How we can minimize the risks of Dengue

Dengue fever is an acute febrile illness .Manifestation of the  disease ranges from benign self limited illness to life threatening complications . No vaccine is available for this disease .Vector control enforced by environmental management is the main stay for prevention.

 In a case of dengue infection, for management to succeed, early diagnosis and prompt treatment is very important.

Early case of dengue infection is difficult to differentiate from other acute febrile illnesses.Examples of other acute febrile illnesses that can mimic dengue include common cold, influenza and acute bacterial pharyngitis, among others.

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Detection of virus by PCR is the gold standard test for the diagnosis of Dengue virus , but the serological testing is also comparable to it,as facility of PCR is not available everywhere.

During the current year we have been experiencing an epidemic of dengue fever in Pakistan. Pathology labs are providing best technical assistance medical officers for the early diagnosis and management of viral infection to combat the epidemic.

In 2011, there was a sudden rise in cases in Lahore with more reported cases than from the previous five years together. A study was conducted on 100 suspected   patients with symptoms of Dengue fever.

The age range between 16 – 80 year, 57 was males and 43 were females.  These patients presented with a symptoms of 3–10 days duration. The average duration of symptoms at presentation was six days. Fever was predominat symptom (98%) as were the myalgia and bone pains (90%). The other symptoms are listed in table 1. Haemoglobin level ranged between 7-10 gm/dl in 30% of patients.  Other laboratory parameters are listed in table. 2.

The sera of patients were analyzed by rapid test chromatography for Dengue IgM antibodies. 20% patients were seropositive .

Clinical Features               no of patients               %

Fever                                       98                        98

Myalgia                                    90                       90

Nausea/anorexia  /

sore throat                                95                       95

Abdominal pain                        47                       47

Rash                                         20                      20

Bleeding manifestation               12                      12

Hepato splenomegaly                 2                         2

Pleural effusion                          1                          1

Ascitis                                       2                          2

Table.2: Hemoglobin and the Biochemical Parameters among the patients [100 patients]

Parameters                     n=           %age     Range

Hb% (gm/de)

•          >10 gm/dl            60            60      

•          7-10                    30            30           5-13

•          <7                       10            10 

  

Lencoytec count  103/L

•          >8.0                     27            27

•          8-2                       55            55        1.5-9.5

•          <2.0                    18             185

       

ALT u/l

•          40-160                 60                60      40-240                                

•          >160                    40                40

      

            

AST

•          40-160                 61               61        40-282                

•          >160                   59                 59            

         

         

  We delivered the CBC reports to patients immediately and treatment was started with out delay.As a result, most of the patients were treated at home and only 20% cases were hospitalised .98% patients recovered fully.

 The dengue will be defeated again IA, as human life is very precious and no negligence is acceptable in the measures to control the disease.