Is rapid onset of platelet drop and fluid leakage due to DEN-2?

The large numbers and the severity of the current dengue epidemic raging in the country may be due to the circulation of the DEN-2 type, as opposed to the earlier types, says Dr. LakKumar Fernando, hastening however to add that it is too early to confirm yet.

There are four dengue virus types or strains – DEN-1, DEN-2, DEN-3 and DEN-4.

He stresses that in this dengue epidemic, the reduction in the platelet count of the patient and the onset of fluid leakage seem to be more rapid and starting earlier than in the disease caused by the other three virus types. This is why it is crucial to do a fullblood count as the platelet drop and fluid leakage occur on Day 2 and 3, unlike in the other three types, when they come later by about Day 4.

The pattern which Dr. Fernando suspects is happening with DEN-2 and seems quicker is:

The platelet count dropping from Day 2, whereas with the other types it occurs on Day 3 The fluid leakage beginning on Day 3, whereas with the other types it usually occurs on Day 4 As to why he suspects that the virulence of this epidemic is high, he says that it could be due to “many factors”. It could be because a large proportion of the population has had a primary (earlier) infection with another type, as dengue is now endemic in the country. “With a second infec- tion, the patient would be hit harder.”

Why do patients die, even if they come to hospital on time? “It could be due to a drop in the strict monitoring schedule of those with Dengue Haemorrhagic Fever, if there are no other serious issues with the patient and the patient has sought treatment on time. The monitoring may slag a little due to the staff being weary and tired out because of the heavy workload from attending to the non- ending stream of patients.