With goat's milk prices soaring to near Rs 2,000 a litre and papaya leaves running out of stock, it is tough being Indian and trying to keep your platelet count from sinking. It's dengue season, and there are rumours of a more-virulent-than-normal strain doing the rounds - and miraculous home remedies are all that one can bank on.
Based on the ELISA test, the total number of reported dengue cases across India last year was around 50,000, according to the National Vector Borne Disease Control Programme. This year, till September alone, the number stood at 38,000. States like Tamil Nadu, Andhra Pradesh, West Bengal and Puducherry have seen a marked decrease in the incidence of the disease compared to last year. There has been a spurt in reported cases in Kerala, Karnataka and Orissa. Delhi too is seeing an upward curve in numbers, having reached the 2,100 mark last month, against a total of about 2,000 cases in all of 2012. The number game now will all depend on how long the monsoons take to recede.
According to Dr Atul Gogia at New Delhi's Sir Ganga Ram Hospital, these figures can be misleading since records depend on the testing methodology. Only those testing positive for the ELISA test figure in the list of reported cases. Since ELISA is an expensive test, priced at around Rs 2,000, most patients opt for the cheaper platelet-count test, which can cost as little as Rs 50 at a Central Government Health Service (CGHS) clinic. Also, the actual number of cases may be much higher since not every case needs hospitalisation and symptoms start to wane in seven days in most cases.
Gogia explains that since there is no particular treatment plan for dengue, patients tend to panic. That is the biggest reason for hospital beds being almost overbooked. He adds that not every case needs hospitalisation and if a patient can eat properly, the platelet count is 80,000-100,000 and blood pressure is normal, recovery at home is adequate. "Being in touch with your physician and monitoring your platelet count once a day is enough in such cases," he advises.
About the increase in the number of cases this year, he says that there's no specific reason other than the extended monsoons. Poor waste disposal and water logging has led to a massive breeding ground for the Aedes aegypti, commonly called the tiger mosquito for the stripes on its legs. The only solution lies in prevention of mosquito bites.
The common method of curbing mosquito proliferation is fogging, but often the pests develop resistance to chemical repellents, and research should go into how they adapt to the toxins. Authorities may also want to look at the viability of using the tilapia fish as a biological control of mosquito proliferation. As Pakistan has successfully proved in its battle against dengue, the common fish eats larvae and eggs of the mosquito. Pakistan has brought down dengue cases to a tenth of what it was in 2011 by releasing tilapia in ponds and areas with stagnant water.
Apart from this, people themselves need to take care of the surroundings around their houses and keep their arms and legs covered to avoid bites. Other preventive measures include mosquito repellent creams, which Gogia suggests are quite effective. Mosquito coils and mats can be a nuisance because of the smoke, but creams like Odomos and repellent bands and patches are effective.
When asked about home remedies like drinking the juice of papaya leaves or goat's milk and having kiwi fruit to increase platelet counts, Gogia says that these are not "scientifically driven", but have no adverse effect on the patient as long as proper cleanliness and food hygiene is maintained.
Though a disease notorious for being in the spotlight every year in India, the important thing to remember is that it is one among other infectious diseases and has a short life-span between the monsoon and winter season. While panic is a natural response since it has no treatment plan other than paracetamols and platelet transfusion, the key thing to remember is that it isn't an incurable infection and isn't necessarily one that brings with it a death sentence.
