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Published on: Jul 24, 2024
3 minute read
By: SecondMedic Expert

Why Dengue Fever Causes Low Platelet Counts And How To Manage It

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Dengue fever, a mosquito-borne viral infection, has become a significant public health concern in many tropical and subtropical regions. One of the hallmarks of severe dengue is a drop in platelet count, which can lead to serious complications. Understanding why dengue fever causes low platelet counts and how to manage this condition is crucial for anyone living in or traveling to affected areas.

Understanding Dengue Fever

Dengue fever is caused by the dengue virus, which is transmitted primarily by Aedes aegypti mosquitoes. The virus has four distinct serotypes (DENV-1, DENV-2, DENV-3, and DENV-4). Infection with one serotype usually provides lifelong immunity against that specific type, but only partial and temporary immunity against the others. Subsequent infections with a different serotype increase the risk of severe dengue, including dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS).

Why Dengue Fever Causes Low Platelet Counts

Platelets are small blood cells that play a crucial role in blood clotting. A normal platelet count ranges from 150,000 to 450,000 platelets per microliter of blood. Dengue fever often leads to a significant drop in platelet count, a condition known as thrombocytopenia. There are several reasons for this:

1. Bone Marrow Suppression: The dengue virus can infect and impair the bone marrow, which is responsible for producing blood cells, including platelets. This leads to reduced platelet production.

2. Increased Platelet Destruction: The virus and the immune response it triggers can increase the destruction of platelets. The body’s immune system mistakenly targets platelets, thinking they are infected cells.

3. Increased Utilization: In severe dengue, there is increased leakage of plasma from the blood vessels. To combat this, the body uses up more platelets for clotting, leading to lower counts in the bloodstream.

4. Splenic Sequestration: The spleen may sequester or hold onto more platelets than usual in dengue fever, reducing the number of platelets circulating in the blood.

Symptoms of Low Platelet Count

A low platelet count can lead to several symptoms, which may vary in severity:

- Easy bruising

- Petechiae (small red or purple spots on the skin)

- Bleeding gums or nosebleeds

- Blood in urine or stools

- Heavy menstrual bleeding

- Fatigue and weakness

In severe cases, internal bleeding and shock can occur, which are life-threatening conditions requiring immediate medical attention.

How to Manage Low Platelet Counts in Dengue Fever

Managing low platelet counts in dengue fever involves several strategies aimed at supporting the patient until their body recovers. Here are some key approaches:

1. Hydration

Maintaining adequate hydration is crucial. Fluids help maintain blood volume and support overall bodily functions. Oral rehydration solutions, coconut water, and plain water are often recommended. In severe cases, intravenous (IV) fluids may be necessary.

2. Monitoring Platelet Counts

Regular monitoring of platelet counts is essential to assess the severity of thrombocytopenia. This helps healthcare providers decide on the necessary interventions and monitor recovery.

3. Medications

There are no specific antiviral medications for dengue. However, supportive care includes:

Acetaminophen: To reduce fever and relieve pain. Avoid nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin, as they can increase the risk of bleeding.

Platelet Transfusions: In cases of very low platelet counts or significant bleeding, platelet transfusions may be necessary.

4. Rest and Nutrition

Adequate rest and proper nutrition support the body's recovery. A balanced diet rich in fruits, vegetables, and lean proteins can help maintain energy levels and support immune function.

5. Avoiding Certain Foods and Activities

Patients with low platelet counts should avoid activities that can increase the risk of bleeding, such as contact sports. Additionally, foods that may thin the blood, like garlic and ginger, should be consumed in moderation.

6. Natural Remedies

Some natural remedies are believed to help increase platelet counts, although scientific evidence is limited. These include:

Papaya Leaf Extract: Some studies suggest that papaya leaf extract can help increase platelet counts.

Pomegranate and Kiwi: These fruits are rich in vitamins and antioxidants that support overall health.

Preventing Dengue Fever

Preventing dengue fever is the best way to avoid complications like low platelet counts. Preventive measures include:

Mosquito Control: Eliminate standing water around your home, use mosquito repellents, and install screens on windows and doors.

Protective Clothing: Wear long-sleeved shirts, long pants, socks, and shoes when outdoors.

Vaccination: In some regions, a dengue vaccine is available and recommended for individuals who have had a previous dengue infection.

Conclusion

Dengue fever and its complications, such as low platelet counts, pose significant health challenges in many parts of the world. Understanding the reasons behind thrombocytopenia and implementing effective management strategies can help mitigate the risks and support recovery. By taking preventive measures and staying informed, individuals can reduce their risk of dengue fever and its potentially severe consequences.

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A. Dengue fever causes low platelet counts due to bone marrow suppression, increased platelet destruction, increased utilization for clotting, and splenic sequestration. The dengue virus affects the body's ability to produce and maintain adequate platelet levels.

A. Managing low platelet counts involves staying hydrated, monitoring platelet levels, taking acetaminophen for fever and pain, resting, eating a nutritious diet, and avoiding activities and foods that increase bleeding risk. In severe cases, platelet transfusions may be necessary.

A. Signs of a low platelet count include easy bruising, petechiae (small red or purple spots on the skin), bleeding gums or nosebleeds, blood in urine or stools, heavy menstrual bleeding, fatigue, and weakness. In severe cases, internal bleeding and shock may occur.

