Urgent need to create social awareness on Dengue!

Prevention measures essential to curb the ongoing dengue menace in the city Despite the best efforts from doctors, the breakbone fever will continue to exist over the next one month

Although, the dengue fever cases registered have decreased over the past few years; the tropical disease has seemed to bounce back in India at a five-year high. The reason for this is the outbreak of a new type of disease virus known as Dengue 4. Given this scenario, the disease occurrence will continue for the next one month, and necessary prevention measures must be taken.

It is extremely important to note that platelet transfusion is only needed in dengue cases where the platelet count is less than 10,000, and there is active bleeding. Unnecessary platelet count can cause more harm than good. Adequate hydration is the best management approach to dengue while monitoring crucial signs. In most cases, hospitalization is not required, and families must not insist towards this as it deprives seriously ill patients from getting hospital beds. Only severe dengue cases must be admitted basis the treating physicians discretion. One must always remember that 70% of the dengue fever cases can be cured just through the proper administration of oral fluids. Patients must be given 100-150 ml of safe water every hour and it must be ensured that they must pass urine every 4-6 hours.

Speaking about this issue, Padma Shri Awardees Dr A Marthanda Pillai National President Indian Medical Association (IMA) and Dr KK Aggarwal Honorary Secretary General IMA and President HCFI said, “The misconceptions that people have about the mosquito-borne tropical disease has contributed towards making India the ‘Dengue capital’ of the world. Nowadays, individuals ignore the fact that the disease is manageable and preventable. Also, it can be effectively treated with the right kind of first aid, medication, and precautions. In addition to this, people forget that surviving dengue the first time doesn’t make us immune to reinfection with another strain, so one should always take precautions after recovering from the infection. The need of the hour is to raise awareness about prevention, treatment options and busy common myths about the disease. Instead of panicking and spreading panic, we must all work together towards solving the problem and preventing as many cases as possible.“

What are symptoms of severe dengue fever?
*Abdominal pain or tenderness
*Persistent vomiting
*Clinical fluid accumulation (pleural effusion/ascites)
*Active mucosal bleeding
*Severe restlessness or lethargy
*Tender enlarged liver

How to identify dengue fever by applying the Formula of 20:
*If there is rise in pulse by 20
*If there is fall in upper BP by 20
*If the difference between upper and lower blood pressure is less than 20
*If there is rise in hematocrit by 20 percent
*If the platelet counts are less than 20,000
*If the petechial count in one inch of the arm is more than 20 after tourniquet test

If all of this happens then it is essential to take 20 ml of fluid per kg body weight in a span of 20 minutes and then approach the doctor.

First aid for Dengue patients:
*If a person has warning signs of dengue with normal blood pressure 10ml of fluid per kg body weight must be administered in the next 20 minutes (oral or IV). Then the dose should be reduced by 50% in the next hour. If they have low blood pressure than the quantity should be 20ml per body weight
*A patient should drink as much fluids as he can
*Best oral fluid is one litre of safe water added with six spoons sugar and half spoon salt
*Anyone who is ill with dengue shouldn’t cut down on food. Consuming nutritious food in sufficient quantities is important.
*Best treatment for dengue is 100 ml of fluids per hour for 48 hours from when the symptoms are noted in patients with normal BP patients and 150 ml per hour in patients with a low BP

Dangerous Parameters: When you should be worried?

While first aid will help you control the situation so that it doesn’t reach the extreme. But a patient is advised to consult a doctor in situations like:
*When there is an absence of baseline hematocrit value. If hematocrit value is less than 40 percent in adult female and less than 46 percent in the adult male, then a doctor should be consulted, as it might be a case of plasma leakage.
*When the platelet counts are rapidly falling.
*When the difference between the upper and lower blood pressure is falling.
*When liver enzymes SGOT levels are more than SGPT levels. Liver enzyme levels more than 1000 can lead to severe plasma leakage and less than 400 can cause moderate plasma leakage.
*When there is a progressive increase in hematocrit with a progressive reduction of platelet count