Battling dengue with comorbidities: Doctor explains what to be careful of

Dengue fever seems to be exploding in Kerala this year due to conducive weather, with intermittent rainy and hot days. Just on Tuesday (June 23), the state reportedly had 159 confirmed dengue cases and two deaths. The largest number of cases were reported in Palakkad (47), Kozhikode (31) and Ernakulam (24). The state reportedly had around 17 dengue deaths this year. The fever is much more dangerous for people with comorbidities or other existing diseases, as it makes it much harder for the body to cope with drops in blood pressure and organ stress. Dr Sreeram Shankar, a physician at the Government Hospital, Palakkad, explains how people with various conditions should manage dengue.

Patients with diabetes
During a fever, a loss of appetite or vomiting may prevent patients from eating properly, which can cause blood sugar levels to drop dangerously low. Therefore, the dosage of insulin and other medications may need to be adjusted under a doctor’s guidance. When consuming fruit juices, avoid adding sugar.Tender coconut water should be consumed only in limited quantities.

Patients with high blood pressure
Blood pressure should be monitored at regular intervals. Dehydration can cause a sudden drop in blood pressure and lead to weakness or dizziness. If any changes in blood pressure are noticed, consult a doctor to reassess and adjust the dosage of medicines if required.

Patients with kidney disease
The common advice to `drink plenty of water' does not apply to people with kidney disease. Excessive water intake can lead to fluid accumulation in the body and cause breathing difficulties. Tender coconut water and fruit juices are rich in potassium, which may disturb the heart rhythm in kidney patients. Therefore, they should consume fluids and fruits only in the quantities recommended by their doctor.

Patients with heart disease
Those with normal heart pumping function can consume adequate amounts of water. However, patients with heart failure or reduced pumping capacity should regulate their fluid intake strictly according to the advice of a cardiologist.

Liver cirrhosis
In patients with liver cirrhosis, excessive water intake can cause fluid accumulation in the abdomen and body swelling. Such patients should consume fluids only as advised by their doctors. However, those with only fatty liver can drink adequate amounts of water, just like other dengue patients.

Other patients
Patients who are bedridden after suffering a stroke should be provided with adequate calories and fluids through their diet to meet their nutritional requirements. People with thyroid disorders should not stop their thyroid medicines during fever. No specific dietary restrictions are required for them.

Time-taking recovery
Even after dengue fever subsides and the platelet count returns to normal, the body takes time to regain complete strength. Avoid strenuous activities for at least two weeks after the fever has gone. Severe fatigue and loss of appetite may continue for two to three weeks and there is no need to panic about these symptoms.

However, if fatigue and loss of appetite persist for a longer period in people with existing conditions such as diabetes or heart disease, they should consult a doctor to assess the status of their underlying illnesses and undergo necessary basic blood tests.

For those with existing health conditions, dengue is not the time for self-medication. Consult your doctor at the first sign of fever and follow the right advice on medicines and diet to ensure a safe recovery.