"Big Rise In Organ Failures" Due To Dengue As Cases Spike In Delhi

The dengue outbreak in Delhi is certainly "more severe" this year and is causing a huge spike in multi-organ failures, a senior doctor at the city's Institute of Liver and Biliary Sciences (ILBS) told NDTV.

The national capital reported three dengue deaths on Monday, taking the total number of deaths to nine - the most in a season since 2017, when ten people died.

Delhi logged 1,171 dengue cases from November 1-6, after reporting 1,196 through October and 217 in September (the highest for that month in three years), according to news agency PTI.

"This year, certainly we have found that the infection is more severe. And those people who have got dengue in the past have also been infected. So it clearly means that there are four serotypes and one serotype can protect you from not having it again. But it does not protect you from having another serotype," said Dr SK Sarin, Vice Chancellor, ILBS, and Chairman of the Delhi government panel on COVID-19.

There are four dengue serotypes, meaning that it is possible to be infected four times.

"There have been abdomen patients coming with vomiting, nasal bleed, and liver failure. So almost like two to three cases in a week are coming with severe liver failure. They have kidney failure, brain failure, so multi organ dysfunction and they are very sick. And the time is so short. From the time they have, they're not having that much platelet reduction but organ failure, which is rather a bit unusual," said Dr Sarin.

Dengue is divided by the World Health Organisation (WHO) into two categories: whether you have symptoms or you have no symptoms. If you have symptoms then it is severe, so dengue which is severe causes reduction in blood pressure and shock. Severe dengue is a leading cause of serious illness and death.

"These patients have got very high liver enzymes, for normal liver enzymes upper limit is 40, in dengue we used to see 300-500, this year the liver enzymes have gone up to 7,000-10,000 as if someone's whole liver is collapsed. There is no urine made by the kidney. Brain failure, heart failure. And there are bleeding tendencies all over. These are some of the multi-organ dysfunction that people with severe dengue have come and they require blood pressure management, ICU treatment that creates a huge load," said Dr Sarin.

The doctor advised against giving aspirin to people running high fever as it causes bleeding.

"So my suggestion is if somebody has fever, then please do not give Aspirin (or Ibuprofen) like things because they cause bleeding. So you can enhance bleeding by giving such drugs to those infected with dengue. Give Paracetamol to these patients, refer them to the hospital, hydrate them very well give them water so that they can reach the hospital in time," the doctor advised.

There is no specific treatment for dengue. Early detection of disease progression associated with severe dengue, and access to proper medical care lowers fatality rates of severe dengue to below 1 per cent, says WHO.

"The dengue cases among children are on the rise this time. They are being admitted to hospitals in a serious condition. Earlier, we saw the platelet count used to drop, now patients are suffering multi-organ failures. The liver and kidney are badly affected. The ICUs are filled with children. This time, dengue patients are requiring ICU hospitalisation," said Dr DS Rana, Chairman, Ganga Ram Hospital.

The increase in dengue in Delhi may also be because of a rise in cases in neighbouring Uttar Pradesh and other areas of the national capital region.

Delhi went through a major dengue outbreak in 2015, with reported cases crossing 10,600 in October alone, making it the worst in the national capital since 1996.