• Cases surpass 55,000 as hospitals struggle with rising admissions
• Nearly 800 new infections reported daily as outbreak intensifies
• Climate change, urbanisation, legal loopholes fuel worsening outbreak
• Authorities warn mosquito breeding in public institutions remains a major challenge
• Weak enforcement outside Western Province hampers mosquito control
• Economists caution prolonged epidemic could inflict heavy economic toll

Sri Lanka’s public healthcare infrastructure is being pushed to its absolute limits as a catastrophic dengue epidemic sweeps across the island. With nationwide infections officially surging past the grim milestone of 55,000 cases, nearly 800 new patients admitted daily, and emergency treatment units filling up, the country has now entered a critical phase.

While the alteration in the epidemic’s rhythm has been attributed to changing climate patterns, the fact remains that dengue has become a recurring public health crisis in Sri Lanka, particularly within the Colombo Municipal Council (CMC) area, where high population density, rapid urbanisation, inadequate waste management, and frequent water stagnation continue to create ideal breeding conditions for Aedes mosquitoes. 

Despite annual vector-control campaigns and public awareness drives, the city records significant dengue outbreaks year after year, especially during and after monsoon periods. Health authorities have repeatedly identified construction sites, neglected premises, and densely populated neighbourhoods as major contributors to mosquito breeding, making dengue a persistent challenge.

The present situation

To date, Sri Lanka has reported 57,668 dengue cases this year, with adults over the age of 20 accounting for the vast majority of infections, according to the National Dengue Control Unit (NDCU). The highest number of cases has been recorded in the Western Province, with 30,253 cases reported so far.

The CMC has reported 2,404 dengue cases this year as of Wednesday (1), accounting for 4.3% of the country’s overall dengue caseload. CMC Chief Medical Officer of Health Dr. K.A. Sriprathapan, speaking to The Sunday Morning, said: “Up to yesterday (1), 2,404 cases have been reported – 4.3% of the islandwide total of 55,406 cases. We have recorded no dengue deaths in the CMC area this year.”

On 30 June, the University of the Visual and Performing Arts in Colombo was temporarily closed due to the rapid spread of dengue fever among students. While it is scheduled to reopen on 13 August, all academic activities, examinations, and tests have been postponed for now and student hostels have also been completely closed. 

When contacted by The Sunday Morning, NDCU Consultant Community Physician Dr. P.C. Samaraweera stated that several factors had contributed to the current outbreak, including unplanned urbanisation, internal migration between districts, different immunity levels of people, and the prevalence of obesity and diabetes.

“Among these, the higher proportion of the type two dengue serotype is a significant factor,” she said, adding that the prevailing weather conditions had further worsened the situation. According to her, intermittent rainfall and sunny periods serve to create more breeding grounds for mosquitoes, contributing to the increase of vector densities (the number of disease-carrying mosquitoes in an area).

Dengue mitigation efforts

The majority of dengue mosquito breeding sites in Sri Lanka have so far been identified in Government institutions and public places such as schools, while abandoned and unoccupied properties continue to pose a significant challenge to control efforts, according to the Public Health Inspectors’ (PHI) Union of Sri Lanka.

While several attempts at bringing the situation under control are presently underway, Dr. Samaraweera emphasised that inappropriate waste management remained a significant challenge. “Mosquitoes breed the most in waste, so when it is not disposed of properly, this effect continues,” she said.

According to her, despite the continuous dengue control programmes and efforts, case numbers are yet to show a decline.

Colombo’s dengue tackling efforts

Incidentally, Dr. Sriprathapan said that the CMC had adequate funding to continue its dengue control activities. 

Meanwhile, a special three-day Dengue Eradication Programme was launched by the CMC on Thursday (2) in coordination with the Environmental Police and provincial authorities, highlighting efforts to control the situation. The programme was implemented under the guidance of the Ministry of Public Administration, Provincial Councils, and Local Government.

