Bangladesh: Dengue Outbreak - Jul 2023

Bangladesh is experiencing the worst nationwide outbreak of dengue in its history, with a significant impact on the public health system in the country. Sporadic outbreaks have been occurring in Bangladesh since 1964. There was a major epidemic dengue outbreak in 2000 and since then, there have been varying intensities of dengue every year in Bangladesh. In 2019, Bangladesh experienced a major dengue epidemic, with 101,354 dengue cases recorded and 164 dengue-related deaths. However, since the beginning of this year, the number of cases has increased significantly, exceeding cases over the same period of time in the previous years and the number of deaths is the highest ever recorded. (UNICEF, 5 Sep 2023)

As of 18 July 2023, the country recorded 127 fatalities, a staggering five times higher than in the previous year. On 18 July, a record-breaking 1,533 patients were admitted to hospitals, bringing the total number of admissions to 24,000. The current dengue outbreak has affected 60 districts of Bangladesh. Comparing the incidence data from 2022-2023 of all eight divisions, it is determined that incidence is highest in Chattogram, Dhaka and Barisal. (IFRC, 24 Jul 2023)

From 1 January to 7 August 2023, the Ministry of Health & Family Welfare of Bangladesh reported a total of 69 483 laboratory-confirmed dengue cases and 327 related deaths, with a case fatality rate (CFR) of 0.47%. Of these, 63% of cases and 62% of the deaths were reported in the month of July 2023. Although dengue is endemic in Bangladesh, the current dengue surge is unusual in terms of seasonality and the early sharp increase in comparison to previous years, where the surge started around -late June. The CFR so far this year is relatively high compared to previous years for the full-year period. (WHO, 11 Aug 2023)

Between 1st January and 19th August 2023, the Ministry of Health and Family Welfare of Bangladesh reported a total of 97,476 dengue cases (including 37.6 per cent women and 17.8 per cent children (0-18 yrs), with 466 deaths (56.9 per cent females, 18.7 per cent children up to 18 years old). According to WHO, the mosquito-borne disease has spread to all 64 districts in Bangladesh, with one in every five people infected being a child (17.8 per cent so far infected). In Cox’s Bazar, Rohingya camps 1W, 3, 4, 9, 17 and 18 have become hotspots for dengue cases. As of 19th August 2023, a total of 7,196 persons [885 Bangladeshi and 6,311 from Rohingya camps] have confirmed positive for dengue. A total of 609 persons (451 Bangladeshi and 158 Rohingya refugees) were admitted to Cox’s Bazar Sadar Hospital and another 437 persons were admitted to Upazilla Hospitals. 10 persons (8 from Rohingya camps, 2 from the host) died due to Dengue-related complications. (UNICEF, 31 Aug 2023)

As of 4 September 2023, 133,134 dengue cases (including 38% women and 19% children (0-15 yrs) have been infected, with 646 deaths (58% female, 12% children below 15 years old). In Cox’s Bazar, as of 30 August 2023, 9,670 persons (1,214 Bangladeshi and 8,456 Rohingya refugees) had tested positive for dengue. Ten persons (eight from Rohingya camps, two from the host community) died of dengue-related complications. [...] It is to be noted that, these numbers reflect only reported cases from government hospitals and some selected private hospitals that are reporting. The actual number of cases (unreported) is much higher. (UNICEF, 5 Sep 2023)

As of 18th September 2023, 170,768 dengue cases (including 39% women and 19% children (0-15 yrs) have been infected, with 839 deaths (58% female, 12% children below 15 years old). Until 13th September 2023, a total of 12,924 persons [1,808 Bangladeshi and 11,116 from Rohingya camps] had tested positive for dengue. A total of 1,087 persons (845 Bangladeshi and 237 Rohingya refugees) were admitted to Cox’s Bazar Sadar Hospital and another 793 persons were admitted to Upazila Hospitals. 13 persons (11 from Rohingya camps, 2 from the host) died due to Dengue-related complications. (UNICEF, 20 Sep 2023)

During September 2023, a total of 79,598 cases (defined as dengue NS1 or anti-dengue virus IgM positive and hospitalized) including 396 deaths have been reported. This is the highest number of monthly cases and deaths, compared with the available historical data from 2019 to 2023. A total of 206,288 dengue cases including 1,006 deaths have been cumulatively reported between 1 January and 1 October 2023 with a case fatality rate (CFR) of 0.49%. (WHO, 4 Oct 2023)

