Dengue epidemic has outlasted the rains...and the bills keep coming

Mohammad Tanzim lies beneath a white mosquito net at Dhaka Medical College Hospital. His head rests on a purple pillow. A cannula is taped to his hand. Beside his bed, his family is counting the cost of nine days of dengue.

The 28-year-old runs a small restaurant in Gazipur. He has not been able to open it since falling ill. His elder brother, Mohammad Mustakim, a house painter, has also stopped working to look after him.

By November 2, the family had spent more than 60,000 taka on treatment, tests, medicines and travel between hospitals. 

"We had to borrow the money, and now we have to repay it," Mustakim told Daily Waadaa.

Tanzim first sought treatment in his hometown of Kishoreganj. When his condition failed to improve, the family arranged an ambulance to Dhaka. The journey alone cost between 5,000 and 6,000 taka.

He was admitted to Dhaka Medical College Hospital (DMCH) on October 31.

"If he had received proper treatment there, we wouldn't have had to spend so much money or go through all this trouble," Mustakim said.

The brothers have lost income at the same time as their medical expenses have mounted. Their experience paints a financial burden that hospital admission figures cannot measure.

In Gazipur, Tanzim said, dengue had already unsettled the neighbourhood where he worked.

Shopkeepers and garage workers had fallen ill. Some businesses had temporarily closed. Owners had returned to their villages, worried about becoming infected.

"Many people have fallen ill. Some have closed their shops and gone home out of fear," he said.

Tanzim said two people in the neighbourhood had died in recent weeks. 

He described crowded residential buildings near drains, with workers' families living alongside shops and workshops. He told Waadaa he had seen virtually no mosquito-control activities despite the reported infections.

A hospital system under pressure

At DMCH, patients occupy beds and mattresses spread across a large ward. Intravenous fluid bags hang from metal stands. Relatives sit beside patients, share floor space and attend to family members undergoing treatment.

In another room, a baby lies beneath a mosquito net while two women sit nearby. The net separates the child from mosquitoes, but the hospital surroundings remain crowded.

Three wards have already been designated for dengue patients. Some patients are also being accommodated in regular medicine wards. When Waadaa visited on November 2, 73 of the 78 beds in one dengue ward were occupied.

Dr Sajjad Mahmud, an assistant professor in the hospital's medicine department, expected the remaining beds to fill as new patients arrived to replace those being discharged.

"In the previous two years, dengue cases generally started declining by the first or second week of October. But we are already in November, and patients are still coming in large numbers," he said.

The pressure reflects a substantial national caseload.

According to the Directorate General of Health Services (DGHS), three people died and 1,674 were hospitalized in the 24 hours ending Saturday morning, November 7.

That brought the year's reported deaths to 458 and hospital admissions to 147,580. Another 5,826 patients were receiving treatment in hospitals nationwide.

The death toll had already surpassed the 413 deaths recorded throughout 2025, when 102,861 people were hospitalized.

October accounted for 174 deaths, compared with 148 in September. Another 39 deaths were recorded during the first seven days of November. Dr Sajjad said the spread of dengue beyond major urban centres was particularly concerning.

"Dengue is no longer limited to city corporation areas. We are receiving patients from rural areas as well," he said.

That geographical expansion has implications for hospitals outside Dhaka, where patients may first seek treatment before being referred to larger facilities. For families such as Tanzim's, a transfer to the capital adds transportation costs and can require relatives to abandon work for extended periods.

The disease is also no longer confined to the months when Bangladesh traditionally expects its heaviest mosquito-borne transmission.

At least in the wards visited by Waadaa, November has brought little relief.

The national figures have since moved higher. On November 8, Bangladesh recorded 2,333 new dengue hospital admissions, the highest single-day total of 2026, surpassing the previous peak of 2,249 on October 25.

Three more patients died, bringing the year's death toll to 461. Hospital admissions reached 149,913, while 6,063 patients remained under treatment nationwide.

Dhaka division accounted for 1,124 of the latest admissions. Khulna reported 332 and Chattogram 272, with patients also admitted across the country's other five divisions.

The figures, released by DGHS, show that the outbreak has yet to enter a sustained decline. The scale is severe, though Bangladesh's dengue history has not followed a consistent upward trajectory.

In 2019, the country recorded 101,354 hospital admissions and 179 deaths. In 2022, there were fewer admissions, 62,382, but more deaths, 281. The worst year was 2023, when 1,705 people died. Another 575 deaths followed in 2024.

The 461 deaths recorded so far this year make 2026 the third-deadliest year since national dengue surveillance began in 2000.

Prof Halimur Rashid, director of the Communicable Disease Control programme at DGHS, said this year's outbreak was broadly consistent with previous seasonal trends.

"Dengue cases usually peak in November. We expect them to start declining from mid-November," he told Waadaa.

Mosquito control, and the vaccine

For public health experts, the persistence of dengue points to a larger problem. Bangladesh has spent years responding to outbreaks without establishing a sufficiently sustained programme to prevent them.

Prof Mushtuq Hussain, a former adviser to the Institute of Epidemiology, Disease Control and Research, said transmission was expanding geographically while continuing in areas where dengue had already become established.

"Dengue is spreading into new areas while transmission continues in previously affected places. Without a sustained, scientifically guided vector-control programme, the outbreak cannot be brought under control," he told Waadaa.

The Aedes mosquitoes that transmit dengue breed in water-holding containers and other suitable sites, including those found around homes, construction areas and commercial premises.

Prof Mushtaq said occasional spraying and cleanliness campaigns were inadequate.

He called for an integrated approach involving mosquito surveillance, identification and elimination of breeding sites, environmental management and targeted control measures.

"People already know how dangerous dengue can be. What is needed is to demonstrate, practically and consistently, how mosquito breeding sites can be eliminated," he said.

The problem is particularly difficult in densely populated neighbourhoods where housing, shops, garages and workshops share limited space. Residents can remove standing water from their own premises. But breeding sites elsewhere in a neighbourhood can continue to support transmission.

Prof Mushtaq argued that successive governments had failed to give dengue prevention sustained attention, allowing the disease to spread into previously less-affected areas.

There is also a second question: vaccination.

Bangladesh is considering introducing a dengue vaccine, but no immediate nationwide vaccination programme has been announced.

On October 1, Health Minister Sardar Md Sakhawat Husain said the government was holding discussions with the World Health Organization (WHO), UNICEF and Gavi before making a decision.

Five days later, State Minister for Health Dr MA Muhit said vaccination was being considered as a long-term measure rather than an immediate intervention. An internationally recommended vaccine already exists.

Qdenga, developed by Japanese pharmaceutical company Takeda and also known as TAK-003, has received WHO prequalification.

The WHO recommends its use in children aged six to 16 in areas with high dengue transmission. The vaccination schedule consists of two doses administered three months apart.

The recommendation is deliberately targeted. WHO does not recommend routine use in children younger than six and advises caution in lower-transmission settings because of remaining uncertainties about protection against some dengue virus types among people who have never previously been infected.

Experts said a vaccine programme would not eliminate the need for mosquito control, clinical surveillance or timely hospital treatment. WHO explicitly recommends vaccination as part of a broader prevention strategy, rather than a substitute for existing measures. 

For now, families must rely on avoiding mosquito bites and obtaining timely medical care. At DMCH, Tanzim's immediate concern is recovering sufficiently to return to Gazipur and reopen his restaurant.

His brother must return to painting houses. The business has been closed. Both men have lost working days. The family still has a looming problem to tackle.

"We borrowed the money, and we have to pay it back," Mustakim said.

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