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Times of India
23 August 2010
By Prithvijit Mitra
Kolkata, India

97 Cases Detected Already; KMC To Hold Camps To Screen Malaria & Dengue Patients
Dengue Makes A Silent Entry In City
Even as the number of malaria cases keep spiralling in the city, its mosquito–borne cousin has made a silent entry. Nearly a hundred dengue cases have already been recorded this season.

The civic authorities, grappling with the malaria menace, are yet to take up screening or launch awareness campaigns against the disease. Experts fear that scores of dengue patients remain untreated as they are not being advised to take an NAC Elisa test that detects the disease. As a result, hundreds could be getting infected in the next one month.

According to the last Kolkata Municipal Corporation (KMC) count, 97 in Kolkata have been affected by dengue this year. Since the KMC health clinics do not have the facility to conduct NAC Elisa tests, patients must take it at private facilities or at the School of Tropical Medicine. A couple of government hospitals have the facility as well. Majority of dengue suspects are escaping diagnosis and are being treated for ordinary fever or influenza. What has complicated matters is a "fever tide" that has now gripped Kolkata. This has made it difficult to differentiate dengue patients from the rest and hastened transmission over the last few weeks.

"Symptoms of dengue are similar to that of influenza which makes it difficult to detect without a test. It leads to high fever, joint pain and headache as in influenza. Patients rarely bother to take a test unless the fever continues for a week or more. So, dengue patients are passing through the net and helping transmission," said Tomonash Bhattacharya, tropical medicine expert.

The only symptoms that distinguish dengue from influenza are retroorbital pain (pain in eyeballs), body rashes and reddening of the eyes. These are often overlooked and passed off as being associated with fever or influenza even by physicians. "There have been cases where patients were treated for influenza for more than two weeks even though the symptoms suggested dengue. Since they were not kept in isolation, transmission must have happened. Unfortunately, this has been happening almost every year," said Debashish Basu, preventive medicine specialist.

Doctors advised patients to go for an NAC Elisa test only after they have had fever for five days or more. If taken before that period, the test often fails to confirm dengue. "Scores of patients are being advised to take the test immediately on having fever which is neither helping treatment nor breaking the chain of transmission," said Bhattacharya. Suspected patients must also get their platelet count checked to rule out haemorrhegic dengue which could be fatal.

KMC is planning to hold 15 camps to screen malaria and dengue patients. "Since malaria is a bigger problem now, we are not having any separate campaign for dengue. But we are keeping a watch on the situation," said Atin Ghosh, MMiC (health).

So long as such steps are taken, doctors advise Kolkatans to watch out for the tell–tale signs. "If you have excruciating pain in the joints along with fever, go into isolation and take complete rest. Pain in the eyeballs and body rashes should immediately be reported to your physician. Use mosquito nets even during the daytime for dengue transmission happens only before sundown," said Bhattacharya.

Chikunguniya could be the next to hit Kolkata, warn experts. Patients who have been left incapacitated by high fever but have not tested positive for dengue or malaria should be screened for chikunguniya, they said.

Dengue symptoms
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