Dengue patients are streaming into hospitals and many have a low platelet count that is affecting their health and recovery time
Published : 31 Oct 2022, 01:38 AM
Dengue, the Aedes mosquito-borne disease, is running rampant in Bangladesh with the number of patients visiting hospitals rising fast.
Most of the dengue patients are losing blood platelets much faster than earlier seen, the doctors say. Sometimes patients do not even realise that they are losing platelets. As a result, delayed hospitalisation is making their treatment complex for physicians.
Dengue patients often suffer from different physical complications and the experts suggest anyone with the disease seek medical help quickly.
As many as 35,262 dengue patients were admitted to hospitals this year as of Oct 28, according to the Directorate of Health Services. At least 128 of them died.
An adult person has 150,000 to 450,000 platelets in each microlitre of their blood, according to Johns Hopkins University.
The primary function of blood platelets is to prevent and stop bleeding. They clump together to form a clot that helps block blood from flowing out of the body, helping it to heal wounds. When platelet levels drop below 150,000, people can be in medical danger.
As many as 54 dengue patients were being treated at Holy Family Red Crescent Hospital last Thursday.
Shahadat Hossain, a dengue patient from Pirojpur, was one of them. He visited Dhaka recently and was diagnosed with dengue upon returning home in Pirojpur. As his blood platelets were dropping fast, Shahadat was admitted to the hospital in Dhaka last Saturday, said his brother Shakhawat Hossain.
“His blood reports showed the platelet count had decreased to 45,000 and at one point, it dropped to 8,000. We initially took him to Dhaka Medical College Hospital but it was overcrowded. Later we brought him here.”
Hospitals are seeing more patients with dengue who are losing platelets fast, said Professor Dr Abu Hena Mostafa Kamal, head of the hospital’s medicine department.
“In most of the cases, we have patients whose platelet count dips to 10,000 to 15,000. They are also taking a long time to recover even after platelets are infused and thus need to stay in hospital for longer.”
Shamsul Mia, a resident of Mohakhali in Dhaka, brought his son to the DNCC Hospital in Mohakhali when he caught a fever. Shamsul did not know the platelet count in his son’s blood had dropped so far.
“He had fever, vomiting and diarrhoea. On Tuesday I took him to a doctor nearby who asked to do a blood test. It was then on Wednesday we found his platelets had dropped to 22,000. We admitted him to the hospital immediately. The next day his blood report showed platelets dropping further to 10,000. The doctors asked us to arrange a blood transfusion for him.”
Abdullah Al Mamun, a dengue patient admitted to the DNCC Hospital, said he was suffering from a fever for six days. His doctor asked for a blood test when he visited him on Monday, and the test result on Tuesday showed his platelets dropped down to 23,000.
”Doctors in the hospital where I had my medical test done asked me to get admitted as soon as possible. Later I came here [DNCC Hospital]. On Wednesday, my platelets dropped further to 6,000. I'm taking the medicines my doctor prescribed. They haven’t talked to me about a blood transfusion yet.”
Ahmed Hossain from Shonir Akhra and his wife were admitted to Khidmah Hospital in Khilgaon after they were diagnosed with dengue.
Ahmed’s blood report showed his platelets stood at 140,000 on Sunday, said his daughter Nurunnahar. Then on Monday, it dipped to 68,000 and to 40,000 on Tuesday.
“Father was vomiting and felt suffocated. He had head and body aches, and said he was feeling very unwell.”
Md Nazrul Islam, a college student in Dhaka, had a platelet count of 18,000 when he was admitted to the Khidmah Hospital on Sunday after contracting dengue.
Nazrul was receiving treatment at home for three days after he caught dengue but was brought to the hospital when his condition deteriorated. The platelet count issue was discovered then, said his mother Anowara Begum.
”We hadn’t realised his platelets dropped so much. We brought him to the hospital to treat his respiratory distress and allergic symptoms. As of now, he has received three bags of blood and his platelet count has increased a little. Today morning [Monday] it stood at 20,000.”
“Bone marrow produces platelets. When the platelet count drops, bone marrow replaces it in eight hours. But it is not the case this time as we see platelet counts dropping fast and not being restored,” said Asst Prof Ashraful Haque of Sheikh Hasina National Burn and Plastic Surgery Institute, a blood transfusion expert.
”In many cases, platelets drop below the danger level before the patient shows any symptoms. But the bone marrow can’t replace it. As a consequence, we assume it is a post-coronavirus infection effect. Most of us contracted [coronavirus] and took different medicines. For many reasons [our body] mechanism is not normal at the moment.”
“Many people took blood thinning medicines during the coronavirus pandemic which might have hampered the normal process of platelet formation. We should do research on it,” he explained further.
Prof Ashraful Haque said it is highly risky when platelets drop below 10,000 in the human body, but for many people, platelets dropping below 20,000 poses a risk.
”Platelet counts below 10,000 may cause bleeding in any part of the body, fluid retention in lungs or stomach. This is common in dengue, but this time it’s happening at an accelerated rate.”
Loss of platelets causes many health risks including bleeding, said Dr ABM Abdullah, a former dean of Bangabandhu Sheikh Mujib Medical University.
”Bleeding from the gum line, or with vomit and faeces is common. Bleeding from any body parts and fluid retention in the stomach or lungs may happen. This may push the patient to a state of shock or even to death.”
As most of the patients do not realise they suffer from a platelet drop, they should seek medical help immediately when they catch a fever, said Dr Abdullah.
”Dengue has spread nowadays and no one should neglect the possibility if they catch a fever. They must see a doctor and do a dengue test and platelet count. It’s not possible to find out if platelets have dropped without a medical test. We can avoid the risks if we’re aware from the beginning,” he said, adding a patient must be hospitalised once the platelet count drops below 100,000.