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Fever decoded

With viruses and bacteria infecting people with a vengeance, here's a ready-reckoner on how to differentiate a simple flu from a more potent illness.

health and fitness Updated: Sep 30, 2012 01:28 IST
HT Correspondent

When Tushar Pushkar came home from school with a runny nose and fever five days ago, his mother Deepa hoped it was yet another viral infection that would go away on its own. When the fever stayed over 102o F over three days, the worried mom visited a paediatrician.

"I usually don't rush to a hospital but when the fever did not come down, especially at night, I got petrified that it might be dengue. He stopped eating, lost almost one kg in three days," she says. Luckily for the Pushkars, it was viral fever.

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She's not the only parent fretting about fever-causing infections that seem to be striking the young and old at will. Last week, Priya Walia, 2, developed tiny red rashes on her skin, which turned out to be a viral skin infection.

"Most children these days are turning up with symptoms of respiratory and stomach viral. Priya just needed symptomatic treatment using anti-allergy medicines and calamine lotion because all viral infections are self-limiting and resolve within a week," says Dr Nitin Verma, senior consultant, department of paediatrics, Max Hospital, Saket.

"Seasonal fevers have kept us very busy for three weeks, with most people reporting of a cold, cough and high fever and in some cases, gastrointestinal problems. The current influenza outbreak is quite potent as the illness lasts for a week after which people get better on their own. The fever, however, leaves them very weak," says Dr Anupam Sibal, group medical director of the Apollo hospitals group, who also runs a clinic in Defence Colony.

Since viruses cause most fevers, the disease is self-limiting and the fever takes about a week to go away on its own. "There is no need for antibiotics. The symptoms can be treated to make the patient feel comfortable, and may include paracetamol to bring down the fever, or an probiotics and oral rehydration solution for a stomach infection," says Dr Sibal. Till dengue is ruled out, avoid taking disprin as it can intensify internal bleeding.

Experts say you should look for "localising" symptoms that indicate the underlying cause of the fever. While a cough, runny or blocked nose and a sore throat indicate an upper respiratory tract infection, rash, breathlessness and vomiting could be signs of a serious illness such as dengue. "People, however, should not panic if the platelet count is low as some viral illnesses other than dengue may also cause platelets to drop," says Dr Dr SP Byotra, chairperson, department of medicine at Sir Ganga Ram Hospital, New Delhi. The normal range of platelets is between 1.5 lakh and 4.5 lakh.

Since the platelet count and the total white blood cells (WBC) go down because of other viral infections as well, people need not take lower than normal counts as a surefire indication of dengue. If the fever is dengue, however, the fall in platelets is more dramatic, with people losing up to 50,000 to a lakh in 24 hours.

Even if the blood tests confirm dengue, there is no need to panic. "This year, the strain of dengue going around and most people do not need hospitalisation. The majority of dengue cases can be treated at home with paracetamol (crocin) for fever and lots of water," says Dr Byotra.

A transfusion is needed only if the patient starts bleeding from the gums, mouth or nose or the total WBC goes below 1,500 (normal is over 4,000) and platelets go as low as 15,000.