By Lara Pickford-Gordon Monday, March 16 2009

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HELLO DADDY!: With his parents close by, four-year-old Lindon Barclay tries to use a public pay-phone along Harris Promenade, San Fernando yesterday ...

A Chaguanas doctor who has seen more than 15 confirmed dengue cases for the year is concerned that a “virulent” strain of dengue fever may be circulating because of the rapid fall in patients’ platelets.

This is an indication the patient has dengue haemorrhagic fever (DHF) — which is a severe form of dengue fever and if left untreated can result in death.

In an interview, the doctor said while the number of persons visiting his office for treatment of dengue was not large “the ones I am seeing show very dramatic signs because their platelets are dropping very fast. They are very ill.”

The doctor said that for patients to progress to DHF so quickly suggested that they may be infected with a new strain of dengue.

(Persons who are infected with one strain of dengue have immunity to that strain but not to others.)

He questioned if a different strain of dengue was circulating in the country. The doctor said this had to be confirmed by the Caribbean Epidemiology Centre (CAREC). There are four virus serotypes for dengue — Type I, II, III, IV. All of them have circulated in the Caribbean.

There is no cure for dengue or dengue haemorrhagic fever and the patient’s symptoms are managed according to the treatment protocol of CAREC and the Health Ministry.

He said the community had to be alert to reduce the breeding sites of the Aedes aegypti mosquito as the change in weather pattern was contributing to the problem.

“People have to take ownership of the environment — empty lots, back drains, plant pots with water. The Government and Local Government cannot do it alone.”

A drop in platelets results in the inability of the blood to clot and this leads to easy bruising, blood spots in the skin, spitting up blood, bleeding gums, and nosebleeds.

Last year Type II serotype of dengue was circulating in TT. According to a report from the Pan American Health Organisation (PAHO) team which visited TT last year the strain “demonstrated an extremely high infection rate for children and complications associated with Dengue — Dengue Haemorrhagic Fever and Dengue Shock Syndrome, which were more prevalent than in previous years.”

The PAHO team noted that the cycle peak year was well managed compared to previous peak years, and said the trend of increased infection rates in children over the past year and severity of infections associated with repeat cycle episodes over the past 20 years were challenges for future dengue cycles. PAHO said responding to this challenge required a collective effort with households and communities. It said “all measures” must be taken immediately and consistently over the next ten years to ensure dengue infections are controlled “to an absolute minimum”.

To achieve this, it said, the Aedes aegypti mosquito must be controlled.