MCD dengue cases not up-to-date

Civic bodies underplay data of affected people in city, say doctors

The city’s municipal corporations confirmed one more case of dengue death in Delhi.

Mohini B Masih, 29, was admitted to Lok Nayak Hospital on October 25 and died on October 31. She was in her ninth month of pregnancy and the MCD statement says that she died of dengue fever, combined with seizure disorder and hypothyroidism.

Deccan Herald had reported about the critical condition and subsequent death of the Bhajanpura resident, who worked as a nurse in GB Pant Hospital. The baby could also not be saved.

According to the latest data released by the MCD, the city has reported 1,401 dengue cases in 2012. Out of these, 1,390 originated in Delhi, while 11 came from other states.
There is a widespread speculation that the MCD data are extremely underplayed.

The count from leading private hospitals itself shows the discrepancy. In addition, there are a lot of cases in smaller hospitals and clinics that do not reach the database of MCD ever.

Various branches of Fortis Hospitals and Sir Ganga Ram Hospital have received 550-odd cases each, while Moolchand Medcity has confirmed nearly 400 cases. Apollo hospital has confirmed nearly 250 cases of dengue.

Government hospitals — AIIMS, Safdarjung, Deen Dayal Upadhyay, Guru Teg Bahadur and Lok Nayak — have jointly reported over 1,300 cases.

“This happens every year. In 2010, from Okhla they reported 100 cases. I alone attended 30 patients and referred them to other hospitals, where the patients got dengue treatment,” said Dr Ahmed Farooqui, who runs a clinic in Okhla. “The data don’t represent the full picture. Numbers are underplayed,” he said.

He added that the real number would be at least thrice of what the municipal corporations are registering.

Dengue test methods

The other hitch is non-acceptance of ‘rapid test’ as the confirmation test of dengue by the MCD. “There are two ways of detecting dengue.

Test of antigens through blood sample, called NS1 antigen test. The other is test of antibodies, called IgM,” said Dr Chand Wattal, chairperson of department of microbiology, Sir Ganga Ram Hospital.

Both the tests can be conducted in two different manners — rapid test and ELISA (enzyme-linked immunosorbent assay). The MCD accepts only those patients as dengue affected who get confirmation through ELISA, saying it is more accurate.

“ELISA is considered more accurate. However, the difference in accuracy is very low among the two tests. Both have accuracy levels above 90 per cent,” said Dr Wattal.

Rapid test is conducted at half the price of ELISA. Also, its results come out in half-an-hour, while ELISA takes four hours or more.

Most laboratories, especially the smaller ones, conduct only rapid test, which is much easier. ELISA test needs a higher level of setup not available at most of them. All government hospitals have facility to conduct both the tests.  
 
“Many of us are of the view that detections through rapid test should be included in the data released by the MCD.

Almost all rapid test detections are confirmed by ELISA. They can mention confirmation through the two tests separately,” said a professor of community medicine department of a central government hospital in Delhi.

“At least we will know what is the actual spread of the disease and take measures accordingly,” said the professor.

He said the actual number of people suffering from dengue in the city can be four to five times higher than the official figures.