Even as the toll due to chikungunya complications rose to 10, a top hospital in the capital maintained that the majority of these deaths “had an unusual clinical course” leading to death and the “unusual situation required close observation”.
On Wednesday, Apollo Hospital confirmed five deaths where the patients had also tested for positive for the mosquito-borne infection. In a statement, the hospital said five deaths of “patients with chikungunya fever” had taken place in the last three weeks. Most of the patients were elderly and “had co-morbid disease conditions,” said the hospital.
The hospital said these patients had also suffered from “complications like chronic kidney disease, coronary artery disease” and that these complications “affect the course of recovery”.
According to Apollo Hospital authorities, of the five patients, four were men and one was a 45-year old woman. Three of the male patients were over 80 years old and the fourth patient, a 31-year-old-man, had tested positive for both dengue and chikungunya.
Meanwhile, authorities of Sir Ganga Ram Hospital, which has reported four deaths due to chikungunya, have told the Delhi government that the patients had “unusual clinical course leading to their death”, said sources.
The hospital also said that “such an unusual association requires close observation and further research to establish any casual relationship”.
It has also informed the Delhi government that of the four patients, “one had pre-existing history of diabetes mellitus, two patients had history of hypertension and one patient had no history of any pre-existing disease,” said sources.
“Chikungunya is characterised by high-grade fever with chills… and generalised weakness. It is a self-limiting disease in vast majority of cases and requires only symptomatic treatment with paracetamol and adequate hydration. Most of these patients recover at home and do not require hospitalisation. ..We wants to re-emphasise that majority of our patients diagnosed with chikungunya recovered without hospitalisation and majority of those few patients requiring hospitalisation also recovered,” said Dr DS Rana, chairman (Board of Management), Sir Ganga Ram Hospital.
The hospital has now told the Delhi government that there was “discrepancy between clinical diagnosis unsupported by lab tests” — when it had initially tested suspected cases of chikungunya by conducting “immunochromatographic assay to detect chikungunya specific IgM antibody”. Due to the discrepancy, on September 1, the hospital started conducting a more sensitive and specific test — rT-PCR — on these patients.
“Many patients suspected of having chikungunya were subjected to a screen test by doing immunochromatographic assay to detect chikungunya-specific IgM antibody for detecting chikungunya. Majority of patients tested by this methods were found to be negative, while they were strongly suspected to have chikungunya… In view of this discrepancy… the department of Microbiology started performing molecular tests, namely rT-PCR, to detect chikungunya virus from blood of clinically suspected patients,” the hospital has told the Delhi government.