Chief Medical Officer (CMO) Dr Sandeep Chaudhary said that lack of platelets may not be the cause of death in dengue patients. Addressing a virtual meeting with private doctors and nursing home operators on Tuesday, the CMO discussed the subject in detail with them. He said that according to international standards, a patient does not require platelet transfusion unless the platelets count is less than 10,000 and there is no active bleeding.
“Platelets transfusion is not the primary treatment for dengue. In fact, platelets transfusion does more harm than good to the patient if it is used in a patient whose platelet count is more than 10,000,” he said, adding that the primary cause of death in patients suffering from dengue is capillary leakage, which causes blood loss in the intravascular compartment and results in multi-organ failure.
“In the case of plasma leakage from the intravascular compartment to the extravascular compartment, the patient should be transfused with fluids at a rate of 20 ml per kg body weight per hour. This should be continued until the difference between the upper and lower blood pressure is greater than 40 mmHg, or until the patient passes a sufficient amount of urine. This is all that is needed to treat the patient, transfusion of unnecessary platelets can make the health condition of a patient worse.” the CMO said.
According to him, while treating dengue patients, physicians should remember the ‘Formula of 20’ that is rise in pulse rate of more than 20, fall of BP of more than 20, difference between lower and upper BP of less than 20 and the presence of multiple hemorrhagic spots on the arm after the tourniquet test suggests a high-risk condition, and the person needs immediate medical attention.
Dr Chaudhary said that dengue fever is a painful mosquito borne disease. It is caused by any one of the four types of dengue virus, which is transmitted through the bite of an infected female Aedes aegypti mosquito. “Common symptoms of dengue include high fever, runny nose, mild skin rash, cough, and pain behind the eyes and in the joints. However, some people may develop a red and white patchy rash followed by loss of appetite, nausea, vomiting etc,” he said, adding that the patients suffering from dengue should seek medical advice, rest and drink plenty of fluids. “Paracetamol can be taken to reduce fever and reduce joint pain. However, aspirin or ibuprofen should not be taken, as they can increase the risk of bleeding,” he advised.
According to him, less than one percent of dengue cases are at risk of complications, if the public knew the warning signs, all dengue deaths could be avoided. “Dengue NS-1 is the best test for dengue. NS-1 is ideally a positive reading on day one to seven. It does not give false positive reading. If negative on the first day, repeat it the next day. Always ask for an ELISA based NS-1 test as card tests are misleading,” he said.
District Malaria Officer Sharat Chand Pandey said that dengue has been confirmed in 41 patients against the total of 769 ELISA tests conducted so far in the two sentinel labs of the district located at IMS BHU and Pandit Deendayal Upadhyaya (DDU) Hospital.
