Casualties in war against dengue

The turn of events in the past two days are still haunting us. I feel scared thinking it could be my son too,” says Satendra Singh, neighbour of seven-year-old Abhinash Rout who died of dengue last Tuesday. Shortly after his death, his parents committed suicide. The couple Laxman and Babita jumped off the terrace of the rented flat in Lado Sarai.

“My wife was on good terms with the boy’s mother. It is still unthinkable what the parents had to go through taking their son from one hospital to the other for treatment,” says Singh.

Their couple’s landlord Rajpal has a dengue story of his own. “My brother’s daughter was down with dengue infection too. But she recovered... the same infection cost the seven-year-old his life,” he says.

Another neighbour Hari Joshi, who was admitted to Saket City Hospital on Saturday after suffering from high fever for days, says fear has gripped the neighbourhood.

“I have been suffering from fever for a week now. Initially, we thought it was dengue. But the test reports showed it was typhoid... I decided to get admitted finally today,” said Joshi.

The capital has seen over 1,250 cases of dengue this season, according to data released by the municipal corporations. There has been a steep rise in dengue cases since mid-August. At 778, the figures in August reached an all-time high since 2010 when 885 cases were reported during the corresponding month. The first week of September alone saw 428 cases.

Though the municipal bodies have confirmed two deaths till now, Abhinash Rout is among the at least 10 victims who have succumbed to dengue this season. Bara Hindu rao Hospital recently reported the death of a six-month-old girl due to dengue while AIIMS saw a 21-year-old man and a 45-year-old man succumbing to dengue shock syndrome. At Lal Bahadur Shastri Hospital, an 18-year-old boy died of dengue on Wednesday night.

The highest number of cases this year have been from the North Delhi Municipal Corporation area. The civic body reported 511 cases, 192 of them from Narela alone.

Residents complain that the municipal corporation has not made adequate efforts to curb dengue. “In my family, five people have suffered from dengue. There have been over three deaths in which doctors suspected dengue in our locality last week. There is hardly any fogging drive by the corporation,” says Dilip Singh, a resident of Khera Kalan village in Narela in northwest Delhi. Locals are living under extremely unsanitary conditions, he says.

Is the government prepared?

In 2014, the city saw 995 dengue cases in the whole year. The steep rise this year may be due to the dengue strain subtype 4 which has surfaced after almost four years, say microbiologists at AIIMS, which recently submitted a preliminary report on dengue strains this year to the Centre.

Even though government hospitals have added extra beds to accommodate the spurt in patients, they are falling short. At almost every government hospital, at least two dengue patients are occupying one bed. Several government hospitals have postponed routine surgeries to treat dengue patients due to lack of beds.

“The Delhi government recently notified us to delay all routine surgeries. Surgical wards are now being used to treat dengue patients. With the majority of our patients coming from lower economic background, such dengue patients will not be able to afford treatment outside,” says Dr Rakesh Singhal, in-charge of the casualty department at Swami Dayanand Hospital.

The hospital has treated 138 suspected dengue cases in the past one month. “The rush has been since mid-August. Till now, 50 people have tested positive for dengue at the hospital,” says Dr Mukesh Kumar, who heads the medicine department.

The Delhi government has now decided to procure 1,000 extra beds. “The 1,000 beds will be allocated to hospitals as per the demands. The government will also soon ban the use of rapid diagnostic kits across hospitals. It is giving inaccurate results in several cases, and unnecessarily spreads panic,” says Dr Charan Singh, nodal officer, vector-borne disease, Directorate of Health Services.

Major hospitals like Lal Bahadur Shastri Hospital, Deen Dayal Upadhyay Hospital, Guru Teg Bahadur Hospital, Ram Manohar Lohia Hospital and Bara Hindu Rao Hospital are making patients share beds.  They also face a shortage of staff to deal with the rush.

“There are 57 designated beds for dengue cases. At any given time, there are at least 70 patients undergoing dengue treatment. We have to admit patients suffering from suspected dengue symptoms. The patient would test positive for dengue only between the fourth-fifth day of the fever,” says a senior administrative doctor at LBS Hospital.

GTB Hospital saw 50 fresh admissions on Thursday and has recorded 50-60 dengue admissions on a daily basis in the past few weeks, says a senior doctor.
“There have been at least four deaths due to suspected dengue at the hospital,” says a doctor.

Doctors say there is panic as several people are coming in with positive reports from the rapid diagnostic tests done in private clinics or hospitals.

“Around 800-1,000 fever cases are coming to the hospital daily in the OPDs and emergencies. There is double sharing of beds for dengue patients at our hospital too,” said Dr Savita Babbar, medical superintendent at Deen Dayal Upadhyay Hospital. Her hospital is getting an average of 20 dengue cases every day.

And RML Hospital saw 83 positive cases on Friday alone. Since mid-July, the hospital has dealt with over 400 cases.  “There are 70 dengue beds but the admissions are higher than this. The rest are being accommodated in the emergency wards,” says RML spokesperson Dr V K Sinha. The other hospital which has seen a heavy traffic of patients is Bara Hindu Rao.
“We have treated 231 positive dengue cases till now of the 1,073 suspected dengue patients. Currently, we are awaiting the results in 165 cases,” says Dr D K Seth, Director, North Delhi Municipal Corporation-run Bara Hindu Rao Hospital.

The hospital has set up eight fever clinics besides its OPD and emergencies, which are also handling dengue patients.  Around 800 fever cases are turning up daily at the hospital with 127 currently admitted with high fever.

Muncipality -run Kasturba Hospital has reported 21 confirmed dengue cases out of the 79 admissions till now. The Delhi government-run Lok Nayak Hospital deals with 20 dengue positive cases daily.

Hospitals on the capital’s periphery, like Rao Tula Ram Hospital, saw 16 suspected dengue cases on Saturday. Twenty patients were already admitted there with high fever.

Doctors at government hospitals say the figures from individual hospitals point out that the figures given by the municipal corporations may be underestimated.

Patients with high fever and symptoms of dengue like vomiting, weakness, body ache should immediately see a doctor, say experts. “But patients need to understand not every fever case is dengue,” reminds Dr Babbar. There is no need to panic.

The government hospitals also report delays in getting dengue blood test reports. Though the Health Department claims the reports are now coming in the same day, doctors say in several cases they get them only after four or five days.