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Thursday March 28, 2024

Dengue on the rise

By Muhammad Qasim
November 06, 2016

Rawalpindi

The incidence of Dengue Shock Syndrome and Dengue Hemorrhagic Fever has been recording a great increase this year among patients of dengue fever being tested positive and it is alarming that nearly 30 per cent of all patients tested positive for dengue fever here at the three teaching hospitals in town suffered either from DHF or DSS.

Data collected by ‘The News’ reveals that till November 1 this year, the allied hospitals in town received a total of 2,601 confirmed patients of dengue fever of which as many as 782 suffered DHF, while 51 contracted DSS. The on-going severe outbreak of dengue fever has claimed at least seven lives at the allied hospitals this year.

The cases of DHF are differentiated from dengue fever on the basis of history of bleeding from gum or skin while the mortality rate of DSS is much higher as compared to dengue fever. The health experts believe that rare complications of dengue fever, DHF and DSS are more fatal forms of the infection. The DHF occurs usually by day 3-5 of the fever.

Studies reveal that bleeding during DHF can occur from the gums, nose, intestine, or under the skin as bruises or spots of blood especially under a tourniquet. The liver is often enlarged. Patients can have rapid onset of marked drowsiness, lethargy or restlessness or the presence of shock as manifested by a rapid and weak pulse, low blood pressure and cold clammy skin. Such patients should be immediately referred to a good hospital for further management. DHF shock can be a mortal illness and requires rapid and careful in-hospital management with assiduous correction and replacement of fluid, electrolytes, plasma and sometimes, fresh blood/platelets transfusions. Mortality from DHF ranges from 5-30% (in untreated native populations) and the highest risk is to infants under one year.

According to a recent survey done by medicine and emergency department of PIMS, one in every three patients reaching hospitals with fever is suffering from dengue fever and of all patients of dengue fever, nearly 30 per cent patients goes into dengue shock or hemorrhagic fever.

In allied hospitals including Holy Family Hospital, Benazir Bhutto Hospital and District Headquarters Hospital, special measures are being taken to treat dengue fever and a large number of doctors have been deputed to run the dengue screening counters, dengue clinics and especially equipped dengue wards and intensive care units. Intensive Care Consultant at HFH Dr. Muhammad Haroon expressed this to ‘The News’ saying that dengue shock can be prevented by increasing fluid intake from first day of diagnosis. The main reason for deterioration of dengue patient is dehydration, he said.

He added that every patient should increase fluid intake up to three to four litres per day. The next most important thing is monitoring of blood counts. White cells and platelets are decreased in over 87 per cent of dengue positive patients but it should be emphasized that the management of dengue is changed over the last four years by infectious disease society of USA, India & association of critical care medicine, said Dr. Haroon.