Spurt in H3N2, dengue cases keeps doctors on their toes

    Panaji: Viral infections are on the rise, with doctors seeing more dengue cases than they did last year.
    “The number of dengue cases this year is very uncharacteristic. Every day, I see a minimum of four to five new cases,” said consultant physician Dr Rufino Monteiro.
    Most of the dengue patients coming to him are from Panaji, Caranzalem, Dona Paula, Santa Cruz, and Bambolim. Some are from as far as Calangute.
    “Dengue is really a big problem this year. It’s not very fatal, but the problem is the platelet count drops very low in some cases ,” said Monteiro.
    At Healthway Hospital, Old Goa, consultant physician Dr Chitralekha Nayak also says that 50% of her admissions are dengue cases, mostly from Panaji.
    Respiratory infections are also on the rise this time of year. Almost all the cases Nayak is seeing presently are of H3N2 (a subtype of the Influenza A virus). At the beginning of the monsoon, however, she was seeing only H1N1 (swine flu) cases, which was the prevalent virus last year.
    Nayak has found H3N2 to be milder than swine flu. “We do get elderly patients with H3N2 presenting with giddiness, getting admitted because they’re too weak to get up from the bed or are not taking fluids orally, but they are discharged after two days. This year, the H3N2 virus symptoms are milder compared to the H1N1 we saw last year,” she said.
    Where those with H1N1 presented with high-grade fever right from the start, progression into pneumonia was faster. H3N2 was more manageable, with fever touching a maximum of 101 degrees and weakness as a classic symptom. “I’ve not seen a bad pneumonia case because of H3N2, but weakness, loss of appetite and cough continue to trouble them for 15-20 days,” said Nayak.
    However, in the south, pulmonologist Dr Pravin Bhat is not only seeing a rise in respiratory infections this monsoon but also more severe forms with severe wheezing and breathlessness, and admissions are required in some cases. He is also receiving H1NI and H3N2 cases besides those of influenza A and B. The cases are being seen in adults and in the paediatric age group.
    “Viral infections would come and go during the monsoons without causing much problem, but this year, we are seeing more severe forms. What would usually come as upper respiratory infections and disappear quickly are now progressing to the chest and developing into bronchitis and pneumonia,” Bhat told TOI.
    Bhat said that those in the vulnerable age group — patients of diabetes, heart disease, kidney disease and COPD or chronic asthma — must consider the influenza vaccine on their doctor’s advice.
    “The WHO guides us on which vaccines to use and they are already out in the market. We advise some patients to take them. Once they take the dose, it takes around 10-14 days for the antibodies to form. The vaccine is repeated every year and is a good preventive strategy,” he said.

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