Lok Sabha Question No. 934 (UNSTARRED), answered on 2021-12-03
Subject: Dengue Epidemic
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Dhanush M Kumar, Magunta Sreenivasulu Reddy, M.K. Vishnu Prasad, Prataprao Govindrao  Patil Chikhalikar, Gajanan Chandrakant Kirtikar, Ravneet Singh, Ranjanben Dhananjay Bhatt, Bhavana Gawali (Patil), V. Kalanidhi, C.N. Annadurai

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 934 TO BE ANSWERED ON 03 rd  DECEMBER 2021

## DENGUE EPIDEMIC

## 934. Shri Dhanush M. Kumar:

Shri MaguntaSreenivasulu Reddy:

Dr. Vishnu Prasad M.K.:

Shri PratapraoPatilChikhlikar:

Shri GajananKirtikar:

Shri Ravneet Singh Bittu:

ShrimatiRanjanbenDhananjayBhatt:

ShrimatiBhavanaPundalikraoGawali:

Dr. KalanidhiVeeraswamy:

Shri C.N. Annadurai:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether the Government is aware that the increasing dengue  epidemic has become  an annual affair causing lot of health issues including death of patients in the country;

- (b) if so, the details thereof indicating the number of dengue cases reported and death occurred and the financial assistance provided during each of the last three  years and the current year State/UT-wise including Tamil Nadu;

- (c) whether  the  Government  has  issued  any  guidelines/advisory  to  follow  the standard  treatment  procedure  to  prevent  as  well  as  treat  dengue  cases  and  setting  up  of dengue wards similar to COVID treatment, if so, the details thereof and if not, the reasons therefor;

- (d) whether  the  Government  is  engaging  with  public  health  experts  to  chalk  out  a future  action  plan  to  reduce  the  incidence  of  dengue  and  other  non-communicable  and communicable diseases in the country; and

(e) if so, the details thereof along with the other steps taken to control Dengue cases?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE

## (DR. BHARATI PRAVIN PAWAR)

(a)  & (b)

During 2021 (till 21.11.21), a total number of 1,64,103 cases have been reported due to Dengue in the country, as against 2,05,243 in 2019. The Case Fatality Rate has been sustained at <1% since 2008.  It has further come down below 0.2% in 2018 and 0.1% in 2019, which has been maintained  at  this  level  since  then.  Accordingly,  it  cannot  be  said  that  the  Dengue  cases  are rising in the Country.

The  state  wise  details  on  the  cases/deaths  reported  and  the  financial  assistance  provided respectively is at Annexure-I and Annexure-II .

(c)

Government of India has developed National guidelines on Dengue case treatment/management, in consultation with experts and shared with all States/UTs for implementation. The guidelines emphasize on the preparedness of hospitals for case treatment/management. In addition, total 15 advisories  issued  from  time  to  time  to  States/UTs  during  2021  for  prevention  and  control  of dengue including case management.

(d) & (e)

The National Center for Vector  Borne Diseases Control (NCVBDC) administers the National Vector Borne Diseases Control Programme (NVBDCP) for prevention and control of six vector borne diseases i.e., Malaria, Kala-azar, Lymphatic Filariasis, Dengue, Chikungunya & Japanese Encephalitis.  The  programme  guidelines  /  action  plans  for  Dengue  &  other  Vector  Borne Diseases have been developed in consultation with Public Health Experts and States/UTs.

Government of India has taken the following measures for prevention and control of dengue in the country:

-  Provided Technical Guidelines for prevention and control, case management & effective community participation to the States for implementation. 15 advisories were issued from time to time to States/UTs for prevention and control of dengue in 2021.
-  Free  diagnostic  facilities  through  713  Sentinel  Surveillance  Hospitals  and  17  Apex Referral  laboratories  identified  across  the  country  are  fully  functional.   7.26  Lakh  IgM tests have been provided by Government of India. Additional funds have been provided to states for procurement of NS1 kits for early diagnosis.
-  Under National Health Mission, necessary and sufficient budgetary support is provided to states/UTs  for  dengue  control  activities  i.e.,  dengue  case  management,  vector  control activities  (provision  of  domestic  breeding  checkers,  insecticide,  fogging  machines  etc), training support, awareness activities, etc.