According to Minister of Public Administration, Provincial Councils, and Local Government Prof. Chandana Abeyratne, officials from district secretariats and divisional secretariats across the country are part of the Dengue Eradication Programme, running alongside the Clean Sri Lanka programme.

The special programme primarily targeted Government and private institutions, schools, religious places, construction sites, unoccupied lands, and abandoned houses – all of which are common breeding grounds for mosquitoes.

“It is not only fumigation. We are carrying out premises inspections, fumigation, and spraying simultaneously. At the end of the day, we analyse the data and take legal action against those maintaining mosquito breeding sites,” Dr. Sriprathapan said. 

He added that the CMC had identified several high-risk sites that required enhanced interventions, including Cinnamon Gardens, Thimbirigasyaya, Narahenpita, Kirula, Kirulapone, and Gothamipura.

Additionally, according to him, the CMC has engaged in around 600 instances of legal action this year against people and institutions that have allowed mosquito breeding on their grounds.

Gampaha under control?

Meanwhile, despite a number of recorded cases, the Gampaha Municipal Council maintains that dengue is still under control within the municipal area. Authorities are said to be maintaining inspections, fogging operations, and awareness campaigns in high-risk areas. 

According to Gampaha Mayor Eric Lakshman Ediriwickrama, the council has allocated adequate resources for dengue control efforts and is continuing to undertake prevention measures throughout the area. “In any case, there is no outbreak in the Gampaha municipal area, but there are some cases reported. Our situation is under control,” he said.

Ediriwickrama stated that inspections were conducted on a regular basis at schools and Government buildings, as well as fogging operations to reduce mosquito populations. Adding on to the mitigative attempts, a special dengue control programme had been organised in the Yakkala North area following a dengue-related fatality.

Kalutara’s eradication activities

Speaking to the The Sunday Morning, Public Health Inspector (PHI) of Kalutara Gihan Malinda Fernando said that dengue control activities in the Kalutara Municipal Council area were being carried out with existing public health resources, with authorities relying on routine inspections and targeted legal action rather than a dedicated dengue control budget.

According to Fernando, dengue prevention initiatives are mostly carried out by staff from the Medical Officer of Health (MOH) office, with minimal additional funding.

“We don’t usually spend a lot of money on separate dengue control programmes. We carry out these programmes using the staff already available at the MOH office. If we conduct a special programme, perhaps on a Sunday, we might provide tea or some food, but we haven’t really spent much on such programmes. We have been managing by utilising the available officials as much as possible,” he said.

He said that public health authorities kept track of the number of houses inspected as well as the locations where mosquito larvae were discovered, with inspections conducted on a regular basis these days.

Fernando added that prompt legal action would be taken against those found maintaining mosquito breeding sites. “We have filed about six court cases within the municipal council area over the past 2–3 months,” he said.

He also noted that the Kalutara Municipal Council region was not experiencing severe dengue transmission at present: “We don’t really have an epidemic situation in the municipal council area. The epidemic is currently in the Kalutara Pradeshiya Sabha area, specifically in the Pulathisi Grama Niladhari Division, where the industrial zone is located.”

According to Fernando, intensified control measures, including fogging operations, are being implemented in the affected area. “We have been doing a lot of fogging and other activities there. About 15 cases have been filed recently, and each factory was fined Rs. 10,000,” he said.

Barriers to controlling the situation

While several efforts are being carried out across Sri Lanka, several challenges have cropped up amidst the chaos. 

PHI Union President Upul Rohana stated that although recent entomological surveys showed that the general population was increasingly aware of dengue prevention, breeding grounds still existed on properties that were difficult for authorities to monitor, creating a more prominent issue than the assumed lack of knowledge on the general public’s part.

“Currently, most of these positive breeding sites are found in Government institutions and public places such as schools. From the recent entomological surveys, it appears that the general public is acting with some awareness. However, houses and lands owned by people who are not living in Sri Lanka or houses in towns that are kept locked up by owners who live elsewhere are a big problem. We don’t have anyone to take legal action against and no one to even talk to,” he said.

