputy Director of NVBDCP, Dr. Tinurenla Anicahri, and state consultants also attended the meeting.