Dengue management in The Hindu Trichy on 18.10.2017

The Hindu Trichy on 18.10. 2017

Platelet deficiency is not the cause of death, say doctors

R. Krishnamoorthy
TIRUCHI,

OCTOBER 18, 2017 00 :00 IST

UPDATED: OCTOBER 18, 2017 04:33 IST

“Primary cause of death is capillary leakage”

Medical fraternity here have been reaching out to the public with the assurance that dengue patients can effectively be nursed back to health and that there was no need for undue anxiety.

The scenario of people running around in search of platelets for transfusion is all too common in the corridors of the hospitals. However, contrary to the perceptions, platelet deficiency is not the cause of death of people suffering from dengue.

The primary cause of death in patients suffering from dengue is capillary leakage, which causes blood deficiency in the intravascular compartment, leading to multi-organ failure, M. A. Aleem, Neurologist, and former Vice-Principal of KAP Viswanatham Government Medical College, said.

According to International guidelines, if a patient’s platelet count is below 10,000, and there is spontaneous, active bleeding, platelet transfusion is required.

“Most people do not realize is that the first line of treatment for dengue is not platelet transfusion. It, in fact, does more harm than good if used in a patient whose counts are over 10,000,” he said.

Fluid replacement amounting to 20 ml per kg body weight per hour must be administered. This must be continued till the patient passes adequate urine. This is all that is required to treat the patient.

Giving unnecessary platelet transfusion can make the patient more unwell, Dr. Aleem explained.

Common symptoms of dengue include high fever, running nose, a mild skin rash, cough, and pain behind the eyes and in the joints.

However, some people may develop a red and white patchy skin rash followed by loss of appetite, nausea, vomiting, etc. Patients suffering from dengue should seek medical advice, rest and drink plenty of fluids.

Uninhabited plots require attention. Stagnation of water in such plots in the midst of weeds pose danger to the health of residents, according to R. Ganesan, a resident of Tiruvanaikoil

Though the civic body has been spraying pesticides at water stagnation points, the onus is as much on the public to prevent breeding of the aedes aegypti mosquitoes, doctors say.

According to Health Department officials, all hospitals have been apprised of the WHO protocols in providing care to dengue patients.