Dengue worries as monsoon nears

Hyderabad: With the arrival  of monsoon, dengue fear grips the city, and not without reason.  Studies have found  that almost 66 per cent of cases of dengue had “unusual and rare manifestation.” Hepatitis was observed in as many as 70 per cent of the dengue cases.

Experts say that the classification of dengue has been expanded by the World Health Organisation to include unusual manifestations of the disease, while  physicians  unaware of  it could jeopardise the diagnosis.

Researchers from the Nizam’s Institute of Medical Sciences studied  dengue patients at the hospital between 2011 and 2013. Unusual manifestations of dengue like acute renal failure, pleural effusion, encephalitis, sepsis, hepatitis, oral candidacies etc. were observed in 66 per cent of the dengue affected patients.

“An unusually high proportion of patients had  unusual and rare manifestations. A lot of these manifestations were noticed in patients who had dengue for the second time,” M. Neeraja, doctoral student at Nims and author of the study, said.

The study was published in Archives of Virology by Neeraja with Dr Lakshmi Vemu and Dr Gopal Reddy in a collaborative research with Osmania University and DRDE Gwalior. About 70 per cent of the dengue patients had Hepatitis as a manifestation while 10 per cent had acute renal failure. Interestingly, almost all the patients were  aged between  21 to 35 years.

Researchers say that it is important to check for the stereotype of the virus causing the disease. Four dengue stereotypes have been  generally identified in the country with a fifth one recently discovered globally. “Stereotype 1 is mostly found in North India. While stereotype 2 and 3 found in South India are responsible for manifestations of the dengue,” Ms Neeraja explained.

Molecular tests  are required to identify the stereotype  but are expensive and hardly carried out. “Lack of awareness among primary physicians may jeopardise clinical diagnosis,” the study noted.