The current outbreak of dengue is so aggressive that doctors think it could be one of the worst epidemics in years. Each doctor in Hyderabad is treating up to 20 cases of the mosquito-borne viral infection a day, with patients being rushed to hospitals with blood platelet counts as low as 40,000 to 50,000 where a normal platelet count ranges from 150,000 to 450,000 platelets per microliter of blood.
Doctors in the city report increasing number of dengue cases and fear that the disease could be heading to becoming an epidemic even as government agencies may be misrepresenting numbers.
Even as the disease shows no signs of abating, Dr Sudha Menon, director of internal medicine in Fortis Hospital, says, “The cases are definitely more than last year, and the virus is more aggressive. But as the government does not accept dengue case records from private clinics and hospitals, the severity of the disease this year is being minimised. The fact is that fevers are higher, body pains are greater and the blood platelet count reductions are more serious.The virus is resistant to normal preventive measures; it is getting smarter and is able to resist mosquito repellents and fogging,” adds Dr Menon.
Warning against self-medication
The disease, which is also called Breakbone Fever because of the intensity of the pain in the joints and muscles, has no warning symptoms other than high fever and severe body pain.
Dr Sreedevi Parupati, general physician of Lucid Medical Diagnostics, stressed the importance of seeing a doctor as soon as the symptoms occur. “It is really, really bad this year. If a person gets it a second time, then it becomes very worrying so it is necessary to educate the people to see a doctor and not self-medicate with Combiflam and Paracetamol,” says the doctor.
Dr Sreedevi is especially cautious of Combiflam. “Combiflam is especially dangerous as it reduces the blood platelet count, which can lead to dengue haemorrhagic fever in a person,” she asserts.
The additional challenge dengue brings along is that the disease has no specific treatment. Doctors can only provide supportive care, leaving the body’s own immune system to fight the disease. Worse still, it usually takes three to five days for test results to confirm dengue, so too, Dr Sreedevi cautions that a negative test result should not be taken for granted.
“Patients should do a daily platelet count, and even if the fever subsides they should do a Complete Blood Picture test 24-48 hours later to be on the safe side,” she cautions.
Home remedies not tried and tested
There have been several publications exalting different home remedies to treat dengue, especially the use of juice extracted from papaya leaf as the leaves are believed to increase platelet count.
However, Dr Shyamala Iyengar, senior consultant physician at Apollo Hospitals in Hyderguda, says there is no scientific basis in these claims as there are no scientific evidences that such remedies help. In fact, papaya leaves, for instance, may have chemicals and pesticides in them, which one needs to be careful of.
“There is no harm in trying it, but we need to know how safe the extracted juice is. The disease in 99 per cent people improves by itself, so it doesn’t matter if such juices are used. That being said, no trials have been conducted based on proper scientific methods to prove its benefits. Also, with medicines, one knows the dosages to be prescribed, but with papaya leaf juice, we do not have a unified or quantified dose, so one does not know how much quantity to have. Such trials have unfortunately not been done yet,” asserts Dr Iyengar.
Preventive measures
The incidence of dengue has increased 30-fold over the last 50 years.The dengue virus comprises four distinct serotypes DEN-1, DEN-2, DEN-3 and DEN-4 andcauses a severe flu-like illness and, in some cases, a potentially lethal complication called severe dengue.
As per Dr Iyengar, the dengue mosquito, Aedes aegypti, usually bites during the day. The best forms of protecting oneself is keeping one’s home and surrounding environment clean and preventing mosquitoes from breeding.
But Dr Menon believes not enough is being done in terms of public sanitation and reducing garbage. “Public awareness is also low and water logging is everywhere,” she says.
Even Dr Iyengar agrees with Dr Menon. “Strict measures for environmental sanitation need to be taken to bring down mosquito breeding. There has to be serious political will, and citizens need to take care of the environment and look beyond the walls of their house to battle dengue because we don't know how big a problem we will have on our handsin the next 10-15 years,” she cautions.
