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      Devastating urban flooding and dengue outbreak during the COVID-19 pandemic in Pakistan

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          Abstract

          Pakistan has recently been overwhelmed by extreme torrential rains, with its most populous city of Karachi experiencing its worst floods in almost a century. Poor flood control and water disposal facilities have led to an immense risk of another dengue outbreak, with multiple cases being reported recently. The enormous accumulation of stagnant water in urban areas is a major source of mosquito breeding and transmission. Historical data has shown the correlation between the number of dengue cases and average rainfall in the region. The monsoon rains have pounded at a time where health authorities are battling to contain the Coronavirus (COVID-19) pandemic. There is a need to implement centralized dengue control strategies to undertake large scale water drainage, sanitation, and disinfection drives in disaster-stricken areas alongside public health awareness programs to combat the after-effects of this natural calamity.

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          Most cited references6

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          Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

          Summary Background In December, 2019, a pneumonia associated with the 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China. We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia. Methods In this retrospective, single-centre study, we included all confirmed cases of 2019-nCoV in Wuhan Jinyintan Hospital from Jan 1 to Jan 20, 2020. Cases were confirmed by real-time RT-PCR and were analysed for epidemiological, demographic, clinical, and radiological features and laboratory data. Outcomes were followed up until Jan 25, 2020. Findings Of the 99 patients with 2019-nCoV pneumonia, 49 (49%) had a history of exposure to the Huanan seafood market. The average age of the patients was 55·5 years (SD 13·1), including 67 men and 32 women. 2019-nCoV was detected in all patients by real-time RT-PCR. 50 (51%) patients had chronic diseases. Patients had clinical manifestations of fever (82 [83%] patients), cough (81 [82%] patients), shortness of breath (31 [31%] patients), muscle ache (11 [11%] patients), confusion (nine [9%] patients), headache (eight [8%] patients), sore throat (five [5%] patients), rhinorrhoea (four [4%] patients), chest pain (two [2%] patients), diarrhoea (two [2%] patients), and nausea and vomiting (one [1%] patient). According to imaging examination, 74 (75%) patients showed bilateral pneumonia, 14 (14%) patients showed multiple mottling and ground-glass opacity, and one (1%) patient had pneumothorax. 17 (17%) patients developed acute respiratory distress syndrome and, among them, 11 (11%) patients worsened in a short period of time and died of multiple organ failure. Interpretation The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome. In general, characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia. Further investigation is needed to explore the applicability of the MuLBSTA score in predicting the risk of mortality in 2019-nCoV infection. Funding National Key R&D Program of China.
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            A review of dengue as an emerging disease in Pakistan.

            The presence of dengue virus has been detected using neutralization and haemagglutination inhibition antibodies in local populations in Pakistan since the 1960s. However, the first epidemic was not reported until 1994. This was followed by some cases in 1995, but the disease was confined to the port city of Karachi. Since 2006, dengue epidemics have occurred every year and the range has extended to most cities in Pakistan. Dengue now affects thousands of people and has caused hundreds of deaths. It has become a major health problem in Pakistan, and it is likely to become an even greater health problem in the coming years. This review gives an insight into the dengue situation from the early 1960s to the most recent epidemics in Pakistan, and also describes the primary vector of this disease (Aedes aegypti) in Pakistan. As such, it provides the first comprehensive review of the emergence of this important public health problem. Copyright © 2012 The Royal Institute of Public Health. All rights reserved.
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              Effect of Rainfall for the Dynamical Transmission Model of the Dengue Disease in Thailand

              The SEIR (Susceptible-Exposed-Infected-Recovered) model is used to describe the transmission of dengue virus. The main contribution is determining the role of the rainfall in Thailand in the model. The transmission of dengue disease is assumed to depend on the nature of the rainfall in Thailand. We analyze the dynamic transmission of dengue disease. The stability of the solution of the model is analyzed. It is investigated by using the Routh-Hurwitz criteria. We find two equilibrium states: a disease-free state and an endemic equilibrium state. The basic reproductive number (R 0) is obtained, which indicates the stability of each equilibrium state. Numerical results taking into account the rainfall are obtained and they are seen to correspond to the analytical results.
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                Author and article information

                Journal
                Med J Islam Repub Iran
                Med J Islam Repub Iran
                Med J Islam Repub Iran
                MJIRI
                Medical Journal of the Islamic Republic of Iran
                Iran University of Medical Sciences
                1016-1430
                2251-6840
                2020
                15 December 2020
                : 34
                : 169
                Affiliations
                1Ameer-ud-Din Medical College affiliated with University of Health Sciences, Lahore Pakistan
                2Lahore General Hospital, Lahore, Pakistan
                3Wah Medical College, affiliated with University of Health Sciences, Wah, Pakistan
                4Kabir Medical College, Gandhara University, Peshawar, Pakistan
                5School of Pharmacy, Monash University, Bandar Sunway, Malaysia
                6Department of Pharmacy, Quaid-I-Azam University, Islamabad, Pakistan
                Author notes
                Corresponding author: Dr Muhammad Junaid Tahir, junaid262626@ 123456gmail.com
                Article
                10.47176/mjiri.34.169
                8004574
                33816368
                69c0dc1b-ba82-41de-961b-34727e9956a3
                © 2020 Iran University of Medical Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial-ShareAlike 1.0 License (CC BY-NC-SA 1.0), which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

                History
                : 14 September 2020
                Page count
                References: 15, Pages: 2
                Categories
                Letter to the Editor

                dengue,covid-19,floods,rain,pakistan
                dengue, covid-19, floods, rain, pakistan

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