Rohana said that the PHIs did not have the workforce to conduct inspections at every home and institution throughout the year. Instead, surveillance efforts are directed towards high-risk areas identified through data analysis and entomological surveys. “If those surveys show mosquito densities that are high enough to cause an outbreak, we organise programmes and work with the community to conduct cleaning campaigns. Apart from that, we cannot inspect all houses and all locations throughout the year. We really don’t have the workforce to do that,” he acknowledged.

Several attempts to contact the Health Ministry regarding the matter proved futile.

Gaps in the legal system

Despite the present situation painting a dire picture and dengue raising its head year after year, Rohana stated that strong legal provisions that worked to mitigate such epidemics currently existed only in the Western Province under the Nuisances Ordinance. According to him, the act empowers authorities to take direct legal actions and impose spot penalties.

“Outside the Western Province, there are no strong acts or ordinances that allow for direct legal action. Although we have the Prevention of Mosquito Breeding Act No. 11 of 2007, it has faced several legal challenges in Magistrate’s Courts and is generally not being used,” he said.

He added that authorities often relied on the Quarantine and Prevention of Diseases Ordinance, although it only provided limited enforcement powers.

“Even that has been challenged in Magistrate’s Courts in some instances when we used it against dengue breeding sites. Besides that, we use the Penal Code, but that only allows for a maximum fine of Rs. 1,500. As such, outside the Western Province, there is no strong legal framework. We have been requesting amendments to the law for years. But as far as I know, the proposed amendments are still with the Legal Department of the Ministry of Health,” Rohana said.

Hospital capacities

As the situation escalates, hospitals in the Western Province, particularly in Colombo and Gampaha, are currently operating beyond maximum capacity. Addressing the concerns that hospitals may become overwhelmed by the growing number of dengue patients, Dr. Samaraweera said that authorities already had contingency measures in place to manage any surge in admissions.

“When hospitals reach capacity, we have protocols for that. We utilise wards that are less congested, such as ENT or dermatology wards. Additionally, we make back referrals to the hospitals close to main hospitals. We believe it won’t reach a point where the hospitals cannot cope,” she said.

A shift in climate

Continuing to reassure the public despite the sobering data presented, Dr. Samaraweera noted that there was hope, with the situation expected to improve in the coming weeks with weather conditions becoming less favourable for mosquito breeding. 

“Since 8 June, we have been working and running programmes continuously, but the cases have not decreased yet. However, these climatic factors should decrease in a few weeks. With that, we expect the case numbers to drop from this current level within about three weeks,” she explained.

Economic burden of dengue

The current dengue outbreak also poses a threat to Sri Lanka in economic terms. A significant financial burden on the nation’s economy seems unavoidable if case numbers continue to rise, putting further strain on the healthcare system and lowering workforce productivity, according to University of Peradeniya Department of Economics and Statistics Prof. Ariyarathna Herath. 

Prof. Herath warned that a persistent increase in dengue cases would require more Government spending on healthcare services, disease prevention programmes, medicines, and manpower, putting further pressure on public finances. 

“If dengue continues to increase according to the current situation, it will become a severe problem. It will be difficult to manage with the existing capacity of hospitals and infrastructure. It will definitely increase the overall cost of the health sector and badly affect the economy,” he said.

He also noted that the Government may be pushed to increase funding for islandwide dengue preventative initiatives, recruit more paid labour if necessary, and purchase additional medicines and medical supplies to meet increased demand. 

“If our capacity is not enough, it will create a lot of issues. Economic activities may become limited in some sectors. Similar to the Covid-19 period, some areas could even face restrictions or be closed down if stronger control measures become necessary. That will definitely create an economic loss.”

Beyond the direct cost to the hospital system, he emphasised the indirect economic losses caused by infected workers’ inability to return to work for extended periods of time: “These patients are often active members of the workforce, but they may be unable to work for one or even two months while recovering from dengue at home or in hospital. That loss of productivity also creates economic costs. Both the direct healthcare costs and the indirect impact on the workforce will ultimately affect the country’s economy significantly.”