Healthy Soch
“Rise in hematocrit along with rapid fall in platelets is the danger sign in dengue”
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New Delhi, November 15, 2019:
A16-year-old girl suspected to be suffering from dengue died at a Delhi hospital. She was running fever for the last 8-10 days. She was a resident of a housing complex; more than 1500 families are residing in various towers of the housing complex. The National Buildings Construction Corporation (NBCC) is responsible for cleaning, sweeping, collecting garbage and carrying out anti-malarial and anti-larval activities at the complex.
Less than 1100 cases of dengue and no deaths due to the mosquito-borne disease have been reported so far this year in the city. Cases of malaria and Chikungunya have also decreased in Delhi. Of the total dengue cases, there were 787 in October, while in the same month 249 malaria cases were also recorded. 143 cases of Chikungunya have also been reported this year.
Last year, 2,798 dengue cases and four deaths were recorded by the SDMC. It had also reported 473 cases of malaria and 165 cases of Chikungunya.
In 2015, more than 15,000 dengue cases had been recorded and 60 people had died in the national capital.
Preventing death in dengue: Caveats
- A dengue case may become serious when the fever is subsiding or has just subsided. This is the “critical phase”. This usually happens between 5-7 days of onset of illness. Severe dengue is a potentially fatal complication, due to plasma leaking, fluid accumulation, respiratory distress, severe bleeding, or organ impairment. Warning signs include: Severe abdominal pain, persistent vomiting, rapid breathing, bleeding gums, fatigue and restlessness.
- The clinical marker is reduced pulse pressure, which is the difference between upper and lower blood pressure with acute fall in platelet count with simultaneous rapid rise in hematocrit value. Rise in hematocrit along with rapid fall in platelets is the danger sign and is indicative of impending severe dengue. More than the falling platelet count, it is the rapidity of fall in platelet count that is important.
- If the difference between the upper and lower blood pressure is less than 20, rise in pulse by 20, rapid fall in platelets to less than 20, 000 and the hematocrit value is more than 50, suspect serious dengue, especially if the patient is experiencing acute weakness, start fluid replacement at 20 ml/kg/hour immediately before transferring him or her to the hospital
Dr KK Aggarwal
President Heart Care Foundation of India
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