Dengue Outbreak: Most fatalities due to shock syndrome

Around 71.81 percent of the 88 dengue patients who passed away between October 15 and October 21 died of shock syndrome, according to Directorate General of Health Services data.

Also, 14.16 percent died of expanded dengue syndrome, while 3.3 percent died from dengue hemorrhagic fever, shows DGHS data.

DGHS also found that 59 percent of the 88 patients died within a day after hospitalization, while 26 percent passed away within two-three days, six percent each between four-ten days, and three percent died after more than 10 days.

WHO coined the term "expanded dengue syndrome" in 2012 to describe patients that do not fit into either DHF (dengue hemorrhagic fever) or DSS (dengue shock syndrome) but show atypical symptoms in vital organ systems such as cardiovascular, neurological, kidneys, intestines, and hematological systems.

Meanwhile, 17 more dengue patients died in the 24 hours preceding yesterday morning, taking this year's total dengue fatalities to 1,272, said a DGHS release.

17 more dengue patients died in the 24 hours preceding yesterday morning while at least 2,014 cases of the mosquito-borne disease was recorded during this period, according to DGHS.

At least 2,014 dengue cases were reported in the 24-hour period, raising the caseload to 2,57,060.

"Most patients with dengue shock syndrome come to the hospital late, which makes it difficult for doctors to help them recover," said Brig Gen Quazi Md Rashid-Un-Nabi, director of Sir Salimullah Medical College Mitford Hospital.

Patients arriving at the hospital are mostly from outside Dhaka, including Madaripur, Bhola, Patuakhali, and Faridpur.

"By the time patients realise they are in shock and come to the hospital, some of their organs have already been damaged," he said, adding that patients need to be hospitalised if they stop urinating for six hours.

Shock syndromes in dengue patients are of two types -- compensated and decompensated. In compensated shock, a patient's blood pressure may be low or apparently normal, with narrow pulse pressure of 20 or less, said HM Nazmul Ahsan, associate professor at Shaheed Suhrawardy Medical College Hospital.

"Whereas, the patient is disoriented with cold clammy skin, unrecordable blood pressure and pulse, and is unable to urinate when under decompensated shock. Patients with these symptoms die within a short time despite being under treatment," he mentioned.

A patient may suffer a shock syndrome if not hospitalised within 48 hours of showing the symptoms -- severe stomach aches, breathing difficulties, weakness, bleeding from gums or nose, and vomiting.

Immediate hospitalisation after suffering from a compensated shock can help prevent decompensated shock and the chance of recovery is 50 percent, he added.