As of 26th September 2023, a total of 14,272 persons [2,362 Bangladeshi and 11,910 (24th September) from Rohingya camps] have been reported for dengue cases. A total of 1,327 persons (1,071 Bangladeshi and 256 Rohingya refugees) were admitted to Cox’s Bazar Sadar Hospital and another 990 persons were admitted to Upazilla Hospitals. 14 persons (12 from Rohingya camps, 2 from the host) died due to Dengue-related complications. (UNICEF, 8 Oct 2023)

A total of 239,614 dengue cases (defined as dengue NS1 or anti-dengue virus IgM positive) including 1,169 deaths have been cumulatively reported between 1 January and 15 October 2023 with a case fatality rate (CFR) of 0.49%. During September 2023, a total of 79,598 cases including 396 deaths have been reported. This is the highest number of monthly cases and deaths, compared with the available historical data from 2019 to 2023 (Figure 6). (WHO, 18 Oct 2023)

As of 22 October 2023, a total of 255,046 cases (dengue NS1 or IgM test‑positive persons hospitalized in the reporting health facilities), including 1,255 deaths, have been reported in the country, according to the DGHS (Directorate General of Health Services) Dengue press release. In epidemiological week 42 (16 – 22 October 2023), 15,432 new cases were reported, including 86 deaths. The number of new cases dropped by 3.9% from 16,050 the previous week. During the reporting period, 15,845 hospitalised persons were released from the hospital after treatment. The weekly number of reported cases has dropped for the third consecutive week. Decrease in cases is mostly observed in the northern districts where less than or equal to 5 cases are reporting weekly per 100,000 population. [...] All the divisions reported fewer cases compared to the previous week, except Khulna, Mymensingh and Rangpur. Dhaka division reported the highest number of cases. (WHO, 23 Oct 2023)

As of 7th November 2023, 283,593 people (including 40 per cent women and 17 per cent children (0-15 yrs) have been infected with dengue, with 1,425 deaths (57 per cent female, 10 per cent children below 15 years old) reported. Even worse, one in every five people infected is a child, and children under five are at greater risk of severe illness (4 per cent so far infected), with a case fatality rate (CFR) of 0.47 per cent. [...] In addition, as of 7th November 2023, a total of 16,654 persons [3,573 Bangladeshi and 13,081 (31st October) from Rohingya camps] have been reported with for dengue in Cox’s Bazar. A total of 2,038 persons (1,746 Bangladeshi and 292 Rohingya refugees) were admitted to Cox’s Bazar Sadar Hospital and another 1,356 persons were admitted to Upazila hospitals. 18 persons (15 from Rohingya camps, 3 from the host) died due to Dengue-related complications. (UNICEF, 20 Nov 2023)

A total of 6,912 cases of dengue were reported in Bangladesh during week 47 (20 to 26 November 2023), a 26.6% decrease compared to week 46 (13 to 19 November 2023) (n=9 423). The number of new deaths also decreased by 39.2% from 73 in week 46 to 49 in week 47. During October 2023, a total of 67,769 cases including 359 deaths were reported. The highest monthly numbers of cases and deaths based available historical data from 2019 to 2023 were reported in September 2023 (79,598 and 396, respectively). Between 1 and 26 November a total of 36,992 cases including 250 deaths were reported [...]. A total of 308 167 dengue cases including 1,598 deaths have been cumulatively reported between 1 January and 26 November 2023 with a case fatality rate (CFR) of 0.52%. (WHO, 29 Nov 2023)

As of 7th December 2023, 316,160 people (including 40 per cent women and 17 per cent children (0-15 years old) had been infected with dengue, with 1,643 deaths (57 per cent female, 10 per cent children below 15 years old) reported. In Cox's Bazar, as of 2nd December 2023, a total of 17,469 persons [4,062 Bangladeshi and 13,407 (26th November) from Rohingya camps] have tested positive for dengue. A total of 2,300 persons (2,001 Bangladeshi and 299 Rohingya refugees) were admitted to Cox's Bazar Sadar Hospital and another 1,555 persons were admitted to Upazila Hospitals. 18 persons (15 from Rohingya camps, 3 from the host) died due to Dengue-related complications. (UNICEF, 15 Dec 2023)