Fevers in monsoon can be deceptive, warn docs

Fever during the monsoon can be deceptive since malaria, dengue, chikungunya, jaundice and typhoid can all cause fever, said an advisory issued by the Indian Medical Association (IMA).

Issuing a series of dos and don’ts for the season, the IMA said: “No antibiotic should be started unless a diagnosis of typhoid is confirmed. Cough, redness of the eye and nasal discharge can also be present in viral disorders. In the case of dengue, one may experience pain during eye movement. In the case of chikungunya, patients may have fever, rashes and joint pains. Joint pain will typically increase on compression of the wrist joint. Malarial fever may present with chills and rigors, with no toxemia in between the fever episodes. In jaundice, fever normally disappears by the time jaundice appears clinically. In typhoid, patient looks toxic and the pulse rate may be relatively lower compared to the fever.”

It also advised that fever medicines like aspirin should not be given during the monsoon as many fevers may result in low platelet count.

K.K. Aggarwal of the IMA said: “Most viral disorders are self-limiting and resolve within a week. In the case of most monsoon-related viral disorders, the treatment is adequate hydration. Fever in the setting of chronic medical diseases should not be ignored and must be shown to the doctor at the earliest.”

To ensure that misuse of drugs does not take place during this season and dengue patients don’t end up popping pills, the Delhi government has decided to restrict the sale of aspirin, ibuprofen and diclofenac group of medicines, which lead to destruction of blood platelets. These will now be sold strictly against prescription by a registered medical practitioner.

“We are also stressing on prevention of dengue and related complications. The idea is to control mosquito breeding since majority of mosquito breeding takes place in freshwater collected in plastic containers, broken bottles,

dabbas , plastic overhead water tanks, cement tanks, water coolers, tyres, flower pots, trash, etc. Awareness is the key to containing the situation,” said a senior health official.