Bangladesh 2023 dengue outbreak

More people in Bangladesh died of dengue in 2023 than over the last 22 years combined in an outbreak that extended further across the country than any other before.^1,2

Let’s uncover more about the specific details of this outbreak – which was Bangladesh's deadliest recorded to date – and the factors that contributed to it…²

Where

• Bangladesh: the first time that dengue was reported in all 64 districts of the country²

The numbers as reported in December 2023

• Over 300,000 infections, 1,598 deaths – though this may be underestimated^3,4

• The fatality rate (0.48% or about 1 death for every 208 dengue cases) was higher than previous outbreaks in the country^2-5

The contributing causes

• Higher than usual rainfall from a longer monsoon season and rising temperatures due to climate change^2,6

• Unusually high numbers of dengue carrying Aedes mosquitoes (more rain can mean more stagnant water for mosquitoes to breed in and the higher temperatures helped them develop faster)^6,7

The impact

• Hospitals in Bangladesh were overflowing with patients while dealing with a shortage of intravenous fluids, crucial for treating the less common, severe cases⁸

• Hospital beds full; left patients to sleep on the floor or return home to self-treat^2,4

• Shortage of basic medical supplies, such as injectable blood bags, testing kits and saline⁹

• Patients with other serious illnesses were dying as over-burdened hospitals struggled to provide them critical support¹⁰

The response

• The Ministry of Health arranged extra beds in state-run hospitals in Dhaka¹⁰

• Hospitals across the country were repurposed to care for dengue patients¹¹

• The government coordinated the removal of breeding sites and spraying of insecticide^10,11

• It also ran various awareness campaigns¹¹

• Through UNICEF, religious leaders worked with the Islamic Foundation to help empower communities with information¹²

• The government requested international help for the supply of test kits, fluids, and laboratory equipment to help detect and manage dengue⁹

• Despite the government’s response, it faced criticism by some over its response with questions as to if a more long-term plan and approach against dengue was needed^4,10,11

Looking ahead

• Some experts felt more training could be provided to healthcare professionals on how to diagnose and treat dengue¹³

• Effective community engagement involving mosques (since Bangladesh is a largely Muslim society, mosques play a role in influencing the community), as well as powerful surveillance systems to monitor mosquitoes could help better manage outbreaks¹⁴

• Vaccines are an effective way to control infectious diseases. There may be a demand for vaccines to protect against dengue in Bangladesh (though they are not yet available in the country): a study found that a high proportion of people would, in principle, accept a low-cost dengue vaccine with a favorable efficacy profile¹⁵