As  far  as  Non  Communicable  Diseases  are  concerned,  The  Department  of  Health  &  Family welfare, provides technical and financial support to the  States/UTs under the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), as part of National Health Mission (NHM), based upon the proposals received from the States/UTs and subject to the resource envelope. The programme focuses on strengthening infrastructure,  human  resource  development,  health  promotion  &  awareness  generation  for prevention,  early  diagnosis,  management  and  referral  to  an  appropriate  level  of  health  care facility for treatment of the Non-communicable Diseases.

A  population-based initiative for prevention, control and screening  of  common,  Noncommunicable    Diseases  (NCDs)  i.e.  diabetes,  hypertension  and  common    cancers  has  been rolled out in the country under NHM and also as a part of Comprehensive Primary Health Care. Under the initiative, persons more than 30 years of age are targeted for their screening.  Screening of these common NCDs is also an integral part of service delivery under Ayushman Bharat Health and Wellness Centres.

Preventive  aspect  of  NCDs  has  been  strengthened  under  Comprehensive  Primary  Health Care through Ayushman Bharat Health Wellness Centre scheme, by promotion of wellness activities and  targeted  communication  at  the  community  level.   Other  initiatives  for  increasing  public awareness about NCDs and for promotion of healthy lifestyle includes observation of National and  International  Day  and  use  of  print,  electronic  and  social  media  for  continued  community awareness. Furthermore, healthy eating is also promoted through FSSAI. Fit India movement isbeing  implemented  by  Ministry  of  Youth  Affairs  and  Sports,  and  various  Yoga related  activities are  being  carried  out  by  Ministry  of  AYUSH.   In  addition,  NPCDCS  gives financial support under NHM for awareness generation (IEC) activities to be undertaken by the States/UTs as per their Programme Implementation Plans(PIPs).

National  Multi-sectoral  Action  Plan  (NMAP)  for  prevention  and  control  of  NCDs  has  been developed through series of consultations with various stakeholders including other Ministries/Departments. The action plan has identified action points for 39 Ministries/Departments.

The meetings have been conducted regularly involving public health experts from national level, United Nations Organizations and Non-Governmental Organizations.

Several  committees  involving  public  health  expert  from  National  level,  medical  colleges,  UN organizations etc. have been constituted and regular meetings have been conducted to improve implementation of NPCDCS programme.

Annexure-I Dengue cases reported and death occurred state/UT wise duringlast three years and the current year

