In The World Is Flat, Thomas L Friedman writes about how a shrinking globe and the technological revolution allowed India and China to become an integral part of the global supply chain for services and production.
Globalisation and rapid urban development caused an explosion of wealth and luxury for the Indian middle class. And resulted in us travelling much more than we ever did — within the country and outside — and hosting many more tourists.
A staggering 30,61,446 foreign tourists have visited India since January 2006, roughly three lakh more than last year. But this increased connectivity between people and places and constant movement has also facilitated the spread of communicable diseases like chikungunya — a viral illness that has returned to the country after 32 years — and dengue. On Friday, the central government declared a countrywide chikungunya epidemic.
Dr AC Mishra, director of the National Institute of Virology believes the two major reasons for the rapid spread of chikungunya since it made its return in February 2006 are increased domestic and international travel and a more aggressive form of the virus that travelled from Central or East Africa.
When chikungunya first struck India in the sixties, it was concentrated in urban centres. This time, the rural population is far more affected. “Increased railroad connectivity has resulted in urban problems affecting the rural population,” explains Mishra.
This is aggravated by the hectic construction activity across the country, especially in urban hubs, that has led to pools of stagnant water at construction sites and a population explosion of the day-biting Aedes aegypti mosquito that causes chikungunya and dengue. “And the last straw is that the earlier outbreaks were caused by a milder form of the virus,” says Mishra. “This time, the virus is stronger and is spreading faster.”
While the virus that causes dengue does not spread as fast as chikungunya, the recent outbreak in Delhi has caused much alarm and panic courtesy increased awareness among the general public and media hype.
“Dengue is reported every year. The situation was worse in 2003 when there were roughly 13,000 reported cases of dengue and 240 deaths across the country. This year, some of the cases in Delhi can be attributed to early rainfall, and people being lax about water management,” says Dr Bir Singh, head of community medicine at All India Institute of Medical Sciences.
“Between the first and third weeks of October — the tail end of the monsoon — there is generally a rise in the number of dengue cases,” says Dr James da Costa, a Mumbai-based pathologist specialising in tropical diseases diagnostics. “This usually tapers off by December.”
In an ongoing study, da Costa has found that in 80 per cent of the fever cases, people had developed antibodies to dengue. “We often dismiss fever as a viral infection but many of these cases have had a primary attack of dengue,” he explains. A case of influenza is often presumed. “When the virus returns, it is far more serious and damaging,” says Mishra.
(with inputs from Neha Mehta in New Delhi)