The primary health centre at Dayalpur village in this subdivison of Haryana has a brand new dengue ward. Over the past week, over 100 villagers with a fever have been landing at the doorstep of the centre — just 40 kilometres from the All India Institute of Medical Sciences in Delhi — each day.
Nine of these patients have very low platelet count, indicating dengue.
Only the sickest are admitted for treatment as the ward has just three beds. The rest are sent home and their treatment monitored through the day. The PHC staff are so worried about the fever outbreak that they have persuaded Sarpanch Dharam Pal to get the village, with a population of 6,700 people, cleaned and sprayed with insecticide.
Most people running a fever are also complaining of nausea and an upset stomach. “All patients with complaints of nausea, vomiting, low blood pressure and a platelet count of less than 1 lakh are being placed under observation for dengue. We have had nine dengue cases so far with the lowest platelet count being 12,000/mm3,” says a doctor at the PHC, as he tries to procure another bed for the new ward. The normal platelet range is 1.5 to 4.5 lakh/mm3.
The situation is only slightly better at the PHC in neighbouring Chhainsa village, where about 90 people with a fever reported at the morning OPD.
“Dayalpur and Chhainsa are reporting more cases because awareness is high and we are encouraging people to go to the PHC. I don’t want private doctors to take advantage of the dengue scare,” says Pal, who decided to act when one of his relatives was asked to deposit Rs 20,000 for treatment at a private hospital.
“The fever first appeared about 10 days ago but appears to have intensified over the weekend. Now, every family has two or three people with complaints of fever,” says Balraj Singh, a farmer who has had a fever and bodyache for the past two days. His wife Hemwati and daughter Seema, 15, are also feverish. Balraj and Seema’s blood test results will be out on Thursday while Hemwati’s test shows a platelet count of 1.17 lakh/mm3.
Their neighbour Narender Singh is also ill; so is his niece Monica. “I usually take paracetamol but this time it doesn’t seem to be working. No insecticide has been sprayed in the village, nor have the drains been cleaned,” he complains.
Some of that is about to change. “The panchayat has procured a pump to spray Malathion and DDT in the entire village. The man we hired today could not operate the pump, so we are getting someone from another village tomorrow to do the spraying,” says Pal.
Despite the fact that the two health centres are run by AIIMS and are among the best in the country, they had no testing facilities for dengue till a day back. Up till Tuesday, doctors here were relying on private pathology labs for results. But on Wednesday, they conducted 14 tests at the PHCs itself. “Platelet count can be done here using a simple microscopic procedure for initial screening of dengue. It will help us identify the serious cases,” says a doctor on duty. One of the patients tested today, Santa Devi from Jaya village, has a platelet count of less than 50,000. The 13 others show platelet counts of over a lakh.
But the doctors here are optimistic. As no deaths have been reported in the two villages, they confirm the virus is not very virulent. “Big hospitals like AIIMS are referral centres and are not indicative of the severity of the virus. Since they get the most serious cases, they have high death rates. How serous a disease is can be truly gauged only in a community setting,” says Shiv Lal, director, National Institute of Communicable Diseases.
Going by the PHCs at Dayalpur and Chhainsa, the dengue strain that has struck this time seems to be mild in potency but all pervasive.