| S.N.   | State                    | 2018   | 2018   | 2019   | 2019   | 2020   | 2020   | 2021 (Prov till 21 st Nov)   | 2021 (Prov till 21 st Nov)   |
|--------|--------------------------|--------|--------|--------|--------|--------|--------|------------------------------|------------------------------|
| S.N.   | State                    | Cases  | Deaths | Cases  | Deaths | Cases  | Deaths | Cases                        | Deaths                       |
| 1      | Andhra Pradesh           | 4011   | 0      | 5286   | 0      | 925    | 0      | 3900                         | 0                            |
| 2      | Arunachal Pradesh        | 1      | 0      | 123    | 0      | 1      | 0      | 3                            | 0                            |
| 3      | Assam                    | 166    | 0      | 196    | 0      | 33     | 0      | 75                           | 0                            |
| 4      | Bihar                    | 2142   | 0      | 6712   | 0      | 493    | 2      | 488                          | 2                            |
| 5      | Chhattisgarh             | 2674   | 10     | 722    | 0      | 57     | 0      | 887                          | 0                            |
| 6      | Goa                      | 335    | 1      | 992    | 0      | 376    | 0      | 1137                         | 0                            |
| 7      | Gujarat                  | 7579   | 5      | 18219  | 17     | 1564   | 2      | 9781                         | 3                            |
| 8      | Haryana                  | 1898   | 0      | 1207   | 0      | 1377   | 0      | 10139                        | 7                            |
| 9      | Himachal Pradesh         | 4672   | 7      | 344    | 2      | 21     | 0      | 299                          | 0                            |
| 10     | Jharkhand                | 463    | 1      | 825    | 0      | 79     | 0      | 165                          | 1                            |
| 11     | Karnataka                | 4427   | 4      | 16986  | 13     | 3823   | 0      | 5717                         | 5                            |
| 12     | Kerala                   | 4083   | 32     | 4652   | 16     | 4399   | 5      | 3794                         | 1                            |
| 13     | Madhya Pradesh           | 4506   | 5      | 4189   | 2      | 806    | 0      | 14052                        | 0                            |
| 14     | Meghalaya                | 44     | 0      | 82     | 0      | 4      | 0      | 16                           | 0                            |
| 15     | Maharashtra              | 11011  | 55     | 14907  | 29     | 3356   | 10     | 11294                        | 25                           |
| 16     | Manipur                  | 14     | 0      | 359    | 0      | 37     | 0      | 131                          | 0                            |
| 17     | Mizoram                  | 68     | 0      | 42     | 0      | 67     | 0      | 49                           | 0                            |
| 18     | Nagaland                 | 369    | 0      | 8      | 0      | 1      | 0      | 13                           | 0                            |
| 19     | Odisha                   | 5198   | 5      | 3758   | 4      | 496    | 0      | 7179                         | 0                            |
| 20     | Punjab                   | 14980  | 9      | 10289  | 14     | 8435   | 22     | 22033                        | 0                            |
| 21     | Rajasthan                | 9587   | 10     | 13706  | 17     | 2023   | 7      | 16936                        | 70                           |
| 22     | Sikkim                   | 320    | 0      | 444    | 0      | 11     | 0      | 207                          | 0                            |
| 23     | Tamil Nadu               | 4486   | 13     | 8527   | 5      | 2410   | 0      | 4406                         | 0                            |
| 24     | Tripura                  | 100    | 0      | 114    | 0      | 24     | 0      | 87                           | 0                            |
| 25     | Telangana                | 4592   | 2      | 13331  | 7      | 2173   | 0      | 6284                         | 0                            |
| 26     | Uttar Pradesh            | 3829   | 4      | 10557  | 26     | 3715   | 6      | 27506                        | 8                            |
| 27     | Uttarakhand              | 689    | 3      | 10622  | 8      | 76     | 1      | 732                          | 2                            |
| 28     | West Bengal              | 23301  | 86     | 47928  | 27     | 5166   | 10     | 2878                         | 6                            |
| 29     | Andaman &Nicobar Islands | 49     | 0      | 168    | 0      | 98     | 0      | 159                          | 0                            |
| 30     | Chandigarh               | 301    | 0      | 286    | 0      | 265    | 0      | 1373                         | 3                            |
| 31     | Delhi                    | 7136   | 4      | 5077   | 0      | 1269   | 0      | 9691                         | 9                            |
| 32     | Dadra &Nagar Haveli      | 493    | 0      | 1491   | 2      | 248    | 0      | 450                          | 0                            |
| 32     | Daman &Diu               | 163    | 0      | 625    | 2      | 71     | 0      | 244                          | 0                            |
| 33     | Jammu &Kashmir           | 214    | 0      | 439    | 0      | 53     | 0      | 1187                         | 4                            |
| 34     | Ladakh                   | 0      | 0      | 0      | 0      | 0      | 0      | 0                            | 0                            |
| 35     | Lakshadweep              | 0      | 0      | 0      | 0      | 0      | 0      | 0                            | 0                            |
| 36     | Puducherry               | 592    | 2      | 2030   | 2      | 633    | 1      | 811                          | 0                            |
|        | Total                    | 124493 | 258    | 205243 | 193    | 44585  | 66     | 164103                       | 146                          |