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Asthma Symptoms in Adults: Early Signs, Triggers, and When to Seek Care

Asthma is often perceived as a childhood condition, but a significant number of cases develop or persist into adulthood. In India, adult asthma is increasingly recognised due to rising air pollution, occupational exposure and lifestyle-related risk factors. Unfortunately, asthma symptoms in adults are frequently misdiagnosed as recurrent infections, allergies or age-related breathlessness, leading to delayed treatment.

Understanding adult asthma symptoms is critical for early diagnosis, effective control and prevention of severe attacks.

What Is Asthma?

Asthma is a chronic inflammatory disease of the airways. In asthma, the airways become:

inflamed
narrow
overly sensitive to triggers

This leads to difficulty in breathing, especially during exposure to specific stimuli.

Why Adult Asthma Is Often Missed

Adult asthma symptoms may:

appear gradually
vary in severity
mimic common respiratory conditions

According to Indian Council of Medical Research and WHO data, many adults remain undiagnosed for years, increasing the risk of complications.

Common Asthma Symptoms in Adults

Wheezing

A high-pitched whistling sound while breathing, especially during exhalation, is a classic asthma sign.

Shortness of Breath

Adults with asthma often feel:

breathless during routine activities
difficulty taking deep breaths

This may worsen at night or early morning.

Chest Tightness

Many describe a sensation of pressure or tightness in the chest, which can be mistaken for heart-related issues.

Chronic Cough

A persistent cough, especially:

at night
early morning
after exercise

is a common but overlooked asthma symptom.

Symptoms That Worsen With Triggers

Asthma symptoms often intensify after exposure to specific triggers.

Air Pollution and Smoke

Urban pollution, vehicle emissions and indoor smoke significantly worsen asthma symptoms in adults.

Allergens

Dust mites, pollen, mould and pet dander are common triggers.

Respiratory Infections

Viral infections can trigger asthma flare-ups or reveal undiagnosed asthma.

Physical Activity

Exercise-induced asthma causes breathlessness and wheezing during or after physical exertion.

Weather Changes

Cold air, humidity and sudden temperature changes can aggravate symptoms.

Adult-Onset Asthma

Adult-onset asthma differs from childhood asthma.

Characteristics include:

onset after age 20–30
less association with childhood allergies
more persistent symptoms
higher likelihood of severe disease

Occupational exposure and hormonal changes contribute to adult-onset asthma.

Risk Factors for Asthma in Adults

Several factors increase asthma risk:

long-term exposure to pollution
smoking or passive smoking
occupational chemicals or dust
obesity
family history of asthma
chronic sinusitis or allergies

Women may experience asthma onset or worsening during hormonal changes.

When Asthma Symptoms Become Serious

Seek immediate medical attention if experiencing:

severe breathlessness
difficulty speaking in full sentences
bluish lips or fingertips
rapid worsening of symptoms
poor response to usual inhalers

These signs indicate a potentially life-threatening asthma attack.

How Adult Asthma Is Diagnosed

Diagnosis includes:

detailed symptom history
physical examination
lung function tests (spirometry)
response to bronchodilators

Early diagnosis improves long-term outcomes.

Impact of Untreated Asthma

Untreated asthma can lead to:

frequent attacks
reduced lung function
sleep disturbances
missed workdays
reduced quality of life

According to Lancet respiratory studies, uncontrolled asthma increases hospitalisation risk.

Managing Asthma Symptoms in Adults

Effective asthma management focuses on:

identifying and avoiding triggers
using prescribed inhalers correctly
monitoring symptoms regularly
maintaining follow-up care

Asthma action plans help patients recognise worsening symptoms early.

Role of Preventive Healthcare

Preventive healthcare helps:

detect asthma early
assess lung function
guide lifestyle modifications

Regular health checkups are especially important for individuals with respiratory symptoms or occupational exposure.

Lifestyle Measures That Support Asthma Control

Helpful practices include:

avoiding smoking
improving indoor air quality
wearing masks in polluted environments
maintaining healthy weight
regular, moderate exercise

Lifestyle support complements medical treatment.

Mental Health and Asthma

Stress and anxiety can worsen asthma symptoms.

Stress management:

reduces symptom frequency
improves medication response

Holistic care improves asthma outcomes.

Importance of Medication Adherence

Asthma medications work best when:

taken regularly as prescribed
inhaler technique is correct

Skipping treatment increases flare-up risk.

Long-Term Outlook for Adults With Asthma

With proper management:

symptoms are well controlled
severe attacks are preventable
normal activity levels are achievable

Most adults with asthma lead active, productive lives.

Conclusion

Asthma symptoms in adults are often subtle, variable and easily mistaken for common respiratory problems. Wheezing, breathlessness, chest tightness and chronic cough should not be ignored, especially when triggered by pollution, exercise or weather changes. Early diagnosis, trigger control and consistent treatment are essential to prevent severe attacks and preserve lung health. Recognising adult asthma early empowers individuals to manage symptoms effectively and maintain a good quality of life.

References

Indian Council of Medical Research (ICMR) – Respiratory Disease and Asthma Studies
World Health Organization (WHO) – Asthma Management and Prevention Guidelines
National Family Health Survey (NFHS-5) – Respiratory Health Indicators
Lancet Respiratory Medicine – Adult Asthma Outcomes and Management
NITI Aayog – Air Pollution and Respiratory Health Reports
Statista – Global Asthma Prevalence and Trends

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