The clinical picture of dengue in the district seems to be showing some drastic changes, with many cases rapidly deteriorating into hepatic failure and death, especially in children, doctors have reported.

The high rate of complications and liver cells derangement have been noticed specifically in the dengue cases being reported from the Southern areas of the district bordering Tamil Nadu and requires special attention, a senior paediatrician at SAT Hospital told The Hindu.

Studies sought

“More scientific studies would be required before it can be authenticated whether a more virulent or mutated strain of dengue virus might be in circulation. We have brought our observations to the attention of the Health Department, with the suggestion that special vector-control measures and public alerts might be required in our border areas as dengue cases with serious complications are currently being reported in huge numbers from Tirunelveli and Madurai districts in Tamil Nadu,” she added.

Liver involvement

Normally, dengue cases are managed by administering fluids and blood products. But this season, it was noticed that there is liver involvement leading to rapid deterioration, rather than haemorrhagic syndrome. SAT hospital lost two children to dengue recently due to this sudden turn, doctors said.

These complications have been noticed especially in cases reported from Punalur, Parassala, Karakonam, and Marthandam across the border.

Vector control

Health officials have decided to intensify public awareness campaigns on the increasing fatality rate of dengue fever and to impress upon people the need to ensure that their homes and domestic premises were free of any mosquito breeding sources.

Review meeting

On Thursday, at a review meeting of medical officers in the district, doctors in charge of the recently constituted Epidemic Management Cell asked health field staff to be very vigilant and to alert the public as soon as a dengue case was reported in a locality.

It was pointed out that as soon as a dengue case — confirmed or suspected — was reported, immediate control measures, including source reduction (elimination of all possible mosquito breeding sources) as well as fogging and indoor spraying with Pyrethrin to destroy adult mosquitoes be adopted in all houses within a 100-metre radius of the reported case so that an outbreak can be prevented.

Awareness

The public should be made aware that because of the breeding nature of the Aedes species of mosquitoes which transmit dengue, source reduction should be carried out inside individual homes and on the domestic premises. In almost all houses where dengue was reported, health workers have found mosquito breeding inside homes or in overhead water tanks.

‘Dry day’

At the meeting, it was decided that ‘dry day’ (systematic emptying of stagnant water from all receptacles, including stored water containers in homes to eliminate mosquito breeding sources) would be observed across the State on three consecutive Sundays, May 12, 19, and 26 as a dengue control measure.

The public can report cases of suspected dengue or any increase in fever cases in a particular locality to the Health Department’s helpline, Disha (Dial 1056), so that health workers can be directed to launch immediate control measures in the area, Health Minister V.S. Sivakumar, who chaired the meeting, said.

Senior Health Department officials attended.