Government's Strategy: Focus on Clinical Management, Not Vaccine Rollout

The dengue outbreak in Bangladesh has reached an alarming level, with the total number of fatalities this year hitting 318. With infections spreading rapidly beyond Dhaka, health authorities are heavily prioritising clinical management and patient care, as a suitable and effective vaccine for all age groups remains unavailable.

Dr. Md. Abu Jafor, Director General of the Directorate General of Health Services (DGHS), confirmed to The Business Standard that the government is not considering a vaccine rollout at this stage.

Dengue vaccines are still under research in many areas, and there is "no effective vaccine for all age groups." While some countries administer existing vaccines in limited settings, "no country is providing it widely."

Aggressive mosquito control and public awareness remain critical. Dr. Jafor urged anyone with a fever to "seek medical advice immediately," noting that late presentation significantly reduces treatment success.

DGHS reports adequate saline supplies in hospitals, and the NS1 dengue test has been made free to ensure accessible diagnosis.

Latest DGHS data highlights the severity of the situation as on 12th November, Total Cases (So Far): 80,634, New Hospitalisations (in 24 hours): 912 (as of yesterday morning), Most Affected Demographics, Infections: 65% are male; the 16–25 age group is most affected, Deaths: 53.2% are male, but there is a worrying concentration among children aged 0–15 years.

Public Health Specialist Prof Dr. Kabirul Bashar warned that the outbreak is "far from under control" and transmission is likely to continue through November. He advocated for shifting from fogging to a comprehensive Integrated Vector Management system with trained manpower and dedicated Dengue Control Taskforces at the ward level.

Globally, two dengue vaccines exist: Dengvaxia and Qdenga. However, neither is currently deemed suitable for a mass public programme in Bangladesh.

Qdenga (TAK-003): The only widely recommended vaccine by the WHO, advised for children aged 6-16 in high transmission areas. It requires two doses and is available in private markets in 24 countries.

Dengvaxia: A three-dose vaccine approved in 19-21 countries. Local Candidate: Bangladesh's leading health research institution, icddr,b, is developing a single-dose tetravalent dengue vaccine candidate, TV005, in collaboration with the University of Vermont (UVM), USA.

In September 2023, TV005 successfully completed its second-phase trial in Bangladesh, showing strong antibody responses against all four dengue serotypes.

A decision on launching the crucial Phase III trial of TV005 is expected next month.

Public health expert Dr. M Mushtuq Husain stressed that until an approved and suitable local vaccine (like the icddr,b candidate) is ready, the focus must remain strictly on prevention and decentralising control and treatment services.