What is Dengue Fever?

Dengue is a widespread mosquito-borne infection in human beings, which in recent

years has become a major international public health concern. Dengue virus infections
can present with a wide range of clinical manifestations, from a severe illness to a life-
threatening shock. Both viral and host factors are thought to contribute to the
manifestations of disease in each infected. It is important to understand its burden on
health care. Early diagnosis and suspicion of dengue fever in initial stage might reduce
its effect. We must understand the depth of the problem in terms of its transmission,
clinical presentation, diagnosis, management and prevention.

The World health Organization (WHO) declares dengue and dengue fever to be
widespread in South Asia. WHO currently estimates there may be 50 million dengue
infections worldwide every year. In 2007 alone, there were more than 890 000 reported
cases of dengue in the Americas. Pakistan is at high risk of being hit by large waves
because of many over crowded cities, poor quality of drinking water, inadequate
sanitation, large number of refugees and because of poor health facilities in major areas
of the country. These conditions promote the spread of infectious diseases and
consequently every year a large number of epidemics/outbreaks occur in different parts
of the country.

Dengue in Pakistan:

Pakistan’s first reported a case of dengue fever in 1994. Dengue virus is now pervasive
in Pakistan, circulating throughout the year with a peak incidence in the post monsoon
period. Recent flood in Pakistan made the situation much worse. Dengue Surveillance
Cell Sindh reports 1809 suspected Dengue out of which 881 confirmed till 11th October
2010 with 5 deaths while 16 confirmed cases reported in Islamabad without any death.

Dengue fever is an important infectious disease in Pakistan with increasingly frequent

epidemics. Despite the efforts of the Government of Pakistan, especially in the province
of Punjab, the high cost of prevention has limited the ability of Pakistan to control this.
In Pakistan, in the summer of 2011, more than 300 people died of Dengue fever. The
occurrence of the disease was over 14,000. The outbreaks occurred mostly in the
Lahore. In November 2010, more than 21204 people were diagnosed with dengue fever.
Those infected were mainly from Punjab. Patients were admitted to dedicated wards in
government hospitals.

The secretary of the Punjab Mineral Development Corporation, Ataullah Siddiqui and
Ghias-ud-Din, a member of the Punjab Public Service Commission died as a result of
the dengue fever. On 30 September 2011, the Punjab MPA Mumtaz Jajja also died of
dengue fever. Eight Chinese engineers were reported ill.

Government response:

After all these situations, a special tribunal for Dengue fever was made by the
government of Pakistan. The chairman of the Dengue Emergency Response Committee
was Khawaja Saad Rafique. The Government of Pakistan and the provincial
Government of Punjab took precautionary measures to reduce the spread of the disease.
A hotline called the "Punjab Health Line Project For Dengue" was opened to facilitate
knowledge of the signs and symptoms of dengue fever. Teams of workers smoked areas,
particularly educational institutions and rural areas where the mosquito was present. In
early September 2011, the Government of Punjab ordered the schools, colleges and
universities in Punjab to close for 10 days for intensive fogging to eliminate the
mosquitoes. Article 144 was implemented in Lahore city for the prevention of dengue
fever. After an appeal by the Government of Punjab, private hospitals agreed to provide
free treatment to dengue patients. The Punjab government worked to increase public
awareness. Local authorities in Hyderabad held a seminar. Other programs were held
in educational facilities. A 24-hour government sponsored online service, the "Punjab
Health Line Project For Dengue" provided information about the disease and its
prevention.
International response

For the prevention of Dengue disease, international aid was also received to Pakistan.
In 2011, the Government of Sri Lanka gave medicines and staff to Punjab. A group of
12 doctors from Sri Lanka came to Lahore for contribution. The Indonesian government
sent a medical team of twenty doctors to assist the Pakistani authorities. The World
Health Organization provided technical guidance along with support for provincial and
territorial dengue monitoring and coordination committees.

PAPAYA Leaf Juice:

Therefore, beside of the various method and techniques adopted by Pakistani

government and other institutions for the treatment of dengue fever, we are introducing
a new product that is “Papaya Leaf juice”.

The main objective of the product is to cure dengue fever as well as health conscious
and elergic people. A study was done to investigate the potential of papaya leaves
extracts against Dengue fever in a 45 year old patient bitten by mosquitoes. For the
treatment of Dengue fever the extract was prepared in water. 25 mL of aqueous extract
of papaya leaves was administered to patient infected with Dengue fever twice daily for
5 days.

Case:

A male patient aged 45 years old working as truck driver in a cement factory, was
brought to the emergency department with sever fever of 104 °F. The symptom included
breathing problem, sever vomiting, sever body pain and high blood pressure. He said
that he had been driving truck and transporting cement to various regions of KPK.
During his journey, he used to stay at different locations for rest, at that time he was
bitten by mosquito. After 24 hour of which he started feeling sever pain in whole body.
In the same days three to four patients died of Dengue fever. Subsequently the patient
was admitted in emergency unit in Abbottabad Medical Complex. On the basis of
screening blood test examination he was declared to be a victim of Dengue fever.
The patient has been given different antibiotics and anti malarial drugs but there were
no signs of improvement, and his condition became worse time by time. At the same
time a team was working on the biological activities of papaya leaf. For the patient's
treatment, the leaves of the papaya were collected and thoroughly washed with water.
The leaves were grinded in fruit juicer with water. After extract administration the
patient blood was rechecked for platelets counts again for five consecutive days. After
which the patient starts improvement.