BENGALURU: A month into the monsoon season, the state has witnessed a spike in the number of dengue cases, according to medical experts. While there were 5,821 suspected cases and 834 positive cases as of May 31, the number of positive cases had jumped by 1,187 till July 6.
Since January 1, a total of 2,021 people have tested positive for dengue across the state while there were 12,920 suspected cases. But so far, only one death has been reported from Udupi, according to the department of Health and Family Welfare.
Though independent verification may reveal more deaths, the official tally is updated after the death audit committee of the health department confirms the cause of death. This, however, takes time. The death audit committee last met on July 8, but the report is yet to be published on the website. (Three more deaths may be confirmed by this meeting.)
Udupi has seen the most number of cases at 319, followed by Bangalore City, Dakshina Kannada, Mysuru, Shivamogga, Davanagere and Haveri. Dr B G Prakash Kumar, deputy director of National Vector Borne Diseases Control Programme (Karnataka), said the concentration of rubber plantations and arecanut farms in Udupi district are major breeding grounds for mosquitoes.
“Fifty nine patients have tested positive for dengue in the past month in the city. The suspected cases were 1,100. Most cases are from Bangalore Urban,” said Dr Shanta M from Apollo Hospital, Bannerghatta.
K S Manjunath, medical superintendent, Bowring and Lady Curzon Hospital, said that on an average, 8-10 patients in a day are admitted with viral fever and decreased platelet count. Of them, 3-4 would test positive for dengue.
Dr Pankaj Sahai of internal medicine in Manipal Hospital said, “The hospital receives at least 10 suspected dengue cases every day of which eight tested positive for dengue.”
“Only one per cent of the total patients have dengue haemorragic fever or the severe form — dengue shock syndrome. Among these cases there’s 10 per cent mortality. In most cases, the fever subsides in five days. Patients who develop headache, myalgia and bleeding need to be admitted,” said Kumar.
He pointed out that dengue, malaria and influenza can have the same symptoms. Pain behind the eyes and chills are symptoms of dengue.
“As per the Centre’s guidelines, we conduct ELISA-based NS1 antigen test and IgM antibody test for confirmation. The kits costs between Rs 12,000 and Rs 15,000. Each kit can perfom 96 tests. We don’t use a kit unless there are 5-10 samples,” said Kumar.
Every year, there are media reports that the official figures are lower than the number of cases that hospitals handle on the ground when independent verification is done.
Kumar pointed out that they rely on two indicators to confirm dengue — epidemiological aspect and clinical symptoms. “We take samples before, during and after monsoon. Let’s say out of 20 samples, five per cent tests positive, we consider the entire batch as positive. We look at the disease trend in the community and look at incidence of cases in that particular population. That’s the epidemiological aspect. Otherwise, patients can be treated even with the haematocrit count (thickness of blood),” he said.
Mosquito breeding sites are treated with temefos liquid as against granules by ASHAs (Accredited Social Health Activists) and ANMs (Auxillary Nurse Midwife/village level female health workers). “Ice-cube trays that are not cleaned regularly, trays under flower pots, and plant pots in which water stagnate are bredding grounds for mosquitoes. To kill the larvae, the liquid is added to the stagnated water. Granules don’t dissolve properly,” he said.
Among the steps taken by the state administration as a preventive measure is serotyping, to differentiate between the various strains of virus which helps assess the seriousness of the disease spread. “If we detect type-II virus in a district that has previously seen type-I virus, it is an indication of virus mutation. The situation is serious and dangerous. There can be mortality in such cases,” he said.