Dengue and more: Kolkata doctors see dual infection spurt, flag treatment concerns
Times of India | 13 September 2023
KOLKATA: Doctors, their hands full dealing with a spurt in vector-borne diseases, have noticed several cases of cross-infection in the city. This one-two combo - dengue-malaria, dengue-typhoid or dengue-scrub typhus - is making diagnosis and treatment difficult.
Most doctors TOI spoke to said such cross-infections could prove extremely dangerous, even fatal, especially in those with low immunity.
"This year, we have been coming across a good number of patients with dual infection," said Kausik Chaudhuri, a pulmonologist, who acts as the nodal officer for both vector-borne diseases and Covid at the Beliaghata Infectious Diseases Hospital. "It is either dengue with malaria or typhoid in most cases. We have also at least one case of dengue and Covid," he added.
Supriyo Chakrabarty, group CEO , B P Poddar Hospital, said of the 48 dengue patients at the hospital, five also had typhoid. "We could send them back home," he said.
Dengue and malaria are both vector-borne, the former caused by the bite of an infected aedges aegypti mosquito and the latter through a bite by an anopheles mosquito. Scrub typhus is caused by the bite of infected chiggers, which are in abundance during monsoon. Typhoid is a water-borne disease.
Sayan Chakraborty, a specialist in infectious diseases at AMRI Dhakuria, said there is "a cross-reactivity of antibodies of dengue and typhoid", which means one of those illness could generate a positive report for the other. "So, sometimes, there is a diagnostic dilemma," he said. "Recently, we got a patient in whom both dengue and scrub typhus had been detected. This patient was being treated as a malaria patient elsewhere. This cross-reactive antibodies pose a challenge in final diagnosis."
Doctors said dual infections always necessitated the extra burden of intense monitoring. In dengue, a patient already runs the risk of a sharp fall in platelet count. And about 50% of malaria patients develop thrombocytopenia, a condition that occurs when the platelet count is too low. This made it a double whammy for patients with both dengue and malaria.
Dual infections may prolong hosp stay: Docs
Doctors across city hospitals have come across a number of cases of dual infections - dengue-malaria, dengue-typhoid, dengue-scrub typhus and even dengue-Covid - which is making diagnosis and treatment difficult.
Rimita Dey, a critical care specialist at Ruby General Hospital, said dengue and malaria co-infections "are possible as the two types of mosquitoes could be breeding in the same surrounding. The dual infection can become challenging to treat if the infected have profound co-morbidities."
Doctors said some symptoms of these ailments overlap. But timely detection becomes very important. "While most cases of cross-infection could be treated effectively if intervened in time, it could also prolong hospital stay in many cases. What is more concerning is that many patients' late arrival to hospital means that their platelet count has dropped drastically by then," said Rahul Jain, an internal medicine specialist at Belle Vue Clinic.