First case diagnosed with both COVID-19 and dengue virus infections in Bangladesh: Possible dengue prevention strategies amid COVID-19 outbreak

Coronavirus disease (COVID-19) has been a global concern since January 2020, and the number of COVID-19 cases has been on a rapid surge in Bangladesh since May 2020. More than 20,000 people have been affected, and over 300 died of COVID-19 in Bangladesh as of 17 May 2020.¹ Concurrently, Bangladesh is also on the verge of facing another outbreak, i.e., dengue, an endemic of Bangladesh.² Dengue is a mosquito-borne viral infection and transmitted mainly by the bite of female Aedes aegypti mosquitoes.³ In 2019, more than 100,000 = people got hospitalized owing to dengue virus infection.² As dengue fever and COVID-19 share similar clinical and laboratory profiles, it is challenging to discern these two viruses, and as a result, misdiagnosis would be more frequent.⁴ Estimation suggests the case fatality rate of Bangladesh is low in COVID-19 cases; however, the recovery rate is slow compared with the other South Asian countries.⁵

In addition to this, on 15th May 2020, a 53-year-old man had been diagnosed with both COVID-19 and dengue, and to our knowledge, this was the first case of this kind in Bangladesh. He had been suffering from fever, cough, muscle pain, and breathing complications for 4–6 days and transferred to the intensive care unit (ICU) owing to his critical health condition.² The combination of these two diseases in patients could increase the risk of death and disabilities by several folds. Therefore, the country might have to pay a heavy toll if the dengue outbreak could not be managed early.

However, the government of Bangladesh could take the following measures to manage dengue cases and the suspected dengue cases amid this COVID-19 pandemic: (a) The dengue test should be performed on all suspected patients with COVID-19 symptoms. (b) For those who are confirmed positive for dengue alone, specific temporary medical centers may be established in playgrounds, town centers, stadiums, and so on. It would also be necessary to hold these patients apart from patients with COVID-19. This measure is also significant as most of the specialized hospitals with ICU facilities are transforming into COVID-19 specialized hospitals in Bangladesh. (c) The COVID-19 hotline of Bangladesh should have a separate wing for dengue. From there, the diagnosis and further management of patients with dengue could be coordinated by the Directorate General of Health Services of Bangladesh. (d) Capacity building program on the management of both COVID-19 and dengue cases for health professionals should be commenced.

In addition, prevention of the dengue outbreak could be executed as per the following recommendations of ours: (a) Despite the lockdown-like situation in Bangladesh due to the COVID-19 pandemic, the Aedes survey should be carried out by the respective organizations by the government in Bangladesh especially in Dhaka city. (b) Innovative new technology for controlling the vector should be introduced and implemented, such as Wolbachia project of Bangladesh from 2019.⁶ (c) Destruction of the breeding ground of Aedes mosquitoes and spraying insecticides should carry on. (d) Awareness messages for the general population on prevention and management of dengue along with COVID-19 prevention strategies in both print and electronic media should be incorporated, and (e) finally, active monitoring and surveillance of the vector should be carried out regularly.³ We believe a combination of these measures may help to prevent the impact of the dengue outbreak amid COVID-19 in Bangladesh; thus, it will reduce the case fatality rate and increase the recovery rate of COVID-19 cases, which could be increased by dengue.