Kolkata : ‘Platelet count not enough to gauge dengue severity’

Kolkata: Nose diving platelet count, which is considered a telling symptom in dengue, is no longer so this year. At least five dengue-related deaths were reported from the city this year. In all these cases, doctors found the platelet counts were at a safe level. Doctors now suspect the dengue virus could be changing character.

“In a majority of the dengue cases I have come across this year, patients had stable platelet count. Every virus can change its character. When a mutated virus enters the body, the body mounts a severe inflammatory reaction to resist it, which may be counter-productive for the body,” said Dr Arindam Biswas, internal medicine specialist at RN Tagore International Institute of Cardiac Sciences.

Biswas pointed out that even if the platelet count is high, the platelets may not function normally. Therefore doctors should look for signs of concurrent infection and investigate further.

“So far we have come across four children suffering from dengue fever. The ferratin level shot up dangerously. We lost one child, but were able to save the others,” said Dr Prabhas Prasun Giri, in-charge of paediatric intensive care unit at Institute of Child Health, Kolkata.

The platelet count of first dengue victim this year — Ruhul Mallick, who died on September 18 — was well within the safe zone. But his ferratin level had shot up to 44,000Ng/L against the normal mark of 500Ng/L.

“In each outbreak, the dengue virus tends to act differently. This time the platelet count does not seem to be a major problem,” said microbiologist Dr Bhaskar Narayan Chaudhury.

Behala homemaker Poli Banerjee, who died on September 22 within hours of being admitted in the hospital, had a sharp decline in her condition despite a good platelet count. Cardiogenic shock was pointed out as the cause of death.

In addition to drastic drop in platelet count, last year doctors also came across many cases of dengue induced encephalitis cases. But this year such cases are far and few.

“We had conducted a study few years ago on how serum ferratin can go haywire in dengue cases leading to multi organ dysfunction. While this can be tacked with a combination of steroid and IV immunoglobulin, doctors often tend to overlook this aspect,” Giri said.