Fall in Platelet Count May No Longer Remain the Telling Symptom of Dengue

A major symptom of dengue is the receding platelet count. However, after five reported cases in Kolkata, the telling symptom in dengue may no longer be true. In all these cases, doctors realised the platelet counts were at a safe level -- stoking suspicions over the changing character of the dengue virus.

Dengue is a viral infection which typically appears during the monsoon season. Dubbed as the “break bone fever” or “dandy fever”, symptoms of dengue fever include severe joint and muscle pain, swollen lymph nodes, headache, fever, exhaustion, and rash. The presence of fever, rash, and headache (the "dengue triad") is characteristic of dengue fever.

Dr Arindam Biswas, internal medicine specialist at RN Tagore International Institute of Cardiac Sciences, as quoted by the Times of India, said that in a majority of the dengue cases they have come across this year, patients had stable platelet count. He went on to add that every virus can change its character and 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.

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

Dr Prabhas Prasun Giri, in-charge of paediatric intensive care unit at Institute of Child Health, Kolkata said that this year they have come across four children suffering from dengue fever. The ferratin level in the children had shot-up dangerously and even though they lost one child, they were able to save the others.

“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 further added.

The report added that the platelet count of Ruhul Mallick, first dengue victim this year in Kolkata, was well within the safe zone. But his ferratin level had shot up to 44,000Ng/L against the normal mark of 500Ng/L.

Microbiologist Dr Bhaskar Narayan Chaudhury added that in each outbreak, the dengue virus tends to act differently and this time the platelet count does not seem to be a major problem.