DOCTORS TREATING dengue patients have noticed a change in the way the virus attacks a patient, with medical parameters worsening much more rapidly than they did with patients two years ago. In the latest case, a 32-year-old lawyer succumbed to dengue haemorrhagic shock syndrome on September 9, six days after first developing a slight fever. Lawyer Varad Deore’s medical records show he developed fever around September 3 and consulted a general physician two days later. On September 7, his condition worsened. He was admitted to Fortis Hospital, Mulund, at 10 am the same day.
“At the time of his admission, his platelet count was 12,000. It dropped to 9,000 within hours,” said Dr Supriya Amey, medical superintendent at the Fortis Hospital.
Deore was put on intensive care support the same day. “We conducted a confirmatory test and found it dengue positive. On Friday (September 8), he developed haemorrhagic fever. He was severely dehydrated and fluid management was done,” Amte added.
According to the hospital’s director of intensive care, Dr Rahul Pandit, standard protocols were followed to symptomatically treat Deore. A haematocrit test showed he was fast losing body fluids. His blood pressure also reduced and he suffered multi-organ failure on September 9.
Doctors said Deore exhibited a rare complication usually seen in 1-2 per cent of dengue patients. “We are able to treat most patients on out-patient basis. But in haemorrhagic fever, there is fluid loss and capillary leak. There is rapid decline in health and by fourth of fifth day, the patient succumbs,” added Amte. At Fortis, where dengue admissions have risen in the last two months, this is the second death this year. In August alone, the Brihanmumbai Municipal Corporation recorded 93 confirmed cases of dengue across the city. This year, dengue has caused at least seven deaths in Mumbai till now.
Dr Tanu Singhal, infectious diseases expert with Kokilaben Dhirubhai Ambani hospital, said a complication termed as hemophagocytic syndrome, “where the body’s immune system is affected and excessive white blood cells are produced”, was also on the rise along with dengue infection. “We have been noticing this syndrome with dengue for three years. Last year, we admitted seven patients with this syndrome. This year there were two cases, one of them succumbed,” Singhal said. Since it is a rare complication, the treatment is difficult and patient requires intensive care.
On September 5, a Bank of America executive being treated at Lilavati hospital succumbed to hemophagocytic syndrome as a complication of dengue a week after developing fever. A BMC health officer said the dengue deaths would be analysed to understand the pattern of viral infection progression.