Majority of dengue patients could recover with present methods: Dengue specialist
The current treatment methods including fluid therapy for dengue is very much good enough to manage the disease and 99.9% of patients who walk into hospital with a platelet count just above 100,000/microlitre will recover without the help of papaya leafconcentrate, stressed Dengue Specialist Dr. LakKumar Fernando when contacted by the Sunday Times.
If the leaf-concentrate increases the platelet count without equally reversing all other effects of the disease to the same intensity, it can confuse the clinicians whose treatment of dengue will be based on the up and down trends of platelets. Presently as knowledge on the issue is still limited, the administration of the leaf concentrate can do more harm than good, he reiterated.
Citing the case of an eightmonth-old bought in with DHF, whose platelet count below 10,000/m, and with clear leaking, this paediatrician attached to the Negombo Hospital said his team managed the child very well in the ward and not even in an ICU. The baby was doing fine when the Sunday Times visited the hospital last week. Dr. Fernando has treated more than 200 children suffering from Dengue Haemorrhagic Fever including many who had gone into shock, transferred to his ward at the last minute, and pulled them from the jaws of death, within the last six months.
Referring to capillary permeability, he said the issues surrounding it are complex, unknown and not fully explained to-date. The possible mediators that affect these mechanisms are also not identified, he said, questioning why fluid leakage occurs only into the pleural (chest) and peritoneal (abdominal) cavities. The reason is still unknown.
Therefore, the effects of simple capillary permeability cannot be extrapolated to capillary permeability in dengue which is a complex matter, he added.
Dengue Fever (DF) and Dengue Haemorrhagic Fever (DHF) are not diseases of the platelets, he said. Anyone who gets DF will recover anyway if there are no other illnesses, whether an increase in the platelet count is stimulated or not. But DHF is deadly and needs fluid therapy under conditions which are strictly monitored in a hospital, Dr. Fernando added. (Please see MediScene
cover story)