KARACHI: If we stopped and just looked at the numbers, the panic against dengue would subside. The infection has killed less than one per cent of patients.
In order to prove this point, Dr Mohammad Irfan Ahmed, a haematologist with the Liaquat National Hospital, presented the numbers at a seminar organised by the central laboratory at Civil hospital and the Pakistan Society of Microbiology.
For example, in Lahore there were 160 deaths out of 13,000 patients, which comes to 1.2%. As for Karachi, there have been six deaths out a total of 459 confirmed cases (1.3%). This is compared to 25 deaths out of 4,012 or 0.6% in Karachi last year.
The hematologist talked about standardised treatment to reduce mortality, psychological trauma, unnecessary transfusions, cost and pressure of admissions on the hospital. Actually, 70% of patients have simple dengue fever that can be managed at home. Dehydration is the main cause of complications among patients and not necessarily low platelets or signs of circulatory failure. “Most deaths are due to dehydration and 70% of patients do not bleed,” he said. Bleeding occurs in 30% of cases and life-threatening bleeding occurs in only less than one per cent of cases. Platelets are given only when signs of bleeding appear otherwise patients with 30,000 to 50,000 platelet counts with no signs of bleeding do not require platelet transfusions. “Fever is there for two to seven days, however, the actual problem starts on the seventh, eighth or ninth day,” he said.
He urged patients and their caretakers to ensure they drink as much as they can. He recommended juice, ORS, and homemade lemonade. He agreed with other speakers that molecular tests were helpful with early diagnosis but that they were very costly and available at only a few hospitals.
Prof. Shahana Urooj Kazmi, who runs the microbiology department at Karachi University, said more than 100 countries in the world were fighting to eradicate dengue, a viral infection. It has emerged to be a global problem that is also surmountable as even a small country like Cuba has almost eradicated it.
In the particular context of Pakistan, she said that instead of creating panic, all stakeholders should contribute to develop an effective strategy to help and manage patients. Pakistan needs to set up a surveillance and research centre for dengue and other vector-borne diseases which would work in coordination with the district health units to forewarn them.
Controlling the vector-borne diseases like dengue, congo fever, malaria and yellow fever requires year-round surveillance and research by a multi-disciplinary team of experts, Urooj said. This team must include medical doctors, microbiologists, virologists, molecular biologists, entomologists and epidemiologists. “The team, with the support of mobile diagnostic labs, could help prepare us for outbreaks, reduce vector proliferation sites with community participation, disseminate information to control the infection before it assumes epidemic forms,” she said.
Dr Imtiaz Ahmed, an entomologist from Karachi University, and Dr Farhan Essa of the Dow University of Health Sciences also spoke.
Published in The Express Tribune, October 6th, 2011.
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