At least 40 people have died of dengue fever in Bangladesh as hospitals struggle to treat thousands of patients affected in the worst outbreak of the deadly disease the country has ever seen.

The mosquito-borne viral infection causes flu-like symptoms and can be deadly if it develops into severe dengue hemorrhagic fever.

“We have confirmed 40 dengue-related casualties so far to Monday,” Health Ministry official Ayesha Akhter told AFP. However, local media has reported that over 100 people have died. Among the fatalities was a four-year old boy, the Dhaka Tribune reports.

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Over 44,000 people have been hospitalized with dengue since January, and 2,100 were admitted on Monday alone. Public health workers have had their holidays cancelled for the first time as they work to manage the epidemic. With the Muslim festival of Eid-al-Adha taking place this week, there are concerns that the disease will spread further as people visit their families in rural areas.

Dengue often occurs during monsoon season, between June and September. This year the disease has turned into an epidemic as the Aedes mosquito, which carries dengue, thrives in urban areas like the capital of Dhaka, where thousands of building sites provide the ideal breeding ground.

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