cute diseases have set a calendar to batter people in Delhi and the rest of the country, landing patients in the ICU with seasonal attacks.
For instance, dengue, scrub typhus, encephalitis and malaria peak around July to October.
These fuel a surge in critical care admissions of tropical fever patients, according to the findings of a multicentre study of 34 ICUs across India.
The research which was carried out on 456 patients of critically ill adults and children with non-localising fever has found that dengue (105 patient, 23 per cent) was the most common cause followed by scrub typhus (83 patients, 18 per cent), encephalitis (44 patients, 9.6 per cent), malaria (37 patients, 8 per cent) and bacterial sepsis (32 patients, 7 per cent) during the post-monsoon season of July-October.
Doctors pointed out that from November till March, the H1N1 swine flu virus becomes active along with respiratory distress cases. Summer months see a spate of gastrointestinal illnesses.
There was a clear seasonal trend as tropical fevers dominated the post-monsoon months, contributing more than half (268 patients, 58.7 per cent) of the total 456 enrolled, noted the research.
“We conducted this nationwide study to identify the prevalence, reasons and utilisation of ICU resources and outcome of a patient with tropical fevers in Indian ICUs. Tropical fevers are caused by a number of viruses, bacteria and protozoa, and often get transmitted by an insect bite,” Dr Prakash Shastri, author and vice-chairman in the department of critical care medicine at Delhi’s Sir Ganga Ram Hospital, told Mail Today.
“Starting from November till March, we see a lot of cases of influenza virus, swine flu, bronchitis, asthma, COPD and Acute Respiratory Distress Syndrome,” Dr Shastri said, adding that in the summer months cases of gastrointestinal diseases go up.
He said whenever patients are shifted to the ICU, it means that the person could suffer organ failure that increases the risk of death. Researchers from Sir Ganga Ram Hospital (New Delhi), PGIMER (Chandigarh), CMC (Vellore), PGIMS (Haryana), Sanjivani Super Speciality Hospital (Ahmedabad), Apex Hospital (Bhopal), PGIMS (Rohtak) and Jeevan Rekha Critical Care (Jaipur) studied patient conditions between July 2013 and September 2014.
The findings are published in the latest edition of the Indian Journal of Critical Care Medicine. Most of the study patients admitted to ICUs were either transferred from emergency department (218 patients, 48 per cent) or directly from other hospital ICUs and wards (179 patients, 41 per cent).
Requirement of respiratory support (304, 66 per cent) was the single most common indication for ICU transfer; half of them were transferred for invasive mechanical ventilation, stated the study.
Dr (Prof) Sunit Singhi, author and Emeritus Paediatrics at PGIMER in Chandigarh, told Mail Today, “The outcome data highlights the importance of reaching the diagnosis as those without a specific diagnosis more often required organ supportive therapies and had poor outcome,” he said.
“The challenge lies in clinically diagnosing them at the time of presentation as they often present undifferentiated fever and with overlapping signs and symptoms,” said (Prof) Dr TD Chugh, Emeritus Pathology from PGIMS, Rohtak.