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Thursday, Oct 17, 2019

Take care, but don’t panic, doctors advise dengue patients

Unnecessary hospitalisations, excessive emphasis on platelet count, irrational remedies do not help dengue patients, experts argue

pune Updated: Sep 18, 2019 16:48 IST
Renu Deshpande Dhole
Renu Deshpande Dhole
Hindustan Times, Pune
In fact, 90 per cent of dengue patients recover on their own, with nothing else but a prescription of paracetamol.
In fact, 90 per cent of dengue patients recover on their own, with nothing else but a prescription of paracetamol.(PICTURE FOR REPRESENTATIONAL PURPOSES ONLY)
         

Doctors In the city have urged people to take precautions and not panic with regards to the prevalence of dengue in the city.

“A renowned city hospital has had to turn down other patients because dengue patients are occupying most beds. Dengue patients themselves often insist on being admitted because of the scare around the disease. Not all persons who’ve contracted the dengue infection need to be hospitalised,” Dr Bharat Purandare, consulting infectious diseases physician, said.

In fact, 90 per cent of dengue patients recover on their own, with nothing else but a prescription of paracetamol. “Many people recover from this viral infection without much medical intervention, as if they would from common flu, without even realising it’s dengue. Severe/ complicated dengue is seen in only about 10 per cent patients and only 5 per cent of dengue patients need to be hospitalised. Dengue is life-threatening in less than 1 per cent patients,” Dr Anant Phadke, renowned health activist said.

The panic around dengue has also brought unnecessary focus on the platelet count. “Most doctors haven’t come across cases where a drop in platelet count has proved to be life-threatening for anyone. Platelet count is only a surrogate marker – it only means that a patient whose platelet count is low is more vulnerable to risks such as decreased blood pressure, organ damage etc. And it is often this organ dysfunction which is dangerous. Low platelet count per se doesn’t kill anyone. Many patients with low platelet count walk out completely fine,” Dr Purandare observed.

Doctors said that platelet count alone does not give a complete picture of a dengue patient’s health. “Excessive dependence on platelet count for management of dengue might lead to doctors missing the warning signs of Dengue Shock Syndrome (DSS). Checking the pulse of the patient and measuring the blood pressure are two simple ways in which a doctor can monitor the infection. If the pulse has increased and the blood pressure has dropped, that means corrective steps for dehydration need to be taken,” Dr Phadke said.

According to Dr. Purandare, “Only 10 per cent patients go into DSS, but it has high mortality. Preventive steps can be taken at the right time if the doctor catches the early signs by monitoring four things – temperature, pulse, respiratory rate and blood pressure. In a country like ours, where the doctor-patient ratio is so skewed, this simple monitoring may be overlooked. But medical examination is irreplaceable and only blood investigation is not enough.”

While the platelet count often comes back to normal (around 1.5 lakh) without any medication and only one in a thousand patient needs platelet transfusion (if the count is less than 10,000), it is advisable for dengue patients to visit the doctor every day to check the vitals and keep a track of the vitals. “There’s no need to panic and go for irrational remedies. There’s no scientific evidence for Kiwis or Papaya leaves increasing platelet count. There’s no vaccine or treatment for dengue. Caution is important,” he said.

First Published: Sep 18, 2019 16:48 IST

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