Times of India
08 October 2010
By Shailvee Sharda
Lucknow, India

Over 600 patients of viral fever are being treated by doctors at government hospitals daily. However, less than 20% fall in the categories of dengue, malaria or chikunguniya.

But platelet and white blood cell (WBC) count of about 15–20% patients is going down. Former head of civil hospital and expert in medicine, Dr H N Tripathi terms the condition as ‘fever and myalagia syndrome’ (FMS). Myalagia, it may be noted, is a condition marked by acute muscle pain and cramps in the body. The remaining symptoms are of simple seasonal viral flu.

"The syndrome is marked by leucopenia (drop in the number of white blood cells), thromocytopenia (drop in the platelet count), altered liver function, retro–orbital pain (pain behind the eyes), chills and anorexia (nausea and loss of appetite). In some patients, the involvement of central nervous system is also seen. Death due to a similar condition has not been reported till now," added Dr Tripathi, who now works with a private hospital.

Senior consultants working in government hospitals of UP have also noted these symptoms in about 10% patients being reported in outpatient departments (OPDs). They believe that since the condition shares many characteristics with dengue symptoms, certain private hospitals are terming the patients as suffering from dengue, which is causing panic. Many private doctors also believe the same.

A senior member of Indian Medical Association, Dr P K Gupta, who is spearheading an awareness drive against infectious diseases, has a different view.

"There are chances of such patients being false negative cases of dengue (dengue virus present but not identified in the report due to use of old techniques)," he said adding that if the possibility of ‘false negative’ has been ruled out, then the condition may be placed in ‘other viral fevers’ category.

Chief surveillance officer, integrated disease surveillance project, UP, Dr Purnima Srivastava admitted the such cases are prevailing. "But we need a very advance lab for detecting which virus was exactly causing the condition," she said.

When asked to comment, head of microbiology department, Sanjay Gandhi Post Graduate Institute Of Medical Sciences (SGPGIMS), T N Dhole said, "It may be a flabby or a rocio–virus. Chances are that the a variant of the two types could also be the cause of trouble."

He said that the lab at SGPGIMS is equipped to decipher the virus which is causing FMS but added that no one, neither the state health department nor patients themselves, have approached the department for the purpose.

"We need samples to conduct tests and find out the troubling virus, but no one is thinking in these terms. Probably, the authorities are waiting for things to worsen so that they may act," said Dr Dhole.

About prevention and treatment, the experts said it is best to visit a doctor if high fever is accompanied by severe head and body ache, pain behind the eyes and loss of appetite. "The condition is self–limiting but care needs to be taken," said one of them.

The experts warned against self medication, especially use of analgesics, for it may lead to a further dip in the platelet count.

Common Factors
Factors common in dengue, and fever and mylagia syndrome (FMS)

• Drop in number of white blood cells (WBCs)
• Drop in platelet count
• Pain behind the eyes
• Chills and nausea/loss of appetite

Treatment

• Simple dengue and FMS are self limiting
• There is no specific treatment for both the conditions
• Doctors usually give medicines to control secondary infections

Prevention

• Avoid mosquito bite
• Wear full sleeves clothes
• Do not let water accumulate anywhere around your house in open
• Self medication, especially of pain–killers, is banned

Warning signs

• High fever with chills
• Severe body ache
• Pain behind the eyes