Financial assistance provided under integrated budget for vector borne diseases including Dengue during last three years and the current year

|                |                                    |          |          |          | (Rs. In Lakhs)   |
|----------------|------------------------------------|----------|----------|----------|------------------|
| S.N.States/UTs |                                    | 2018-19  | 2019-20  | 2020-21  | 2021-22*         |
| 1              | Andhra Pradesh                     | 1075.57  | 106.87   | 487.81   | 2182.36          |
| 2              | Arunachal Pradesh                  | 405.89   | 552.28   | 1060.02  | 6.78             |
| 3              | Assam                              | 1591.38  | 2027.14  | 4012.53  | 991.92           |
| 4              | Bihar                              | 1086.00  | 300.00   | 4023.13  | 246.35           |
| 5              | Chhattisgarh                       | 4295.90  | 1751.84  | 941.51   | 215.32           |
| 6              | Goa                                | 65.00    | 93.00    | 0.00     | 4.68             |
| 7              | Gujarat                            | 1102.38  | 1539.00  | 0.00     | 1691.42          |
| 8              | Haryana                            | 374.00   | 32.00    | 72.00    | 80.27            |
| 9              | Himachal Pradesh                   | 155.00   | 3.00     | 0.00     | 1.67             |
| 10             | Jharkhand                          | 5775.19  | 3482.07  | 1762.67  | 327.82           |
| 11             | Karnataka                          | 376.07   | 196.39   | 106.95   | 788.02           |
| 12             | Kerala                             | 528.00   | 102.00   | 155.00   | 210.35           |
| 13             | Madhya Pradesh                     | 5236.58  | 15006.55 | 375.56   | 33.03            |
| 14             | Maharashtra                        | 571.86   | 101.00   | 536.00   | 75.82            |
| 15             | Manipur                            | 124.30   | 312.07   | 941.35   | 1.00             |
| 16             | Meghalaya                          | 171.46   | 350.33   | 1919.84  | 152.00           |
| 17             | Mizoram                            | 235.04   | 339.13   | 773.98   | 14.64            |
| 18             | Nagaland                           | 171.18   | 534.53   | 1557.57  | 0.56             |
| 19             | Odisha                             | 191.44   | 200.21   | 21143.35 | 154.17           |
| 20             | Punjab                             | 213.00   | 40.00    | 1184.37  | 123.26           |
| 21             | Rajasthan                          | 1481.33  | 870.48   | 614.11   | 113.14           |
| 22             | Sikkim                             | 20.00    | 0.00     | 0.00     | 1.00             |
| 23             | Tamil Nadu                         | 694.00   | 113.00   | 368.00   | 48.06            |
| 24             | Telangana                          | 1340.45  | 74.00    | 90.80    | 21.97            |
| 25             | Tripura                            | 301.74   | 1526.61  | 2862.31  | 655.86           |
| 26             | Uttar Pradesh                      | 3823.04  | 2725.00  | 3913.98  | 1879.45          |
| 27             | Uttarakhand                        | 276.33   | 49.14    | 118.50   | 8.51             |
| 28             | West Bengal                        | 1135.77  | 687.70   | 1371.17  | 83.33            |
| 29             | Delhi                              | 0.00     | 18.00    | 53.74    | 0.00             |
| 30             | Puducherry                         | 72.00    | 220.00   | 169.83   | 0.00             |
| 31             | Jammu &Kashmir                     | 223.30   | 6.33     | 13.05    | 0.00             |
| 32             | Andaman &Nicobar Islands           | 27.30    | 252.89   | 23.09    | 1.58             |
| 33             | Chandigarh                         | 53.00    | 43.61    | 110.00   | 7.85             |
| 34             | Dadra &Nagar Haveli and Daman &Diu | 314.00   | 121.00   | 25.00    | 52.45            |
| 35             | Ladakh                             | 0.00     | 0.00     | 756.46   | 0.00             |
| 36             | Lakshadweep                        | 37.00    | 10.00    | 16.00    | 0.00             |
|                | Total                              | 33544.50 | 33787.17 | 51559.68 | 10174.64         |