Health

Hemorrhagic fever virus strain D2 appeared in the South


The Southern epidemic surveillance system recorded the appearance of the D2 virus that causes dengue fever compared to the previous mainly D1, experts warned that the number of cases and the number of severe diseases would increase.

Dengue hemorrhagic fever is caused by dengue virus with 4 types, denoted D1, D2, D3, D4. Dr. Luong Chan Quang, Deputy Head of the Department of Disease Control and Prevention, Pasteur Institute in Ho Chi Minh City, said that in recent years the D1 strain has dominated in the southern region. In the first half of this year, strain D1 still dominates, but recently when taking surveillance samples in some localities with an increase in the number of cases, experts found that the cases there were mainly D2 strains. In 2019 – the year of many outbreaks, strain D2 also prevailed.

Deputy director of Ho Chi Minh City Department of Health Nguyen Van Vinh Chau, said that from previous observations, it can be seen that when there is a virus type change, the number of cases will often increase. The increase in the number of cases will lead to the number of serious diseases, leading to a high number of deaths if no preventive measures are taken in time.

In fact, the number of dengue cases this year in the southern region is increasing rapidly right from the beginning of the rainy season, the number of serious patients and deaths is many times higher than in 2019. In which, dengue patients in Ho Chi Minh City are highest in the country with nearly 21,000 cases since the beginning of the year – an increase of more than 172% over the same period last year. The city recorded 10 deaths. Many last-line hospitals in Ho Chi Minh City are overloaded and have to add extra beds in the corridors because serious patients rush into the hospital.

“So far, there is no data showing that out of the four types, which one causes more severe disease. However, people with which strain are only immune to that strain. The number of cases increases,” said Dr. Chau. A person can get dengue 4 times in his life with 4 different viruses. In some cases, the second infection is more severe than the first.

With the same opinion, Dr. Le Manh Hung, deputy director of the Hospital for Tropical Diseases in Ho Chi Minh City, said that when there is a circulating strain, adding another strain will make it easier to spread the disease, and the epidemic will spread more easily. Dr. Hung also said that with dengue virus, it is not possible to confirm which strain is more dangerous because the severity of the disease depends on the location and condition of each person. People with obesity, background disease, pregnancy …, regardless of the strain, when infected, it is very easy to develop severe disease.

A doctor at Ho Chi Minh City Hospital for Tropical Diseases treats a patient with dengue fever, June 2022. Image: Quynh Tran

With 30 years of experience in treating children with dengue fever and witnessing many outbreaks, Dr. Nguyen Minh Tien, deputy director of Ho Chi Minh City Children’s Hospital, said that every year the D2 strain appeared more, that year the number of cases increased. and often many critically ill patients.

“The possibility that D2 is the most virulent of the four strains, making patients susceptible to shock and organ damage,” the doctor said, explaining that “the virus strain is just one of the factors that increase the severity of the disease, besides the problems such as overweight children, infants, medical staff who do not detect the disease and handle it in time, the subjectivity of parents … “.

According to Dr. Tien, even if infected with dengue fever, it is necessary to take care by reducing fever, drinking plenty of water, and promptly monitoring for signs of worsening. Severe patients must be treated aggressively, shock resuscitation, hemodynamic monitoring, high molecular weight fluids, vasopressors, respiratory support, when needed to decompress the abdomen. Patients with multi-organ failure requiring dialysis, severe respiratory and circulatory failure requiring ECMO intervention…

Currently, conventional tests cannot tell which strain a dengue patient has. To determine, the Pasteur Institute will isolate the virus, monitor the virus strain to make a forecast for each stage, warn the community, and help clinicians have an appropriate response strategy.

In addition to the change in virus strains, the health sector in Ho Chi Minh City explained that this year the number of cases increased, the number of severe illnesses and deaths was high because doctors experienced in treating dengue had quit their jobs, and lack of high-molecular fluids. , unsafe transfer, late arrival of patients…

Over the past time, Ho Chi Minh City has strengthened many measures, trained hospitals and grassroots medical levels, where the first patients come for examination, helping to increase the ability to detect and promptly handle serious cases. heavy. The city’s health sector leaders suggested that lower-level hospitals and provinces increase their capacity to treat and treat mild cases on the spot, consult with higher-level hospitals, and limit unnecessary hospital transfers. Facilities can send red alert to inter-hospitals and higher-level agencies to send specialists to treat patients on the spot, avoiding hospital transfer, which increases the risk of serious illness for patients if resuscitation on ambulances is not guaranteed.

Le Phuong

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