While the Zika virus has caused quite a stir in Pune, dengue – the more life-threatening vector-borne infection – has presented a different situation to the medical fraternity this season.
Severe symptoms Regarding the symptoms of dengue cases, he said, “We are shocked by the current clinical presentation of dengue this year.
Dr Laxman Gophane, PCMC’s chief health officer, said, “We have recorded over 12 cases of dengue already in the last few days.
Differentiating between dengue and Zika is more challenging as they present very similarly.”The testsTo differentiate between dengue and Zika, the Dengue NS1 test is crucial.
Zika updateOne more positive case of Zika virus infection was recorded in Pune city on Wednesday, bringing the total to 16 cases.
While the Zika virus has caused quite a stir in Pune, dengue – the more life-threatening vector-borne infection – has presented a different situation to the medical fraternity this season.
Typically, dengue causes a drop in platelet count, but it is not too alarming, dropping to around 20,000 on the fifth day of the onset of the infection. However, the platelet count is now plummeting to 5,000 straightaway, which is highly concerning. Patients are presenting with severe symptoms, including gastro, and experts are still investigating the cause of this drastic change.
Discussing the development, Dr Rajesh Gadia, a national expert on vector-borne infections who is attached to KEM Hospital, told Pune Times Mirror: “Everybody is worried about the Zika virus, but nobody is paying attention to dengue, which has quietly started affecting many. We already have over 10 admissions and one patient in the intensive care unit.” Cases are coming in from all over Pune district, especially Wagholi, Phaltan, and other areas, added Dr Gadia.
Severe symptoms Regarding the symptoms of dengue cases, he said, “We are shocked by the current clinical presentation of dengue this year. However, our first aim is to manage the patient and provide immediate medical intervention. We are still studying the significant changes this time around.
“Another important clinical presentation of dengue this time is bleeding as seen in an admitted patient with us. However, it should be noted that only five percent of the patients infected with dengue suffer bleeding.”
12 cases in twin towns
The Pimpri Chinchwad Municipal Corporation’s (PCMC) health department recorded over 12 cases of dengue by Tuesday. Dr Laxman Gophane, PCMC’s chief health officer, said, “We have recorded over 12 cases of dengue already in the last few days. Of these, six are females. However, we are providing treatment to all the suspected cases of fever. We are vigilant so that no case of fever goes unnoticed and undiagnosed.” The PMC health department too stressed that dengue is more life-threatening than Zika, which is self limiting but concerning for pregnant women due to its potential impact on the foetus.
NIV statement
The National Institute of Virology (NIV) stressed the danger of dengue compared to Zika, urging the need to identify and eliminate mosquito breeding sites to control vector-borne infections in Pune.
Dehydration Dr Devashish Desai, an infectious disease expert from Ruby Hall Clinic, when asked about dengue and its different presentation this year, said, “The platelets are starting to drop from the first day onwards, but as doctors, we are more concerned about one clinical presentation, and that is dehydration. Many tend to look at falling platelet counts, but we as experts need to look at their hematocrit value, which tells us how dehydrated the patient is.”
Zika, dengue, chikungunya: Differences
When asked about all three infections that Pune is currently experiencing — dengue, chikungunya, and Zika — all spread by the Aedes aegypti mosquito, and how to differentiate between them, Dr Gadia explained: “The easiest to identify is chikungunya is that it causes fever and severe joint pain lasting for weeks to months. Differentiating between dengue and Zika is more challenging as they present very similarly.”
The tests
To differentiate between dengue and Zika, the Dengue NS1 test is crucial. If negative in the first four to five days, Zika should be considered. Due to low viral loads, Zika PCR tests can sometimes be negative, so an IgM antibody test for Zika on day 10 is recommended. However, this test is currently unavailable, Dr Gadia said.
“We have seen two strains of dengue this year – Dengue 1 and 2. Both have become equally life threatening, causing concern for all. Dengue admissions are going up, and we are just at the beginning of the epidemic. We expect a peak by September and October this year,” he said.
Zika update
One more positive case of Zika virus infection was recorded in Pune city on Wednesday, bringing the total to 16 cases. Of these six cases are from the Erandwane area. Among the 16 cases, eight involve pregnant women.
