Dengue infection: How does dengue impact your blood platelet count? Does every patient require transfusion?

How does dengue impact your blood platelet count?

With the surging rise in the number of dengue cases amidst unseasonal rains, there's now a need for extra preventive care and awareness about dengue. While dengue fever remains a disease best beaten with preventive practices, it's also important that people pay attention to timely recovery, and avoid complications- one of them being a sudden drop in platelet count.

Loss of platelets is one dreaded complication amongst dengue patients, and can impact recovery. While one battles the infection, many also require transfusions and how stable the platelet and blood count level is determines how healthy one may be. But how does a dengue virus so profoundly impact vital cells and cause platelets to drop? Is every case of low platelet count worrisome in dengue cases? We try to explain:

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What role do platelet counts play in vital functioning?

Platelets are colourless, small fragments present in the bloodstream which help support important functions like hemostasis, thrombosis, infection and wound healing. They are primarily produced through the bone marrow, and help to prevent, stop and control clotting. Therefore, when the platelet count is low, or drops, the body cannot form clots (cannot stop or manage an infection spreading) and even lead to bleeding. While platelet loss can have a lot of underlying causes, the symptoms can lead to excessive bleeding, vital organ damage and other fatal symptoms, if not managed in time.

How does dengue impact your platelet count?

The dengue infection primarily spreads through the bite of a virus-infected aedes aegypti mosquito. When the mosquito bites you, the virus enters your body and starts to spread. The drop in platelets is caused by a condition referred to as 'thrombocytopenia', which happens either via direct bone marrow suppression or by means of an autoimmune reaction and antibodies pushed into place. Thus, while the dengue virus in itself doesn't destroy the platelets, it can unleash complications which harm platelet function and count.

Remember, the basic dengue spreads is by entering the bloodstream, attaching itself to the platelets and leading to replication. When this happens, the 'infected' platelets tend to cause damage to the healthy platelets as well, and are further aggravated by the body's immune defence attacking them, mistaking them to be foreign bodies. When the bone marrow function is suppressed as well, it can also lead to a staggering drop in the counts, and cause problems.

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How fast can platelets drop?

While loss of platelets can be registered to a number of underlying conditions, on average, it is assumed that healthy individuals have somewhere around 150,000–450,000 platelets/μL, and when they are infected by the dengue virus, the platelet count can reach as low as <40000 platelets/μL (10-15% of patients can also observe platelet count go beyond the 20,000 mark). In some cases, the drop can be witnessed within a day's time. This usually happens during the peak of infection, 3-4 days of fever. The platelet loss can also be aggravated by existing comorbidities, immunity, age.

What are the signs to observe your platelet count is dropping?

Now, while platelets play a critical and crucial role in healing and recovery, low platelet counts could turn your infection into a severe one, and lead to significant issues. While dengue patients are asked to get routine tests, one of the ways platelet loss can be observed is through signs of bleeding. Thrombocytopenia can lead to easy or excessive bleeding, superficial bleeding (which can show up as rashes and scabs on the skin), blood in the urine, fatigue. With dengue, in cases where the platelet count goes beyond the 10,000/uL mark, it can also cause spontaneous bleeding, which is deemed as a life-threatening risk.

If your platelet counts are low, how can it impact your healing?

As mentioned above, platelets play a very important role in healing and recovery. When the platelet count are diminishing, and the bone marrow is also in a compromised state to be unable to produce good volumes of platelets, it can ultimately slow down recovery, increasing the risks of complications. However, at the same time, it's also important to remember that the rate of loss, and when, and how a patient would need to rely on transfusion depends on the risk of age and comorbid conditions. Less than 10% of dengue patients (those who may also face the risk of severe dengue) may require critical hospitalization, acute transfusion, while the other patients tend to recover well on their own, and the platelet count increases over time.

What can you do to increase platelet count in the body?

Platelet counts can be raised with the help of regular transfusions, in cases where it is required. Apart from such therapies, one of the best ways to spike up platelet count is by including recovery aiding foods in your diet. Including papaya leaf extract, green leafy veggies, fruits, iron-rich foods, vitamin-C and vitamin-K rich foods and supplements are some of the ways to increase and stabilize healthy platelet count during the infection stage.

Here's why women crave chocolate on their period

Many women would know the intense feeling of craving chocolate during those monthly days when the disaster of nature strikes. All you could think of is chocolate, pampering, and conditioning.

The little indulgence in the form of chocolate helps keep your mind off of stomach cramps and breakouts. Not many women are aware why they specifically crave chocolate during their Bloody-Mary days.

According to research, many people believe that it all bottles down to hormonal imbalances during your monthly cycle. As progesterone and estrogen levels drop at the beginning of the period, this causes you to become hungrier.

While cortisol - the stress hormones - levels are steadily on the rise during this period, the level of serotonin - the feel-good hormone - drops rapidly. The whole imbalance makes you crave sugary food which inadvertently leads to boost in feel-good hormones and hence cheer you up.

Nevertheless, many people believe that this does not add up. While the hormonal imbalance might be a reason, it is not the sole reason. One such believer is an advanced accredited practicing dietician, who published a post on her blog giving her views about this mystery.

She explained various avenues of a research which was carried to solve this chocolaty conundrum. She insisted that there is no definitive evidence of relating hormonal imbalance to menstrual chocolate craving.

She cited a study from 2004 which compared chocolate cravings of American and Spanish women.
The American women specifically showed their inclination to have chocolate during their menstrual cycle as opposed to their Spanish counterparts who craved chocolate around dinner-time or while working, notwithstanding their monthly cycle.

The researchers believed that the people now generally let their cravings run amok based on the cues predominantly set in their minds. Since a lot of women have seen or have been taught to associate menstrual period to chocolate, they automatically crave chocolate during the cycle.

The dietitian concluded with a statement that, "After reviewing the current research, I believe that craving chocolate before our period is a mixture of physiology, psychology, and cultural conditioning".

She added that "Our hormonal changes during the days leading up to your menstrual cycle leave us feeling stressed and tired, which we try to eradicate by indulging in our favourite comfort foods. This ends up creating a cycle by which we crave high fat and sugar foods when we get our period every month".

THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.    

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