Pimpri Chichwad municipal corporation engineer dies of dengue induced HLH

Jeevan Gaikwad (57), was undergoing treatment at the Ruby Hall Clinic and according to doctors, was suffering from haemophagocytic lymphohistiocytosis (HLH), a rare syndrome, which is sometimes induced due to dengue.
Jeevan Gaikwad, 57, was an executive engineer working with the Pimpri Chinchwad municipal corporation’s road department.(HT Photo)
Jeevan Gaikwad, 57, was an executive engineer working with the Pimpri Chinchwad municipal corporation’s road department.(HT Photo)
Updated on Oct 04, 2018 03:31 PM IST
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Hindustan Times, Pune | ByNozia Sayyed

An executive engineer working with the Pimpri Chinchwad municipal corporation’s (PCMC) road department died due to dengue on Wednesday. Jeevan Gaikwad (57), was undergoing treatment at the Ruby Hall Clinic and according to doctors, was suffering from haemophagocytic lymphohistiocytosis (HLH), a rare syndrome, which is sometimes induced due to dengue.

In 2018, the state has so far recorded 18 dengue deaths as compared to 68 deaths reported last year. Two deaths have been reported in the Pune municipal corporation and two deaths have been reported from Pune rural areas.

Dr Prachee Sathe, ICU director, Ruby Hall Clinic, said, “Gaikwad came to us on Monday and was critical. He suffered from dengue induced HLH. HLH is difficult to diagnose. Even though we were successful in diagnosing him, he succumbed to the illness on Wednesday due to delayed admission and high mortality rate of the condition.”

Gaikwad, according to doctors, was unwell since the past eight days.

Dr Rajesh Gadia from KEM Hospital, who is heading the largest dengue project in India, where they have treated more than 6,000 cases, said, “This condition is rare and hence, manageable only if the patient is diagnosed early. The treatment, if done properly and diagnosed early, improves the chances of survival.”

Doctors have confirmed the viral strain doing rounds in the state and specifically Pune, is type three (strain of dengue). Detected through reverse transcription polymerase chain reaction test (RT PCR), it is said to be a mild form of dengue and not as hazardous as dengue type 2.

“There is no need to panic as the strain doing rounds in Pune and surroundings cities is not dengue HLH, but dengue type three. This strain is extremely mild and treatable. There are currently 20 cases admitted with us from Pune, Kolhapur, Baramati and Daund; the worst hit is Kolhapur. Only one patient is on ventilator support. So far, we have had 100 patients of dengue in the last two months and all have survived,” Gadia said.

Dr Mahendra Jagtap, state entomologist, said, last year there were a total of 68 deaths due to dengue whereas this year only 18 deaths have been recorded so far. “This is because the strain is in its milder form. Early diagnosis and proper management not only increases the chances of survival, but also decreases the chances of multi-organ failure,” he added.

“It is a myth that HLH takes place in only dengue patients. It is seen in any patient who has a compromised auto immune system. HLH is basically a normal sight where it can be diagnosed when a doctor sees a rapid dip in all blood parameters and in such cases, if a bone marrow biopsy is done, this test can further determine whether the patient has developed HLH and treatment can be then planned. There is no option, but to use steroids in such cases and the patient can be saved, There is no need to create panic about the condition. HLH can also be seen in HIV patients as well so saying that it is only dengue induced HLH is extremely wrong on part of the doctors who are trying to scare people,” said Dr Raman Gangakhedkar, national director and head of epidemiology and communicable diseases, Indian council of medical research (ICMR), India. Gangakhedkar heads 13 institutes in India which deals with communicable diseases in epidemics like the national institute of virology, national Aids research institute (NARI) among others.

Of the cities and districts that have been hit, state entomologist Jagtap said that Kolhapur recorded five deaths, Pune two, Pune rural two and remaining deaths were reported from elsewhere in the state.

He also said that 68 per cent of the cases of dengue are from urban areas and 32 per cent are from rural areas. Of all the cases this year, 34 per cent have been reported from Kolhapur while Pune has seen only 16 per cent.

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