Publication:

Study of dengue outbreak in north west zone of Rajasthan, India

Background Dengue is one of the most important mosquito-borne viral disease globally. The virus is the member of flavivirus group which typically is a single stranded RNA virus. It is 2nd most common arthropod borne disease in India. Due to its atypical presentation often, dengue missed out as a differential diagnosis. High clinical suspicion and proper investigation help in early diagnosis of dengue and its complications.

Methods A total of 200 patients were selected to be a part of study after applying inclusion and exclusion criteria. Only those patients were included in the study who had classical features of dengue- fever with chills, body ache, headache and thrombocytopenia and had a positive serology against dengue virus. Patients who had malaria, enteric fever, and negative serology were excluded from the study. Other causes of pancreatitis, pneumonitis, ascitis, cholangitis, pleural effusion and thrombocytopenia are rolled out. All patients were subjected to a detailed history and a thorough clinical examination. A complete blood count, liver function tests, renal function tests, chest X-ray and USG abdomen were also done.

Results Among 200 patients diagnosed as dengue fever,106 were male and 94 female. 78% patient were from urban and majority were from 20-30 years age group. Average duration of stay in hospital is 3.5 days. Along with fever and malaise, pain abdomen, bleeding diathesis, itching, cough were the major complaints in decreasing order. Different findings in the investigations are: Mean WBC counts - 4251, mean platelet counts - 41831, mean hematocret - 41.8, mean MPV- 8.55, number of patients with deranged ALT/AST- 88(44%). In USG ascitis and edematous gall bladder were the major findings followed by hepatomegaly, splenomegaly and pleural effusion. Number of patients required platelet transfusion were 60. Among these 60 patients average number of RDP transfused is 2 units.

Conclusions Present study concludes that clinical vigilance about various type of presentations is important as timely recognition can influence outcome and may prevent compilations.