The incidence of dengue infections in Nashik is increasing and has also caused stress on the blood banks that face shortage of blood to supply platelets for transfusion. The officiating commissioner of Nashik Municipal Corporation (NMC) has thus issued show cause notices to the health officer and deputy health officer of the corporation.
After several complaints of lack of a clean civic environment, officiating commissioner of NMC, Sonali Ponkshe-Waingaonkar took a round of the city and found heaps of garbage lying on the road. She also found the health department staff responsible for cleaning the roads absent from duty. Stating that the senior officials of the health department have lost control over their staff, she immediately issued show cause notices regarding the lack of cleanliness and absence of department workers from duty.
During Diwali, the mayor, deputy mayor and other representatives who visited the city on similar such complaints had also reported similar results. The health officer Dr Sunil Bukane was then summoned by the mayor and given orders to maintain good health conditions in the city. However the situation did not change.
The incidence of patients suffering from dengue is increasing, observe doctors in various hospitals and clinics in Nashik.
"Dengue is a viral infection caused by a virus that breeds in open accumulated or stored water and dirt. Presently the number of patients with dengue infections is increasing. It is caused when a dengue carrier mosquito bites a person. These mosquitoes are known to be seen during the day time as well. Common symptoms are fever, rashes, body aches, swelling on liver, water retention in chest leading to breathlessness. In severe conditions, the WBC and platelet count in the blood of the patients drops and if this gets severe it may lead to bleeding", explains Dr Kaustubh Gokhale, a well-known city physician.
The normal platelet count in a healthy person is around 2.5 to 5 lakhs. During dengue it is likely to drop. In case it drops below 20,000, the patient is to be immediately admitted to hospital. In other cases the patient needs close monitoring. If the platelet count drops below 20,000 there is a high risk of bleeding that is seen in redness of eyes, blood patches under the skin, blood discharge through urine or through the gums and teeth.
In very critical cases bleeding can take place in the brain or stomach. However, such severe bleeding happens in only 1-2% of dengue patients, according to Dr Gokhale. There are no such cases reported in Nashik at present.
Supportive treatment to control fever and aches is provided during dengue. As the condition may lead to exhaustion and weakness, the patient should be given plenty of liquids, fruits and should be properly hydrated, Dr Gokhale recommends.
The doctor also opines that platelet transfusion is not required in case of marginal drop in the number of blood platelets.
The general trend however has been to provide blood transfusion if a patient is diagnosed with dengue, without considering the need for it. This has created a shortage of blood units in the city's blood banks. The focus should also be on precautions like cleanliness and preventing accumulation of open water, Dr Gokhale states.
Symptoms of Dengue
Fever
Rashes
Swelling on liver
Water retention in chest leading to breathlessness
In severe cases –
Drop in platelets (considered critical if count drops below 20,000)
Bleeding
Precautions
Cover stored water
Avoid accumulation of water in ditches, puddles, or any other such place or in any container
Maintain cleanliness in the city
Avoid garbage accumulation
Maintain personal hygiene
Well ventilated spaces
Avoid crowded places
Report to a doctor in case of any symptom
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