Chikungunya outbreak: Panic a bigger cause for worry than fever, say doctors

'Unless suffering from co-morbid situations, 95 per cent patients do not require to be admitted,' said Dr Navneet Singh, director of emergency and acute care medicine of two super-speciality hospitals. (Representative image) Photograph:( AFP )

WION New Delhi, India Sep 19, 2016, 01.24 PM (IST) Nishtha Gautam
While the central and state governments pass the buck, viral fever deaths in New Delhi and the adjoining National Capital Region (NCR) are on the rise. With a combined death toll of 30 for chikungunya and dengue -- add to it the mysterious viral fever that is feared to have caused 12 deaths in a neighbouring village -- fever is turning deadly in the city. And from slums to posh colonies, everybody is seemingly in danger. As per National Vector-Borne Disease Control Programme (NVBDCP) data, 1,724 people have tested positive for chikungunya and 1,158 for dengue.

But it is to be noted that patients are concentrated, but not limited to, areas that have acute sanitation and cleanliness problems. Mukesh Yadav, a spokesman for the South Delhi Municipal Corporation, has been quoted admitting to the presence of nearly 1,185 unauthorised colonies in south Delhi. The number of chikungunya and dengue patients from here account for one-fifth of the total figure. While there is immense politicking happening over the situation, medical experts have a different opinion.

Dr Navneet Singh, director emergency and acute care medicine of two super-speciality hospitals, B L Kapoor (New Delhi) and Nanavati (Mumbai), says that panic amongst the ill-informed population is a bigger cause for worry than the fever itself. “While it is true that there is a spike in the number of chikungunya patients, it is not a life-threatening ailment. Yes, it is crippling with remnant joint pains troubling the patients long after the fever subsides” emphasises Dr Singh. Elaborating upon the associated panic, he says, “Because of lack of awareness in general public and many myths doing rounds, the moment people are tested positive for dengue or chikungunya they want to be admitted into the hospitals. Unless suffering from co-morbid situations, 95% patients do not require to be admitted.” As per him, both parties, patients and doctors, are to be blamed for the much-talked-about bed shortage in different hospitals.

Referring to profiteering and unethical medical practices, Dr Singh talks of how many doctors play upon the fears of their patients and insist upon admission. On the other hand, many patients with even a slightly higher body temperature than normal check themselves into hospitals. This creates an environment wherein the wrong diagnosis and negligence become commonplace. In government-run hospitals like Delhi's Ram Manohar Lohia, doctors are dealing with hundreds of patients on a daily basis. Impatience and fear on the part of the afflicted and their families are overburdening the already strained delivery of health services in the national capital. Examinations and investigations are not done accurately or in time.

Ex-Indian air force officer Piyush Anand also lost his father last week. While the nonagenarian tested positive for chikungunya, his death cannot be attributed to the fever. As per the experts, each death needs to be analysed for the exact cause so that myths and panic do not spread. In Mr Anand's case, it was cardiac arrest due to pressure on an already weakened heart.

Refuting municipal corporation data on the number of patients, Dr N P Singh, director, Max Super Specialty Hospital, Vaishali says, “The actual numbers have been severely downplayed. There are at least forty times more patients in the capital.” However, he, like Dr Navneet Singh, also says that only 5% of the total number need to be admitted in hospitals. “The full spectrum of the disease needs to be analysed for a better understanding. In roughly 95% of chikungunya cases, paracetamol and ample hydration is needed. It is a self-limiting ailment and the fever usually subsides after 72 hours. Many a time, in a bid to bring instant relief, harsh medication is prescribed which affects the liver adversely and can cause complications.” He adds, “Doctors and patients both need patience. Patients and their families need to be counselled well. Government, doctors and media should all work in tandem. The need of the hour is education, not exploitation.”

New Delhi's poor sanitation management needs to be tackled on a war footing and every year advisories are issued to deal with endemic and epidemic diseases, particularly during the end of the monsoon. However, this year legislators have got too busy with their blame game and the obfuscation of ground realities. In a farcical turn of events, Delhi chief minister Arvind Kejriwal publicly accused a veteran journalist of being an agent of the central government when the latter voiced concern over the issue. His Aam Aadmi Party's flagship mohalla committee programme to deal with micro issues locality-wise has also not displayed much zeal in spreading awareness about the diseases. It was only on Sunday evening that the chief minister released a video appealing to people and political parties for cooperation.