NEW DELHI: The city is in the midst of a dengue outbreak and people are rushing to get their platelet count checked at the first sign of fever, but, doctors say, high haemoglobin levels may also point to a severe dengue infection.
A falling platelet count is thought to increase the risk of death from dengue but doctors have observed that nearly 20 per cent of the patients show a stable platelet count although their haemoglobin levels increase, indicating severe dehydration and the need for immediate medical attention.
In men, 13-16g of haemoglobin per 100ml of blood is considered normal, while in women the level should be 11-13g, said Dr Navin Dang, director of Dr Dang's Lab. Haemoglobin is a protein molecule in red blood cells that carries oxygen to the body's tissues.
A patient should be rushed to hospital if his or her haemoglobin count increases beyond 10% of the average level, said Brig (Dr) Ajay Sharma, professor and head, department of medicine and clinical hematology at the Army (Research and Referral) Hospital.
If haemoglobin is high, it is a danger sign even if the platelet count is normal. Most people, including doctors, keep waiting for the platelet count to fall, telling patients not to worry as their platelet count is normal. But this is wrong," he added.
Doctors say people with higher levels of haemoglobin need to be given fluids rapidly, either orally or intravenously. "When their temperature becomes normal, patients feel better but their platelet count is likely to go down. It is not a dangerous sign if there is no active bleeding. There is no role of platelet transfusion in a patient who has no active bleeding," said Brig (Dr) Sharma.
"In dengue, patients tend to consume less fluids which causes dehydration," said Dr Anoop Misra, chairman, Fortis C-doc Center Of Excellence for Diabetes, Metabolic Diseases and Endocrinology. "When this increases to alarming levels, the blood tissues dry up causing increase in packed cell volume or hematocrit and increase in haemoglobin levels. It can lead to ascitescollection of fluid in the abdomen."
Dr Misra added that medical attention and awareness about the warning clinical symptoms can help save many lives. Till Saturday, dengue had claimed 17 lives in the city and another 3,791 people had been infected, data with the municipal corporations showed.
On Tuesday, at least two more dengue deaths were confirmed taking the toll to 19. Shivam Dubey (14) from West Delhi and Ram Babu (24) from East Delhi died at Sanjay Gandhi Memorial Hospital and Lal Bahadur Shastri Hospital, respectively, on Monday.
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