Don't delay; nab dengue early

Get a full blood count done on Day 2 of fever and not on Day 3, say experts

Don’t delay -- get a full blood count done on Day 2 of fever and not on Day 3 to ‘catch’ dengue early.

This is the strong advice of a dengue expert as dengue numbers soar and in several homes there is mourning over dengue deaths.

For, the dengue strain doing the round, affecting a majority of men, women and children seems to be DEN-2 and it is causing virulent illness, says Consultant Paediatrician of the Gampaha General Hospital, Dr. LakKumar Fernando.

“Therefore, early admission to hospital is the advisable action to follow,” says Dr. Fernando, who is an honorary Visiting Consultant at Negombo’s Dengue Centre which he was instrumental in setting up. He is currently President of the Sri Lanka College of Paediatricians.

Dr. Fernando has come to this conclusion that DEN-2 is felling people, after getting the blood samples of 24 severely-ill patients tested. Twenty of those who had more severe illness compared to the others have been confirmed as DEN-2.

The current dengue crisis has arisen because the platelet counts of these dengue patients affected by DEN-2 are dropping faster than in the other strains (DEN-1, DEN-3 and DEN-4) and if it is Dengue Haemorrhagic Fever (DHF), the fluid leakage starts sooner than in others, it is learnt.

Explaining the rapid onset of the platelet-drop and fluid-leakage, Dr. Fernando said that as dengue has been endemic in Sri Lanka, people have been exposed to this mosquito-borne viral disease for a long time. As such, many have had an earlier or ‘primary’ infection with another strain.

He adds that some may know that they have had dengue earlier but others may not even know that they have had dengue because it could have been mild or asymptomatic. When a second infection comes with a different strain, it hits the patient harder.

Dr. Fernando underscores the following to stress the importance of getting a full blood count (FBC) done on Day 2 of fever:

*In DEN-2, the platelet count may ‘significantly’ drop even from Day 2, whereas with the other types (DEN1, DEN-3 and DEN 4) it usually drops on Day 3.

*The fluid leakage in DEN-2 can also start as early as Day 3, whereas with the other types it usually occurs on Day 4.

Providing some basic information with regard to Dengue Fever (DF) and Dengue Haemorrhagic Fever (DHF), he points out that all four strains can either cause DF or DHF. Never will DF turn into DHF. The infection with one strain provides immunity to that strain only. However, the antibodies created by that strain will make a second infection with a different strain very severe.

“For clinicians, the need is to differentiate between DF and the more deadly DHF. While people will recover from DF, the danger of death comes from DHF,” he adds.