Even as Kerala is battling an outbreak of leptospirosis following the devastating floods which hit the state early in August, authorities are now reporting a spike in the number of dengue fever cases. Health department officials have issued alerts to several districts.
As of Thursday evening, a total of 35 deaths due to dengue had been recorded since August 1. There are currently 3,409 confirmed cases of dengue in the state and over 12,000 suspected cases, yet to be confirmed.
"While there are cases of dengue being reported, we can't term it as an outbreak. We're taking steps to ensure that the mosquito populations are controlled and that people are made aware of what to do in order to protect themselves from such mosquito-borne diseases," stated Additional Chief Secretary Rajeev Sadanand to TNM. "We knew there would possibly be an influx of this and leptospirosis, and we are seeing that now."
Dengue, also known as ‘break bone fever,’ is spread to humans from mosquitos, and is caused by one of the four serotypes of the dengue virus, which belongs to the flaviviridae family of viruses.
“Aedes mosquitoes are the ones which spread dengue. They are active during the day, unlike mosquitoes which transmit malaria,” explained Dr Abinaya, a general physician from Chennai. “Symptoms are usually seen within a week. Commonly, people present with fever and malaise, that is tiredness, but to the point that they won’t even be able to get up or move. What we as physicians worry about is whether or not any signs of bleeding.”
Bleeding signs or bleeding tendencies are indicative of a drop in the platelet count in the blood. Platelets ensure that clot formation takes place when there is an injury; without platelets or with faulty platelet counts, the blood does not clot when an injury occurs and a person risks complications as a result of losing blood.
“More than the fever spikes themselves, we get worried about platelets dropping after the fever has passed. It’s a critical period and we usually recommend that people presenting with possible dengue fever are admitted so that their platelet count can be regularly monitored,” added Dr Abinaya. “There is no active treatment for dengue. Mostly, it consists of supportive measures and managing the platelet counts. Usually, we don’t opt for blood transfusions, unless indicated. A person who has some bleeding tendencies and a platelet count of say 30-50,000, we may opt to transfuse them. However, if someone has a platelet count of 10,000 or less, regardless of whether any signs of bleeding are there, we will transfuse them.”
The most common symptoms of dengue are high fever, extreme fatigue, muscle pain (myalgia), and multiple joint pain. Joint pain tends to be severe in dengue, which is why it is also referred to as ‘break bone fever.’
When a person contracts dengue fever and recovers from the same, they are immune to that particular dengue serotype, but are a higher risk of developing complications if they are subsequently exposed to a different serotype of the virus and present with dengue again.
As of Thursday, there were 5 confirmed cases of dengue in Kerala and 47 suspected cases.
Stagnant waters following the floods have led to an increase in mosquitoes, which in turn are responsible for spreading a number of illnesses, including malaria and dengue.
“We did expect to see a rise in the number of rat fever and dengue following the floods, because these are ailments which tend to affect people following such a natural disaster. Now, we are taking the steps to combat the same,” said a Health Department official.
While people have been asked to take doxycycline as a preventive measure against rat fever, or leptospirosis, experts are recommending that basic measures be taken to prevent the breeding of mosquitoes, which may lead to more of these infections being transmitted, including using mosquito nets and repellent, empty out containers and vessels in which water may stagnate.
Those who present with any symptoms should immediately be checked up and may be admitted for further work up if needed.