At least 90 people died of dengue and 28,820 were hospitalised across Bangladesh in the first 16 days of October, according to Directorate General of Health Services figures reported by The Daily Star. That follows 148 dengue deaths in September, already the deadliest month of the year.

The monthly death toll has climbed steadily: 148 in September, 43 in August, 36 in July, 13 in June and one in May. Hospitalisations reached 43,774 in September, 20,536 in August, 9,206 in July, 20,907 in June and 714 in May.

A death review by the Institute of Epidemiology, Disease Control and Research, led by its director Prof Quazi Ahmed Zaki, found that more than one-third of the 119 patients it examined died within a day of being admitted. It found 62.5 per cent died from dengue shock syndrome, 31.2 per cent from expanded dengue syndrome and 16.1 per cent from dengue with bleeding, while 12.5 per cent died from other causes. Many patients also faced diagnostic delays of at least three days.

Medicine specialist Dr ABM Abdullah said repeated infections and delays in diagnosis and treatment were major factors behind the deaths, noting that people infected a second, third or fourth time face a higher risk of severe complications. He urged children and people with diabetes, hypertension, heart, liver or kidney disease, and cancer, not to ignore even mild symptoms, and warned against taking painkillers without medical advice.

Prof HM Nazmul Ahsan of Shaheed Suhrawardy Medical College Hospital said national dengue treatment guidelines were being applied inconsistently. He said a low platelet count alone does not necessarily require a transfusion, and that unnecessary transfusions and excessive fluid can themselves cause complications. He also called for more accessible testing, especially for low-income communities.

Public health expert Mushtuq Husain called for a three-tier dengue management system linking primary, secondary and tertiary care so that major hospitals are not overwhelmed. Entomologist Prof Kabirul Bashar of Jahangirnagar University said cases might dip slightly in November but a clear fall was unlikely before December, and that continued rainfall could prolong the outbreak.

Separately, The Business Standard reported that a DGHS bulletin on 11 October put the year's dengue death toll at 303, with cumulative cases close to 1 lakh. Health experts quoted by the newspaper stressed removing stagnant water and breeding sites, saying larvicide and source destruction work better than fogging alone.