LAHORE: People sickened by dengue virus develop dengue fever, a weeklong bout of joint and muscle pain. But many who suffer repeat infections have it worse. They come down with dengue hemorrhagic fever and suffer massive internal bleeding and liver damage, said Dr Masood Akhtar Sheikh, General Cadre Doctors Association (GCDA) Punjab president.
He was addressing a seminar on “Special Kids” at Lahore office here on Thursday, he said “Oddly, the virus causing dengue fever comes in four strains, and immunity to one seems to make infection by a second strain more dangerous.”
“In human’s recovery from infection by one dengue virus provides lifelong immunity against that particular virus serotype. However, this immunity confers only partial and transient protection (up to 2 to 3 months) against subsequent infection by the other three serotypes of the virus,” Dr Masood said.
Secondary infections put people at greater risk of severe dengue leading to hospital admissions, something called “antibody-dependent enhancement, he said.
Dr Masood Sheikh added that this condition occurs when the immune response actually makes the clinical symptoms of dengue worse, increasing the risk of severe dengue. Some develop dengue hemorrhagic fever after the initial fever declines — a more severe form of the illness that can cause organ damage, severe bleeding, dehydration and even death. Certain chronic diseases — including asthma, sickle cell anemia, and diabetes mellitus — can increase a person’s risk of developing a severe form of the disease.
Dr Sheikh added that in Asian regions, the predominant dengue serotype of DEN-2 has been replaced with DEN-3.
GCDA General Secretary Dr Rana Rafique said that this phenomenon can also happen in children who received antibodies against dengue from their mothers while in the womb? the consequence of antibody-dependent enhancement is that the body’s immune system response actually makes the clinical symptoms of dengue worse and raises the risk of severe dengue illnesses.
Dr Assad Abbas Shah said that in DHF, bleeding may occur from any site and does not correlate with the platelet count. Hemorrhagic manifestations occur after fever has settled. The commonest site of haemorrhage is the gastrointestinal tract (which manifests as hematemesis or melena), followed by epistaxis. Vaginal bleeding has been reported in females despite high platelet counts. Bradycardia and a confluent petechial rash with erythema and islands of pallor are seen during convalescence period.
Copyright Business Recorder, 2022
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