29 deaths in 18 days

Culprit Is Not H1N1, But An Infectious Malaria With A Nasty Sting

Mumbai: Goregaon teenager Aadesh Sharma’s trauma began with a low-grade fever that quickly rose over the next five days. With falling platelet counts, his parents were worried. But worse was yet to come: Aadesh (name changed) developed jaundice and landed in hospital. This September, Aadesh’s story is being played out in many households. Malaria, the parasitic menace that rides on mosquitoes, has been wreaking havoc in many homes. From September 1 to 18, 29 Mumbaikars had succumbed to complications arising out of malaria, while 1,698 have been admitted to various public and private hospitals.
    The Brihanmumbai Municipal Corporation’s (BMC) malaria surveillance officer Dr Kishore Harugoli said: “Our surveillance shows that malaria cases have gone up this year, as compared to 2008.’’ Doctors across the city, too, paint a grim picture. According to Dr Khusrav Bhajan from Hinduja Hospital in Mahim, out of every 10 patients coming to him, seven have malaria. “Of these seven, one is serious enough to need hospitalisation.’’ A paediatrician from the eastern suburbs added: “I see five to six new patients every day for malaria, but most of them are treated on an outpatient basis
 

RAIN AND CONSTRUCTION PLAY HAVOC
Civic officials feel the increase in malaria cases is due to the freakish weather as well as construction activity in the city. “Due to the intermittent rains in September, the mosquitoes have found an ideal breeding ground in stagnant pools,’’ said Dr Harugoli.
    BMC executive health officer Dr J Thanekar traces the rise of malaria to construction sites, which see a constant influx of labourers. “Those who become infected often do not complete the anti-malarial course back home. They harbour the malaria parasite, which is transmitted to others via mosquitoes,’’ he said.
 

THE METAMORPHOSIS
What is worrying city doctors is the intensity of the malaria onslaught. There was a time when the vivax strain of malaria was considered benign when compared to the falciparum variant, which is also called cerebral malaria as it attacks the nervous system. “In the last few years, vivax has been presenting itself with serious symptoms. This year, what is peculiar about vivax is that patients are coming to hospital with jaundice, renal failure, low platelet count and acute lung injury,’’ said Dr Bhajan.
    However, Dr Neelima Kshirsagar, former dean of KEM Hospital, who is now attached to the Maharashtra University for Health Studies, says there is an urgent need to analyse whether it is vivax that is changing. “It’s possible that in the critical vivax cases, there is a second disease that has been undiagnosed.’’
 

DRUG RESISTANCE
A civic hospital doctor who doesn’t want to be identified said that ever since artesunate (an anti-malarial agent) has been made available in an oral format, general practitioners have been over-prescribing it. “There has been no check to ensure that patients finish the course. This has led to widespread resistance,’’ he said. SILENT MENACE
Malaria is a potentially life threatening parasitic disease. In India, the parasites Plasmodium vivax and falciparum are deadly
 

The carrier
    Usually, people get malaria by being bitten by an infective female Anopheles mosquito
    A person develops disease after 10-14 days of being bitten
 

SYMPTOMS
Typically, malaria produces fever, headache, vomiting and other flu-like symptoms