Ten months ago Dengue fever hit our cities. The outbreak was unprecedented in severity. In the blink of an eye there were hundreds of cases all over Lahore. Doctors and hospitals were caught completely off guard. Many doctors, myself included, were unfamiliar with Dengue fever and how to manage it. As the ranks of patients swelled, the capacity of hospitals to care for them was quickly overwhelmed. Though no one will admit this today, many hospitals in Lahore stopped accepting patients because they simply did not have the capability to take care of any more.
Dengue fever gets its name from the Dengue virus which causes the disease. The virus cannot spread directly from one person to another. It relies on a certain species of mosquito to spread from one host to the next. Patients complain of fever, weakness, headaches, muscle pains and a skin rash. In a small numberof cases patients develop Dengue hemorrhagic fever, with very low platelet counts and risk of internal bleeding. Patients with this complication need to be transfused with a large number of platelets, and the most effective way to donate platelets is through platelet pheresis, a procedure which is unfortunately not widely available. Last year, desperate for platelet transfusion, patients and their relatives were left to scour the various hospitals and labs looking for the mercurial platelet ‘kits.’ The handful of places that had the facility for platelet pheresis were simply not equipped to handle such demand. In our lab we performed more than 700 platelet donation procedures during this episode. Eventually, we ran out of kits too and had to rely on older methods for platelet donation. This desperate situation lasted almost two months, and by the end Dengue had afflicted thousands of patients in Lahore alone.
There is a similar storm headed our way now. It is supposed to be too hot for Dengue fever to be spreading. It is supposed to be too early in the summer. But apparently viruses don’t care when they are supposed to spread. My lab is diagnosing about ten new cases of Dengue fever every day. This is paltry compared to the hundred a day we were diagnosing last year, but the trend is upward. Like most other health care facilities, we have tried our best to be better prepared this time. We have ordered more platelet kits than last year. Most importantly our team is better prepared. I hope that all of our preparation will be enough to handle what seems imminent; even more, I pray that all of this preparation will in the end be unnecessary, and the outbreak will not come to pass.