An outbreak of the deadly dengue virus in southern Pakistan has now spread to the north, partly because more people have been travelling across the country for Eid, medical officials say.
The four-day national Eid ul-Fitr holiday, which marks the end of Ramadan, started on Tuesday and has seen thousands boarding trains, buses or coaches to visit family or return home.
Microbiologist Dr Abbas Hayat, head of the pathology department at Rawalpindi Medical College, close to the capital, Islamabad, expressed apprehension that "as more and more people arrive from areas in Sindh where the disease is endemic, there is a danger the epidemic will spread".
Mosquitoes spreading the disease have ended up in buses or trains heading north; or those already infected with the virus in the south have been bitten by local mosquitoes at their destination, causing the disease to spread further.
Most often, the viral infection manifests itself as high fever, body aches and joint pains and most victims recover within a fortnight. However, in some cases, the disease takes the form of dengue haemorrahagic fever, which can cause uncontrollable bleeding, leading to death if not treated swiftly.
There have been cases in Peshawar, the capital of the North West Frontier Province (NWFP), in the Islamabad and the city of Rawalpindi that lies adjacent to it.
Hundreds of patients are in hospital in the Islamabad and Rawalpindi areas and on Monday Rawalpindi saw its first confirmed death from the disease.
Mehreen Bano, 14, a patient brought to the Cantonment General Hospital (CGH) in Rawalpindi from the nearby village of Pindigheb, died within an hour of being admitted. The girl was reported to have been suffering high fever and nose bleeds for several days.
"Mehreen was brought to the hospital on Monday morning, but her condition was severe and she died within half an hour," Dr Shafiqur Rehman, the medical officer at the CGH, told IRIN.
Out of 77 blood samples sent for testing from the Rawalpindi area to the National Institute of Health (NIH) in Islamabad, 14 have tested positive for the dengue virus. It is believed dozens more, currently either in hospital or discharged after initial treatment, could be suffering from the disease.
However, a severe shortage of testing kits at hospitals has made it difficult to determine the numbers infected. Hospitals across the country are currently demanding testing kits, with more and more suspected patients coming in daily.
The long Eid break has added to the problems in acquiring new kits and pharmaceutical companies involved in importing the kits say it could be two weeks or longer before more can be brought in. "It is a case of market dynamics. The demand is unusual and we were not ready for it, Peshawar-based pharmacist Fazal Afzal said.
Health experts across the country have warned that the dengue epidemic could assume still more serious proportions over the coming days, due to a continuing lack of sufficient public awareness and a failure to take measures to prevent breeding of the Aedes mosquito, which carries the virus.
The onset of colder weather, which would kill off the mosquitoes, is seen as the main hope in stopping the rapid spread of the disease.
There have so far been 432 confirmed cases of dengue in the southern port city of Karachi, the capital of the Sindh province. At least 12 people have died since the outbreak hit in mid-September, the World Health Organization (WHO) has said. While more than 160 patients are still hospitalised in Karachi, the epicentre of the mosquito-transmitted epidemic.
At least another 1,500 people in the province are thought to be infected.
All hospitals in Peshawar, Rawalpindi and Islamabad have been placed on high alert, and isolation wards have been set up at them for patients showing symptoms of dengue.
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions
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