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Delhi hospitals gear up for more dengue cases

Both government and private hospitals in the national capital and surrounding areas are gearing up to handle an increased number of dengue patients. Nearly 240 cases have been reported so far.

The threat of more people falling prey to the mosquito-borne dengue virus is real as rains continue in spells and stagnant rainwater provides ideal breeding conditions for the Aedes Aegyti mosquito which spreads the virus. This mosquito breeds only in fresh water.

'As many as 50 patients have been landing up at Ram Manohar Lohia (RML) Hospital in central Delhi with symptoms of dengue each day. The number of patients has gone up over the past two weeks. At the end of September and during the first week of October, the number may rise further. To meet the situation the hospital has ordered more intravenous fluids and saline drips,' Karan Vats, a doctor working in RML Hospital, told IANS.

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According to civic agencies, 240 cases of dengue have been reported across Delhi till date, which is high compared to the 13 cases reported in 2012 and 84 in 2011.

Guru Tegh Bahadur (GTB) Hospital in east Delhi attends to dozens of suspected dengue patients each day. At present, 30 patients who have tested positive for dengue are under treatment at this hospital.

'We have 30 dengue patients admitted in the hospital. Every day, over 100 patients throng the hospital with dengue symptoms,' a nodal officer dealing with dengue in GTB told IANS.

The scene is not much different at private hospitals.

Moolchand Hospital in south Delhi recorded 41 confirmed cases in August alone; in the first week of September, 31 confirmed dengue cases were found at this hospital.

'The number of patients has spiralled over the past two weeks. We are giving special attention to three patients who have been detected with Dengue Shock Syndrome (DSS),' said Srikant Sharma, senior consultant, Moolchand Hospital.

There are three types of dengue fever: the typical uncomplicated dengue fever; dengue hemorrhagic fever where the patient bleeds from the nose, gums or under the skin and which generally affects elderly people and dengue shock syndrome (DSS) in which fluid leaks outside blood vessels, causing massive bleeding and shock -- this form of the disease leads to multi-organ failure and is fatal.

'For a patient with DSS, monitoring of blood pressure becomes crucial,' Sharma said.

Fortis Healthcare said 20 suspected dengue cases were reported to them till August but a sudden surge in the incidence of the disease occurred in the past week with 15 cases being reported. Two of these were DSS cases.

'The number of patients has gone up in the last week. We have a dedicated unit of medical staff to deal with dengue patients and any emergency cases, ' Vivek Nangia, director, department of pulmonology, Fortis Healthcare, told IANS.

There is no specific treatment or vaccine for dengue. Doctors say those who suspect that they have contracted dengue should use pain relievers with acetaminophen and avoid those containing aspirin. They should also rest, drink plenty of fluids and consult a physician.

With the number of dengue cases increasing, NationWide - The Family Doctors, a pioneering chain of primary care clinics, has started a dengue helpline for Delhi and the National Capital Region (NCR).

'Through the dengue helpline 9555222570 we will clarify doubts about this infection. We believe increased awareness can lead to faster detection and contain the spread of the virus as symptoms often go unnoticed in the initial stages,' said Shantanu Rahman, medical director, NationWide - The Family Doctors.

Doctors say dengue fever usually starts within a week of the infection. Symptoms include high fever, headache, pain behind the eyes, pain in the joints and muscles, nausea and vomiting and rashes on the skin.

'Rain brings with it high chances of dengue outbreak. Post-monsoon, the weather is conducive for breeding of the Aedes mosquito which causes dengue,' a senior official of the National Vector Borne Disease Control Programme (NVBDCP) told IANS.

The best way to prevent dengue is to check stagnation of water.

As per the experts, the water collected in old tyres, open water containers, stagnant water in pot holes, flower pots, excess water dripping from air conditioners are possible sites for mosquito breeding. Open gutters can also serve as breeding grounds for the Aedes Aegypti.

According to the NVBDCP, 22,092 people were affected by dengue till August. Seventy four deaths have been caused by the disease across the country so far this year.

What is dengue?

It is a tropical disease, usually transmitted by mosquitoes and the common symptoms include fever, headache, muscle and joint pains and skin rash. There is no vaccine for dengue and the only way to reduce infections is to improve hygiene levels so as to prevent mosquito-bites and prevent mosquitoes from breeding. It s particularly difficult to create a vaccine because it s caused by different viruses and there are no animal models available for testing. The disease kills over five thousand Indians every year and is a seasonal threat, particularly during the monsoon seasons.

What are the symptoms of dengue?
Characterized by severe flu-like symptoms, dengue affects infants, children and adults alike and could be fatal. The clinical manifestations of dengue vary with the age of the patient. A person suffering from high fever in the range of 40 C/ 104 F, accompanied by any two of the following symptoms could be suffering from dengue:

Symptoms usually last for 2-7 days. Dengue could progress to severe dengue, a potentially fatal complication, causing leaking of plasma, fluid accumulation, respiratory distress, severe bleeding and organ impairment.

The warning signs to look out for occur 3-7 days after the first symptoms along with a decrease in temperature are:

  • Severe abdominal pain
  • Persistent vomiting
  • Rapid breathing
  • Bleeding gums
  • Blood in vomit
  • Fatigue, restlessness

The next 24-48 hours of the critical stage can be lethal; proper medical care is needed to avoid complications and risk of death.

Once you see any of the above symptoms, do visit a doctor as soon as possible.The diagnosis of dengue fever is usually made when a patient exhibits the typical clinical symptoms of headache, fever, eye pain, severe muscle aches and petechial rash. Usually if a patient is from an area that has a huge population of mosquitoes, dengue can be suspected. A blood test to diagnose people with dengue fever, called the DENV (Detect IgM Capture ELISA) may also be used.

If untreated, the most serious complication is dengue haemorrhagic fever (DHF), in which blood vessels start to leak and cause bleeding from the nose, mouth, and gums. Untreated DHF can lead to dengue shock syndrome (DSS), which is lethal in 90% of cases unless promptly and correctly treated, in which case fatality rates can fall as low as 1%, depending on quality of treatment.

Recently there have been news stories on a dengue strain that affects the liver. This condition is also called dengue hepatitis. It leads to severe organ malfunction and in some cases even organ failure. In the case of dengue hepatitis, fever lasts longer, often for more than a week, and leaves the patient extremely exhausted. An indication of this condition, according to experts is the sudden rise in SGOT (Serum Glutamic Oxaloacetic Transaminase) and SGPT (Serum Glutamic Pyruvic Transaminase) levels, sometime almost 20 times higher than the normal level. Dengue hepatitis is characterized by high fever, lasting more than a week, extreme weakness. The blood tests show an increase in SGPT and SGOT levels, a drop in platelet count and WBCs.

Medication

Because dengue fever is a viral infection, there is no specific treatment for the condition. The patient should seek medical advice and drink plenty of fluids. Symptomatic relief can be sought using NSAIDs (Non-steroidalanti-inflammatory drugs) such as Paracetamol. But drugs such as aspirin or ibuprofen should not be taken since they can increase the risk of bleeding. For severe dengue, medical care by experienced physicians can frequently save lives. It is important to maintain the fluid volume of the patient for recuperation of the patient.

Prevention

Dengue is a communicable diseases spread by mosquitoes from one human to another. So, the only way it can really be prevented is by avoiding mosquito bites. One can make sure all egg-laying habitats of mosquitoes like open and stagnant water source are cleaned up. If there are any open water sources you cannot eliminate, cover them and apply appropriate insecticides. Use protection such as window screens, long-sleeved clothes, and insecticide treated materials, coils and vaporizers.

With inputs from IANS

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