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Female Aedes aegypti mosquito acquiring a meal of blood from her human host, 2006. Image courtesy of the Centers for Disease Control (CDC) / James Gathany. (Photo by Smith Collection / Gado / Getty Images)
For Prabina Maharjan, it started with a headache, which then turned into fever and bodily pain.
When she finally arrived at the Sukraraj Tropical and Infectious Diseases Hospital a week ago, the tests showed something odd for this high altitude city: dengue fever, a more associated scourge. in the low-lying tropics of Nepal.
But as climate change brings warmer temperatures, disease threats are changing – and this year, Kathmandu, the capital of Nepal at the foot of the Himalayas, is experiencing an unprecedented surge in dengue fever.
During the first week of September, more than 1,000 cases of fever were diagnosed at the city's Sukraraj Hospital for Tropical and Infectious Diseases, a quarter of them in the Kathmandu region, said Anup Bastola, Senior consultant in tropical medicine at the hospital.
In previous years, the hospital had mainly seen cases of painful and sometimes deadly disease in people from the lowlands of southern Nepal, he said.
"But this year, we have seen many cases in the Kathmandu valley itself," he added.
In a city that has never faced an epidemic of such magnitude, the fear of dengue fever is such that people go to hospitals to undergo tests, even if they do not go to hospital. Have a simple headache or seasonal flu, said the doctor.
"The flow of patients is so high that staff are testing blood samples late into the night," Bastola said.
Among the patients tested were Maharjan's mother, aged 39, who had also caught the disease transmitted by a mosquito, although she was not hospitalized for a week, as she did. has been.
"We were surprised to be infected with a disease commonly considered a Terai disease," said Maharjan, referring to a tropical region of southern Nepal.
Like many, she wonders why the disease is now taking off in the hills of Kathmandu, 1400 meters above sea level.
"There were also mosquitoes in the valley in recent years, but we have never heard of the outbreak of this disease on such a large scale," Maharjan said.
MORE HEAT, LESS KNOWLEDGE
As climate change creates warmer conditions in many countries, threats to health are changing rapidly. Many authorities are unprepared, warned international public health officials.
According to data released by Nepal's Disease Control Division, more than 250 cases of locally acquired dengue fever were detected in the Kathmandu Valley between mid-July and early September, including two deaths.
Last year, the valley saw only six cases, according to agency figures.
Meghnath Dhimal, head of research at the Health Research Council in Nepal, said rising temperatures associated with climate change was the main factor behind the new threat.
"In Nepal, the first outbreak of this disease occurred in 2006, when only five districts were affected. But this year, the disease was discovered in 56 out of 77 districts, "he said.
Warmer conditions help spread the disease by facilitating mosquito breeding and encouraging the virus to replicate more quickly.
But "the migration of infected mosquitoes and human cases from the tropics (from Nepal) plays a role in seeding the disease" into new areas, he said.
Since there is no vaccine or drug specifically for treating dengue fever, reducing the number of mosquitoes is the main way to reduce its spread, said Dhimal.
But the Nepalese government, faced with a growing threat, has not yet put in place enough programs to do so, he said.
"Because mountain areas are rarely affected by dengue fever, the population and government officials are not well prepared to prevent and control the disease," he said.
In most cases, efforts to combat the problem begin "only after gaining ground," he said.
This means that "insects that are not eliminated this year will (lay eggs and) increase again next year after the temperature starts to reach a favorable temperature," Dhimal said.
Another barrier to disease control is simply the lack of awareness of many people about the emerging threat.
For example, residents can protect themselves from mosquito bites at night, but mosquito bites carrying dengue fever during the day, something that few people in Kathmandu know, he said.
A study he conducted in 2012 found that Nepal's lowlanders were five times more likely than those in the uplands to understand the risks of dengue fever.
If the highlands of Nepal want to fight dengue successfully, "public awareness and vector control through effective government action and community mobilization can be the only effective step," said Dhimal.
Related Video: Mosquito trials create hope of overcoming dengue fever [via AFP]
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