Saturday, 1 November 2008

Dengue Stupidity and Platelet Donation

My wife nearly died because of our ignorance of dengue fever. It is so fortunate that she had taken a routine blood test. In that test, her blood platelet was 8 when normally it should be 200. If it were 5, she would have died.

The problem is that there was no warning at all. She only suffers slight fever. There was no clear blood spots but on the second more thorough inspection, there were tiny blood spots on her legs and hips.

The only sure way of detecting haemorrhagic dengue fever, is by taking a blood count test that costs about RM25, the moment you feel cold and your bones painful. Your bones, not the joints. That is why dengue fever is also called bone-breaking fever.

Once the platelet were replenished, she should be safe. It is not blood donation that is required but platelet donation. You can extract platelet from blood but it is not efficient. It requires about 16 litres to extract about 100 cc of platelet so it is very inefficient. This is what is done at Queen Elizabeth Hospital.

There is an excellent article regarding platelet donations provided by Malta Blood Transfusion Service.

It shows that pooled blood is more risky because there are many donors. Also the platelet machine at Queen Elizabeth Hospital, Kota Kinabalu, is painful and requires two insertion points. The machine at Sabah Medical Centre, uses only one insertion point for the vein and is less painful. The donor will feel cold and there is a danger of heart fluttering(jantung berdebar).

The cost per extraction is RM1000 but it allows donors to recuperate faster (2 weeks) despite spending more than an hour with the machine. We should wait for the day when machines can extract platelet efficiently even on normal blood that is already outside the body.

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