Saturday, 20 August 2016

IMA and HCFI release guidelines on dengue and chikungunya management

IMA and HCFI release guidelines on dengue and chikungunya management

New Delhi, 18 August 2016: In an attempt to dispel myths and create awareness about the ongoing dengue and chikungunya outbreak in the city, IMA and HCFI today released a set of guidelines on the management of the disease.

Speaking about the issue, Padma Shri Awardee KK Aggarwal – President HCFI and Honorary Secretary General IMA said,” The incidence of dengue and chikungunya will continue to exist this month and instead of creating unnecessary chaos and panic, it is essential that awareness is created about its prevention and timely steps are taken towards disease management. One must remember that only 1% of the dengue cases are life-threatening. Most dengue cases can be handled on an outpatient basis and do not require hospitalization. Chikungunya is not fatal and does not require hospitalization. Wearing long sleeved clothes, wearing mosquito repellent with permethrin and checking for breeding in and outside one’s house is key“

Whenever Dengue or Chikungunya Case is suspected: do the followings:
  • RWA should come into action and inform everyone in their colony to check for breeding in and around their houses
  • Treating doctor of the dengue or chikungunya patient should inform the local IMA President and Secretary about the disease incidence so that they can send a message to all doctors in that area to stay alert
  • The local MLA/MP should be informed about the outbreak of dengue in a particular area so that the necessary Vector Control Programme is put to action by the respective Municipal body.
Dengue pointers released:
  • Over ninety five percent people suffer from simple dengue fever, which is not as threatening as severe dengue fever.
  • In simple dengue fever there is no capillary leakage, the person requires only oral fluids, 100 ml per hour, and is advised to visit local doctor. Additionally, the patient is recommended to drink 500 ml water at the time of diagnosis
  • Only those patients with dengue fever who have vomiting should consume intravenous fluids
  • Those suffering from severe dengue develop capillary leakage and intra-vascular dehydration.  Also, they suffer from a rapid fall in the platelet count along with rapid rise in their hematocrit levels
  • They will have rapid fall in platelets along with rapid rise in hematocrit levels
  • Persistent vomiting, nausea, extreme exhaustion and lethargy are some of the symptoms of dengue. Along with these symptoms, a victim might suffer unrelieved abdominal pain and mental irritability and confusion.
  • These people require close daily observation
  • Dengue patients are kept under close observation and are recommended to consume 1500 ml fluids (20 ml per kg) immediately
  • And in case, when they cannot consume liquids orally, then intra venous fluids are a must

Chikungunya pointers released:
  • Chikungunya fever is a non fatal debilitating viral illness
  • Common symptoms of Chikungunya develop 3-7 days after being bitten by an infected mosquito include fever and joint pain.
  • Classical triad is skin rash, joint pains and high fever.
  • Most patients will recover within a week. 
  • At present, there is no vaccine to prevent or medicine to treat Chikungunya virus.\
  • Patients are advised to get plenty of rest and drink fluids to prevent dehydration. 
  • It is important to note that aspirin and other non-steroidal anti-inflammatory drugs (NSAIDS) should not be taken until dengue is ruled out to reduce the risk of bleeding since both the ailments present similar symptoms.
  • Joint involvement seen with Chikungunya fever usually subsides in one to two weeks’ time.
  • In 20% cases joint involvement may persist for weeks and in less than 10% cases, they tend to persist for months. 
  • In about 10 % cases, the swelling disappears; the pain subsides, but only to reappear with every other febrile illness for many months. 
  • Each time the same joints get swollen, with mild effusion and symptoms persist for a week or two after subsidence of the fever. 
  • Cold compression may easy pain.
  • Non weight bearing exercises may be suggested. e. g. slowly touching the occiput (back of the head) with the palm, slow ankle exercises, pulley assisted exercises, milder forms of yoga etc.

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