Dying from dengue's second wave

NST: KUALA LUMPUR: Alarm bells are ringing in the Health Ministry as more dengue patients are dying within a day of admission to hospital.
Most are children and those aged 20 to 30, and doctors believe they may have come down with dengue a second time after the first bout went untreated. Sungai Buloh Hospital consultant infectious disease physician Dr Suresh Kumar believes some may not have shown symptoms and had become carriers of the disease, while others may have had the fever and left it untreated.
The disease strikes with deadly force the second time as patients were virtually defenceless, he said, and many people come in very late for treatment.
Pregnant women are in particular danger from dengue as it could affect the foetus.
"If you have a fever, see a doctor. If the fever persists for two days or more, check for dengue. Insist on a full blood count, and haematocrit and platelet count tests."
The white blood cell count of a person with dengue falls rapidly as the disease progresses. A rising haematocrit count is a marker of plasma leakage in dengue infection and helps to differentiate between dengue fever (DF) and dengue haemorrhagic fever (DHF). The test results can be obtained in two hours.
He said doctors should pay particular attention to people showing symptoms of dengue and recognise early deterioration.
He warned that some people may not show symptoms during the four to seven-day incubation period for dengue.
He said patients typically developed sudden high grade fever, often accompanied by among others, facial flushing, generalised body ache and headache, sore throat, loss of appetite, nausea and vomiting.
The Health Ministry came out with clinical practice guidelines on "Management of Dengue Infection in Adults" last year for all doctors to use in the detection, management and treatment of DF and DHF, he said.
And patients who go in to hospitals or clinics with fever are now given a special card so doctors who may treat them later have all the information they need.
The number of reported DF and DHF cases has increased from 44.3 cases per 100,000 people in 1999 to 181 cases/100,000 in 2007. This exceeds the target rate of 50 per 100,000.