Dengue patients hit by platelet quality

HYDERABAD: Reports of dengue cases continue to pour in from Old City even as the government is trying hard to play down the outbreak of the disease. Adding to the woes of patients is the declining quality of the platelet units supplied by blood banks that is crucial in treatment of severe cases.
The district administration along with the GHMC had identified five areas in the South Zone as being high risk.They include Kishanbagh, Uppugudda, Azampura, Hafeez Baba Nagar and Shastripuram and were designated such based on mosquito menace and the number of cases reported. According to estimates from the GHMC entomology wing, around 206 cases have so far been reported in the municipality limits of which about 80 cases are from Old City alone.
District Medical and Health Officer Dr Ananta Reddy said that the situation this week has improved. But medical practitioners from Old City say that the figure given by the government belies the ground reality and the number of cases reported in South Zone itself would exceed the number from the entire district. Around 25 patients are currently receiving treatment in Princess Dureshevar Hospital while the 500-bed Princess Asra Hospital is treating around 30 cases, say doctors treating patients at these hospitals.
“The Asra and Dureshevar hospitals between them receive around 10 cases everyday. The emergency wards in many paediatric private hospitals in other parts of the city are also brimming with dengue patients. Also many of the infected are treated as outpatients by government hospitals. The number ought to be far higher,” said a physician from Dureshevar hospital. Also alarming is the platelet scarcity. One of the major symptoms of dengue is the rapid decrease in platelet count which can result in profuse bleeding that can also turn fatal. If the drop is significant, platelet transfusion is crucial to facilitate blood clots. Doctors say that by pandering to panic, many hospitals are prescribing platelet transfusions where it is least needed, thereby creating a scarcity.
What is more worrisome than the scarcity is the suspected dilution of platelets units. A medical expert who practices at multiple health care facilities in the city said on the condition of anonymity, “Usually one unit of platelet increases the blood count by five thousand. In many cases it has come to our notice that the count increases only by thousand. This points to dilution of platelet concentration which may be done due to scarcity or high demand during the fever season. So we have to administer five units where one unit should have sufficed.” Each unit of Platelet Rich Plasma (PRP), that is plain platelet, costs Rs 1,200. The normal platelet count in the body ranges between 1 - 4.5 lakh. To avoid taking any chances with PRP, some doctors are prescribing Single Donor Platelet (SDP) which can increase platelet count by fifty thousand. However, the SDP comes at a premium of Rs 12,000 per unit.
Director of Institute of Preventive Medicine, Dr Suchitra Murthy maintained that the scarcity was artificial. “Even if the platelet count is at 40,000, the body can still produce enough platelets to recuperate. Only if it goes below this number, transfusion is required. The scarcity is created by some hospitals. There is no scarcity at IPM or in government blood banks,” she said.