Delhi authorities were spraying high-risk areas with insecticide to kill the mosquitoes that carry the disease, but as the death toll rose to 14, doctors’ associations criticized the government for a belated and ineffective response.

There was chaos at Delhi’s leading public hospital, the All-India Institute of Medical Sciences, where doctors were forced to turn away suspected dengue cases because of a scarcity of beds and blood.

People were being treated in corridors and in tents erected outside the building, and television reporters filming undercover within the building said the shortage of doctors on the dengue wards was so acute that patients were helping administer intravenous saline drips to each other.

The hospital was itself struggling to contain an outbreak of the disease, attributed to mosquitoes breeding in stagnant pools of water on the surrounding campus.

One doctor died last week from the fever, and 19 medical students and staff members have fallen ill.

The inability of the government to cope with what is a relatively routine, annual phenomenon throws into harsh relief the crisis within India’s medical system, illustrating how ill-equipped it is to meet basic public health needs.

The rampant spread of the disease also offers a snapshot of the poor sanitation systems in the capital.

After each year’s monsoon season, Delhi is full of stagnating pools of water that offer ideal breeding grounds for mosquitoes, and open sewers run through the city.

“We have failed miserably to get rid of the mosquito which carries this disease,” said Dr. Sanjiv Malik, national president of the Indian Medical Association, pointing out that public health officials had expected a resurgence of the disease this year because it flares up every three or four years.

“The government failed to cover the open drains and sewage channels,” Dr. Malik said. “They haven’t fumigated properly, and public awareness campaigns are beginning only now, when the outbreak is under way. All this should have happened months ago.”

Known as “brain fever,” dengue fever is transmitted by the female Aedes mosquito. Symptoms include high temperatures, joint pains, vomiting and headaches. Severe cases can be fatal, and there is no vaccine or specific treatment.

The outbreak this year is unusually serious; a year ago, 217 cases of dengue had been registered in northern India, less than half the current figure. Officials warn that the outbreak will continue until mid-November, when the mosquito breeding period ends.

The city authorities threatened to fine people who fail to clean up potential breeding areas, warning that mosquitoes were able to breed inside the water cooling systems that are used as a cheap alternative to air conditioners by large numbers of the capital’s middle classes.

There was widespread dismay at the reports of unhygienic conditions in one of the country’s best medical institutes.

The Municipal Corporation of Delhi said it issued 27 notices to the All-India Institute of Medical Sciences in the past two months asking it to control mosquito breeding on its campus, the Hindustan Times reported.

City officials were out in the hundreds at the beginning of the week, working on the public holiday marking Gandhi’s birthday, to spray large swaths of the capital.

“We have also started random checks of homes, offices and places where there could be stagnant water,” a municipal health official, N.K. Yadav, told local media.

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