Via The New York Times: Study Points to Vast Underreporting of Dengue Cases in India. Excerpt:
Nearly 300 times as many people are hospitalized with severe dengue infections in India as are officially reported by the government, according to a study published this week.
The study of the mosquito-borne disease, by researchers at Brandeis University in Massachusetts, is part of a growing body of literature demonstrating that no country in the world suffers as many dengue infections as India.
Officially, the Indian government reports that an average of about 20,000 people are hospitalized annually with dengue infections. The Brandeis study suggests that the real number of hospitalizations is closer to six million, and other studies have suggested that the actual number of Indians infected annually is probably more than 30 million.
“In absolute numbers of cases, we estimate that India has the highest absolute number of cases,” Dr. Donald S. Shepard of Brandeis University, a co-author of the study, said in an interview.
The study estimated that the direct and indirect costs of these hospitalizations exceeded $1 billion annually. The Brandeis study was funded by Sanofi Pasteur, which is in the midst of trials of a dengue vaccine. Sanofi Pasteur has a financial interest in suggesting that dengue’s reach and costs are high, but investigators said that Sanofi Pasteur had no control over the conduct of the research.
The study’s methodology, which focused on only one state in its clinical assessments and included broad assumptions about how patients seek care and are tested for the virus, probably underestimated the actual burden of the disease, Dr. Shepard said.
Government officials have long acknowledged that official data vastly underestimates the burden of the illness, but they explain that any change in the system would impede year-to-year comparisons. That the annual dengue epidemic coincides with the beginning of India’s busiest tourist season may also play a role in the government’s decision making.
As Oscar Wilde might say, suffering 20,000 dengue case may be considered a misfortune; suffering 6 million begins to look like carelessness. And 30 million begins to look like policy.