Dengue death confirmed, platelet kits unavailable

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LAHORE: A dengue patient died for lack of platelet kits in Lahore on November 3, despite the government’s claims that there has not been a single ‘verifiable’ death because of dengue across Punjab, Pakistan Today has learnt.
Muhammad Rafique was admitted to Omar Hospital and was diagnosed with dengue on November 1. His relatives could not arrange more than one kit for platelet transfusion which ultimately resulted in his death owing to the Dengue Shock Syndrome (DSS) – the most severe presentation of the dengue virus.
The hospital record shows patient’s slip (No 3027) issued at his death read ‘high fever, renal failure and spiral bleeding’ as the cause of death. The staff on duty in the Surgical ICU, where Rafique was admitted, confirmed that dengue caused Rafique’s death.
They said that they did not have the mega platelet cell separator facility and patients had to get it themselves. They also revealed that there were five dengue patients still in the unit.
Talking to Pakistan Today, Rafique’s brother Imtiaz said, “My brother had no medical history, he just got fever a week ago. We had him tested for malaria but it was negative.
One day he went to the toilet where he fainted; we rushed him to the hospital where doctors diagnosed him with dengue, telling us not to worry as the disease was curable.
We did all we could to arrange kits for platelet transfusion but could only get one from Sheikh Zayed Hospital for Rs 20,000. We went from pillar to post in search for kits at all government hospitals and labs, even approached medical superintendents, but in vain. We could not find kits for money, let alone free-of-cost. After two days his condition worsened and he died.”
Commenting on different clinical presentations of dengue, Pakistan Medical Society Chairman Dr Masood Akhtar said the virus’s initial presentation was the dengue fever which gets severe turning into Dengue Hemorrhagic Fever (DHF), with a more than 20 percent mortality rate, according to international studies.
However, after timely diagnosis and employing necessary platelet transfusion and hydration, the mortality rate could be brought as low as 1 percent, he said. The worst presentation was DSS, with a 30 to 40 percent mortality rate which caused fluids to set in lungs or abdominal cavity or caused renal shut down.
“Severe form of dengue causes bleeding which can be both internal and external; external bleeding is less harmful while the internal bleeding is fatal and can cause renal shut-down [the patient cannot pass urine],” he added.