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Sunday, July 24, 2011

Dengue - some lessons learnt - prevalence in Chennai city


There are times when you are reminded of God and wonder what small things can often do, even in a relatively advanced World where in a metropolis, you  have access to modern labs and good treatment. 

Sure you have heard and read lot about blood – the red coloured body fluid which supplies oxygen to tissues, supplies nutrients, removes wastes and is the most integral thing in life.  The blood cells are suspended in a liquid called blood plasma. Plasma, which constitutes 55% of blood fluid, is mostly water (92% by volume.  Blood consists of  red blood cells  and white blood cells, including leukocytes and platelets.  Blood is circulated around the body through blood vessels by the pumping action of the heart.  Medical terms related to blood often begin with hemo- or hemato- (also spelled haemo- and haemato-) from the Ancient Greek word αἷμα (haima) for "blood".

Blood loss in any form can cause serious damage – blood comes out often from injures but by a special function it clots also.   Coagulation is a complex process by which blood forms clots. It is an important part of hemostasis, the cessation of blood loss from a damaged vessel, wherein a damaged blood vessel wall is covered by a platelet and fibrin-containing clot to stop bleeding and begin repair of the damaged vessel. Disorders of coagulation can lead to an increased risk of bleeding (hemorrhage) or obstructive clotting (thrombosis). Most of the time this includes the changing of blood from a fluid to a solid state.

Learnt by experience that this function [of coagulation] could be challenged by a tiny miniscule insect !!  sometimes, many of us complain that modern day Doctors prescribe a series of tests even for perceived small ailment… but most of that is to rule out or to analyse and find out the root cause of such ailments……….  One such is an Immunoglobulin test which  measures the level of certain immunoglobulins, or antibodies, in the blood. Antibodies are proteins made by the immune system to fight antigens, such as bacteria, viruses, and toxins.  The body makes different immunoglobulins to combat different antigens.   Whist there are sub classes  :  -  IgA, IgG, and IgM are frequently measured simultaneously. Evaluated together, they can give doctors important information about immune system functioning, especially relating to infection or autoimmune disease.  Once an antibody is produced against a specific antigen, the next time that antigen enters the body, the immune system "remembers" its response and produces more of the same antibodies. In that way, checking for the presence of specific immunoglobulins in the blood can be helpful in diagnosing or ruling out infections or certain other illnesses.

Infections do manifest immunodeficiency helping the Doctors to diagnose the illness and treat the patient accordingly.  Platelets are small, regularly shaped clear cell fragments.   The average lifespan of a platelet is normally just 5 to 9 days. Platelets are a natural source of growth factors. They circulate in the blood and are involved in hemostasis, leading to the formation of blood clots.  If the number of platelets is too low, excessive bleeding can occur.
There are reports of prevalence of Dengue fever in the city and that everyday some children are getting admitted into hospitals with signs of dengue.  This really is a cause for concern.   Dengue fever is a disease caused by a family of viruses that are transmitted by mosquitoes. It is an acute illness of sudden onset that usually follows a benign course with symptoms such as headache, fever, exhaustion, severe muscle andjoint pain, swollen glands  and rash.  Dengue (pronounced DENG-gay) strikes people with low levels of immunity.

After being bitten by a mosquito carrying the virus, the incubation period ranges from three to 15 (usually five to eight) days before the signs and symptoms of dengue appear. Dengue starts with chills, headache, pain upon moving the eyes, and low backache. Painful aching in the legs and joints occurs during the first hours of illness. The temperature rises quickly as high as 104 F (40 C), with relative low heart rate and low blood pressure. A flushing or pale pink rash comes over the face and then disappears. The glands (lymph nodes) in the neck and groin are often swollen.  All are some of these could be pronounced in those affected. 
Aedes is a genus of mosquito originally found in tropical and subtropical zones, but now found on all continents excluding Antarctica.  First described and named by Meigen in 1818, the name comes from the Ancient Greek aēdēs, meaning "unpleasant" or "odious". Some species of this genus transmit serious diseases, including dengue fever and yellow fever.

So the common advice is to keep your surroundings clean with no stagnation of water and provide no breeding ground for mosquitoes.  Mosquito bite is stated to be the main cause for dengue fever which can be too dangerous when not diagnosed and treated properly.
Mosquito is from the Spanish word for little fly – these small insects go through four stages in their life-cycle: egg, larva, pupa, and adult or imago. Adult females lay their eggs in standing water, which can be a salt-marsh, a lake, a puddle, a natural reservoir on a plant, or an artificial water container such as a plastic bucket. There are about 3,500 species of mosquitoes found throughout the world.  Mosquitoes are a vector agent that carries disease-causing viruses and parasites from person to person without exhibiting symptoms themselves.  The dragonfly nymph eats mosquitoes at all stages of development and is quite effective in controlling populations. Gambusia, [the common guppies that is often found in temple tanks and elsewhere] eat mosquito larvae and can be effective in controlling mosquitoes.  The simplest of the ways to keep mosquitoes at bay would be to keep the surrounding free of stagnant water, spraying insecticides and ensuring that the waste is disposed off as immediately as possible. 

Once there were jokes aplenty about mosquitoes of Mambalam – now the uniqueness is gone – mosquitoes are found everywhere; some jocularly said that they cannot fly high and cannot reach the top floors of multi-storeyed apartments.

Regards – S. Sampathkumar.

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