Ignore dengue symptoms at your peril
Thirty-four year old Daraniya Gouthaman from Kallady, Batticaloa left behind a grieving husband and two children, who are in shock following their mother’s death.
She had ignored the basic symptoms of dengue fever, caused by a mosquito.
While Sri Lankans remain fearful of the coronavirus outbreak from China, dengue is claiming lives and putting thousands at risk.
According to the Health Ministry’s Epidemiology
Unit, 46 percent of dengue deaths are of those between the ages of 20 and 40.
Most are neglecting symptoms and seeking medical intervention late.
Daraniya, who graduated in medicine from a university in Russia, had returned to the country and decided to be a home maker to raise her two small children.
Last year, the number of dengue cases soared to 104,695 with 150 deaths. This is a leap from 51,659 cases and 58 deaths in 2018.
This year, already 10,519 dengue patients were reported in January, an increase from last year’s 5,580 cases in January.
Consultant Epidemiologist Dr. Hasitha Tissera told the Sunday Times that warning signs that should trigger immediate medical consultation are lack of improvement in general wellbeing (feeling weak, lethargy, restlessness) even after the fever subsides, continued vomiting and persistent stomach ache, diarrhoea at times, bleeding from any site, and severe headache.
“About 80 percent of dengue deaths at present are adult deaths. When children show behavioural changes especially being weak and agitated, parents take them to a doctor, so early intervention is there for children. But adults ignore and keep taking paracetamol, strong pain killers, over the counter medication and do not get sufficient rest. This is the reason for delayed hospital admissions, but then it is too late,” Dr. Tissera said.
He said it is essential to test the full blood count after two days of fever.
“If you have fever for two days, immediately see a doctor and get an FBC. If the doctor recommends the test a few days later, it is essential to do it. In dengue, at times complications arise four or five days after the fever subsides,” he said reiterating the importance of paying attention to fever.
The Epidemiology Unit advises people to do the FBC in 8-12 hour intervals as recommended by your physician, to not delay showing the report to a doctor (at least within two hours) to get medical advice, to take all blood investigation reports done during this fever period and if the platelet count has reached a low value to see your doctor immediately.
Hospital admissions will be determined by platelet count of the latest FBC, therefore sometimes home based care will be recommended.
“Fever patients are reluctant to go to hospitals out of fear of the coronavirus, but this delay will make the patient, if he or she has dengue, to go to a dengue hemorrhagic fever state/ shock state where treatment is difficult. Even if the fever is down and one is feeling weak, lethargic, aggressive, agitated or feeling dizzy, having reduced urine output and have cold and sweaty feet and hands, it is essential to seek medical intervention without delay as this is a preventable disease,” he said.
Physical rest, taking only paracetamol (follow doctor’s instructions on the dose), sponging with moderately warm water to bring down the fever, having a soft light diet and avoiding red or brown colour food or drinks, drinking more water as well as other fluids such as fruit juice, white rice congee, jeewani and king coconut is advised by Health Ministry.
The Colombo district has the highest number of dengue cases, with Dehiwala, Maharagama and Kolonnawa recording a high number. Negombo Municipal Council, Wattala and Ja-ela have more cases in the Gampaha district. Kandy Municipal Council area, and Akurana are affected by dengue in the Kandy district.
Population density, poor solid waste management, unclean surroundings and extreme weather patterns also contribute to a rise in dengue.
Batticaloa, Jaffna and Trincomalee are some of the worst hit districts following the northeast monsoon rains.
The director of the Health Ministry’s National Dengue Control Unit, Dr. Anura Jayasekare said prevention cannot be done by health authorities alone and stakeholders from environment, local councils, law enforcement, volunteer organisations need to work together to carry out prevention, monitoring, and enforcing the law against wrong-doers.
“Usually the highest number of cases is at mid-year. Cases amplify with the monsoon rains. So our mitigation programmes will be launched by next month. Discussions with the presidential task force on prevention of dengue will continue to take measures to avoid outbreaks,’’ he said.
He said last year’s unusual and heavy rainfall, resulted in an outbreak with over 100,000 cases.
This year, clean-ups will be done during dry weather.
“During the dry spell, mosquitoes are drawn to indoor breeding places such as behind the fridges, containers used to collect water, bird baths and so on. This is the ideal weather to clean gardens, drains, gutters and dispose of unwanted containers that could breed mosquitoes,” he said.
Dr. Jayasekare said people have also complained about dengue inspectors trying to extort money in return for dropping legal action. Regional directors of health have been told to check these claims.
“Our unit has recruited 1,200 mosquito control assistants to help public health officers in supervision,” he added.
Additional reporting and pix by Theva Adiran, Batticaloa correspondent.