Urban News

Their hands full of malaria and other monsoon-related ailments, municipal health officials will seek help from private practitioners and urge private laboratories to help in the analysis of blood samples collected at civic hospitals. In July alone, 4,153 patients have tested positive for malaria and 19 have died in Mumbai so far.

Officials of the BMC’s health department will meet doctors of the Indian Medical Association (IMA) Monday to see if they are willing to spare time to treat patients at BMC hospitals, said Dr Deepak Sawant, Shiv Sena leader. The meeting will be held at IMA House and attended by BMC health officials, IMA officials and some Shiv Sena legislators.

“If there are doctors who are willing to volunteer for BMC to help in tackling the crisis, we will work that out. We are also meeting to discuss the protocol for handling patients,” said Dr Sanjay Oak, director of medical education and research for BMC hospitals.

Also on the discussion board is the fact the malaria parasite is showing new complications, many of these detected in private hospitals earlier this month. Dr Hozie Kapadia, IMA state president said, “We always work in co-ordination with the BMC and state health departments. Since there have been complications with the milder vivax form of malaria this year, it is better to coordinate and work out a proper protocol.” About testing samples, Dr Oak said, “We are collecting a large number of blood sample slides. We are asking private laboratories to interpret the slides and give data after analysis,” said Dr Oak. 

Dr Sawant said private laboratories had shown a willingness to set up sample collection centres at BMC hospitals and help test these.

Changing trends : Common strain behaves like deadlier one

More than the numbers, it is the heightened virulence of malaria that is a concern, doctors say. They agree the deadlier falciparum variety has affected more persons than last year but point out that so has the commoner vivax form, and that the ratio has been the same . The concern is that the common form has come with complications normally associated with the deadlier form: low platelet count, acute respiratory disease syndrome(ARDS) and cerebral malaria.

“There is a lot of talk about increase in the number of cases compared to last year,especially with respect to falciparum malaria. But the ratio between falciparum and vivax cases remains around 10:90, the same as last year,” said Dr Khushrav Bajan of Hinduja Hospital. “If at all there is any increase, it is because the overall malaria cases have shot up. But Mumbai still remains a hotbed for the vivax strain,” agreed Dr Shirish Upadhyay.

Falciparum cases are up 15 per cent from last year, said a BMC assistant health officer. Among vivax cases, some have had a platelet count as low as 40-50 thousand. “The number should be more than a lakh. We only saw this in falciparum cases until last year,” said Dr Shivkumar Utture, president of the IMA in Mumbai.

JJ Hospital dean Dr TS Lahane said, “Falciparum is known as the deadlier form but now complications characteristic to falciparum are being seen in vivax cases.” Currently JJ has two patients who have developed ARDS from vivax malaria, and KEM Hospital three. Jaslok Hospital’s Dr Suresh Rang said cerebral malaria, considered common to the falciparum strain, is now being seen among vivax cases. 

“It is like a chicken-and-egg situation to establish whether the complication developed from the disease, or whether the patient’s immunity decreased due to other problems, which led to contraction of malaria,” Dr Bajan said.

The routine symptoms with malaria are fever with chills; with cerebral malaria, one may have convulsions,or show mild effects such as headaches without fever. “In these cases, if there is any doubt about the cause of the neurological problems, we have started running malaria tests,” said physician Dr Shirish Upadhyay. There have been cases of dengue and jaundice along with malaria.