In recent times, Bangladesh has been witnessing a surge in dengue fever cases, a mosquito-borne illness, resulting in a growing number of infections and fatalities.
The gravity of the situation is evident from the numerous social media appeals for blood donations to aid dengue patients.
The demand for blood rises as the disease causes a decline in platelet levels within the infected individuals.
Platelets
Platelets are the smallest of the three types of tiny blood cells in human blood. Cells are produced in the bone marrow.
Platelets help blood clot and stop bleeding. The level of platelets per microliter of blood in an adult human body range from 150,000 to 450,000. If the platelet count falls below this level, the blood cannot clot.
As a result, there is a risk of bleeding. A decrease in platelets in the blood is medically known as thrombocytopenia.
Why is platelet reduction dangerous?
Not only dengue, but many other diseases can reduce the number of platelets in blood infection. However, if the platelets fall below 100,000, it can be considered a critical condition.
Chittagong Medical College medicine expert Dr Anirudh Ghosh has warned that if the number of platelets falls below 20,000, bleeding may occur without any injury.
He said to the Bengali section of BBC, the UK-based media: “The number of platelets in the blood falling below 10,000 is the most dangerous. At this time there is the highest risk of continuous bleeding from any part of the body.”
Do You Need To Take Blood When Platelets Level Drop?
Medicine expert Professor ABM Abdullah told the BBC that it is not necessary to take blood if the platelets are reduced.
He said: "Decreasing platelets is not the only problem in dengue patients, but lowering body plasma and lowering blood pressure can complicate the situation. In that case, treatment according to the symptoms can cure the patient. In this case, it may not be necessary to give blood."
He further said: “Most dengue patients do not require platelet transfusions. The number of platelets in the blood decreases for a very short time – maybe two or three days. Then the platelets start growing on their own. So, we don't recommend transfusion."
"There are patients whose platelet count has dropped to 10,000, but still no blood has been taken. The patient has recovered. If the patient's blood loss is high, plasma is low, haemoglobin is low, blood pressure is low, then let's talk about donating blood," said Professor ABM Abdullah.
Dhaka TribuneAgain, even if the number of platelets is high, the patient's condition may deteriorate due to its reduced function.
In that case, Dr Anirudh Ghosh, a medical expert of Chittagong Medical College, said to consult a doctor without delay if dengue is detected during the health examination.
Different tests are used to diagnose dengue fever. However, it can be quickly understood whether dengue has occurred through an antigen test called NS1.
He advised to get this test done within five days of fever.
In addition, the number of platelets can be determined by doing a CBC (Complete Blood Count) blood test.
Dr Anirudh Ghosh said that the patient should not be given platelets if the platelets are low in the test.
He said that doctors usually take decisions based on the patient's age and health condition. Usually one unit of platelets requires blood from four donors. One unit of platelets can increase the platelet count by 20,000.
Platelet transfusion is a costly and complicated procedure. Not all hospitals in Bangladesh have machines to separate platelets from blood. For this reason, if there is a dengue patient in the house, it is necessary to find out in advance which nearby hospital has a platelet transfusion system.
Dengue haemorrhagic fever is usually termed as dengue haemorrhagic fever if it becomes complicated or causes bleeding. In this case, it may be necessary to take blood, experts said.
According to the World Health Organization, dengue haemorrhagic fever has several characteristics.
First of all, platelets will be below 100,000, blood haematocrit or PCV i.e. packed cell volume will increase, there will be problems of plasma exit from blood vessels.
When to look for blood?
In dengue haemorrhagic fever, the small holes in the walls of the patient's blood vessels become enlarged. In this, the watery component of the blood or plasma comes out of the vessel through the wall of the blood vessel. This is also called plasma leaking. It can accumulate water in the stomach or chest of the patient. Also, the patient's blood pressure decreases.
Dr Anirudh Ghosh, Chittagong Medical College medicine specialist, said that lower blood pressure is more dangerous for dengue patients than platelet reduction.
There is a risk of bleeding in the brain, kidney, and heart of the patient due to a few other reasons including the reduction of platelets. Haemorrhagic shock can even lead to death. In this regard, he advised to take quick measures.
He said: “If we see that active bleeding is happening and the platelet count is below 20,000, then we suggest taking blood based on the patient's condition. However, the main problem in dengue patients is not platelet reduction. The area of concern here is the drop in blood pressure of the patient. Because when the pressure decreases, the body lacks oxygen. This increases the risk of various organ infections."
In addition to these complications, if the patient's blood pressure drops too much, heart rate increases, haemoglobin drops below normal levels and other complications, blood transfusion may be required.
Symptoms to take blood
- Signs of decreased platelets
- Bleeding under the skin. Purple lesions on the skin
- A red or black rash on the body
- Excessive menstrual bleeding
- Bleeding from the mouth, gums or nose
- Bleeding in urine or stool, black coloured loose stools
- Prolonged bleeding from a wound or cut
- Excessive fatigue and dehydration
Foods that increase platelets
Doctors have advised the patients suffering from dengue fever to have liquid food along with balanced food. However, there are some foods that can be used to restore the reduced platelets in the blood. Five such foods are:
Pumpkin: “Vitamin A” in pumpkin and its seeds helps in the formation of platelets in the blood. So, if the platelets in the blood of the dengue patient are reduced, they can eat sweet pumpkin.
Lemon juice: The large amount of “Vitamin C” in lemon juice increases the number of platelets in the blood. It also increases the immunity of the body. So, dengue patients should consume lots of lemon juice.
Amalaki: Amalaki is also rich in “Vitamin C” and antioxidants. Amalaki boosts immunity and prevents platelet destruction.
Aloe Vera: Aloe Vera is also very useful in clearing any blood infection. Regular consumption of aloe vera juice increases blood platelets.
Pomegranate: Pomegranate is rich in iron which works very well to increase platelets in the blood and remove the weakness of the body. So, give the patient regular pomegranate juice to increase platelets in his blood.
A study by Asian Institute of Science and Technology, a Malaysian research institute, found that papaya leaf juice and ripe papaya juice help to increase the platelet count in the blood of patients with dengue fever.
Experts recommend eating green vegetables, fruits with vitamin C or fresh fruit juice, as well as foods rich in "vitamin B" complex, protein, "vitamin K", "vitamin E".
In this case, experts have advised to avoid packaged food and extra spicy food.
