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Source: http://www.thesundaily.com/article.cfm?id=35380
Dengue now more complicated to diagnose
Meena L. Ramadas
SUBANG JAYA (July 5, 2009): The dengue disease is rapidly progressing and clinical diagnosis should be based on symptoms relating to leakage of blood fluids.
?All our previous knowledge and gut feelings of dengue disease don?t work anymore because the patient doesn't look sick. The patient starts looking sick after going into shock, which has a 80% mortality rate,? said Sungai Buloh Hospital infectious disease physician Dr Suresh Kumar.
Doctors previously focused on blood results, particularly the platelet count, to diagnose a patient with dengue. But not all patients exhibits low platelet counts after contracting the disease.
?The haematocrit (HCT) level is a better indicator of dengue. HCT is the thickness of the blood.
The thicker the blood, the higher the plasma leakage," Kumar told a talk on Clinical Practice Guidelines (CPG) on Dengue Awareness today.
According to him, it is this plasma leaking that leads a dengue patient into shock and causes excessive bleeding.
?Our aim is to prevent patients from going into shock and the way to do that is to detect and stop the leaking,? he said.
Plasma is liquid found in the blood and contains antibodies and other proteins. The warning signs of plasma leakage are abdominal pain, persistent vomiting, restlessness and lethargy and liver enlargement of more than 2cm among some of the symptoms.
Selangor State Health Department senior public health specialist (epidemiology) and head of the state vector-borne disease control unit Dr B. Venugopalan said: ?Patients do seek treatment early and doctors often tell the patients to come back if the fever does not subside in two to three days.
But the fever does subside but only before the patient goes into shock. So, if doctors have detected unusual heart rates, alarm bells for dengue should be ringing.?
Because of new studies, the Health Ministry and Academy of Medicine Malaysia have published a new set of CPG to improve the recognitions and diagnosis of dengue cases and to offer the appropriate care to patients.
The new guidelines were implemented in January and training seminars have been conducted to update doctors to improve recognition and diagnosis of dengue cases.
This is important as the number of dengue cases has risen this year compared to last year.
According to Venugopalan, 23,056 cases were reported nationwide with 57 deaths between January and June.
The Selangor Health Department has also said dengue is the highest recorded infectious disease in the state with 12,562 cases reported as of June 27.
?Doctors should not get too fixated on blood results as symptomatic results are also important,? said Kumar.
Updated: 06:38PM Sun, 05 Jul 2009
Dengue now more complicated to diagnose
Meena L. Ramadas
SUBANG JAYA (July 5, 2009): The dengue disease is rapidly progressing and clinical diagnosis should be based on symptoms relating to leakage of blood fluids.
?All our previous knowledge and gut feelings of dengue disease don?t work anymore because the patient doesn't look sick. The patient starts looking sick after going into shock, which has a 80% mortality rate,? said Sungai Buloh Hospital infectious disease physician Dr Suresh Kumar.
Doctors previously focused on blood results, particularly the platelet count, to diagnose a patient with dengue. But not all patients exhibits low platelet counts after contracting the disease.
?The haematocrit (HCT) level is a better indicator of dengue. HCT is the thickness of the blood.
The thicker the blood, the higher the plasma leakage," Kumar told a talk on Clinical Practice Guidelines (CPG) on Dengue Awareness today.
According to him, it is this plasma leaking that leads a dengue patient into shock and causes excessive bleeding.
?Our aim is to prevent patients from going into shock and the way to do that is to detect and stop the leaking,? he said.
Plasma is liquid found in the blood and contains antibodies and other proteins. The warning signs of plasma leakage are abdominal pain, persistent vomiting, restlessness and lethargy and liver enlargement of more than 2cm among some of the symptoms.
Selangor State Health Department senior public health specialist (epidemiology) and head of the state vector-borne disease control unit Dr B. Venugopalan said: ?Patients do seek treatment early and doctors often tell the patients to come back if the fever does not subside in two to three days.
But the fever does subside but only before the patient goes into shock. So, if doctors have detected unusual heart rates, alarm bells for dengue should be ringing.?
Because of new studies, the Health Ministry and Academy of Medicine Malaysia have published a new set of CPG to improve the recognitions and diagnosis of dengue cases and to offer the appropriate care to patients.
The new guidelines were implemented in January and training seminars have been conducted to update doctors to improve recognition and diagnosis of dengue cases.
This is important as the number of dengue cases has risen this year compared to last year.
According to Venugopalan, 23,056 cases were reported nationwide with 57 deaths between January and June.
The Selangor Health Department has also said dengue is the highest recorded infectious disease in the state with 12,562 cases reported as of June 27.
?Doctors should not get too fixated on blood results as symptomatic results are also important,? said Kumar.
Updated: 06:38PM Sun, 05 Jul 2009