Difficult treatment, high costs
In recent days, the Children's Hospital of HCMC has recorded a sharp increase in dengue patients requiring hospitalization, including many critical cases. One notable case is H.C.K., a 7-year-old resident of Tan Tao Ward, HCMC, who was hospitalized in severe dengue shock on the fifth day of illness, accompanied by coagulation disorders, gastrointestinal bleeding and severe liver injury. Doctors had to intubate the child and provide mechanical ventilation, while also administering blood and blood products to save the child.
In another case, a 10-year-old resident of My Duc Commune, An Giang Province, developed severe dengue shock on the fifth day of illness, with an unmeasurable pulse and blood pressure. After receiving anti-shock treatment at a local hospital, the child was transferred to the Children's Hospital of HCMC in critical condition. Doctors had to administer vasopressors, intubate the child, provide mechanical ventilation, transfuse blood and drain the abdominal cavity to relieve pressure.
Adults can also deteriorate very rapidly after contracting dengue. Dr. Nguyen Thanh Phong, deputy director of the Hospital for Tropical Diseases in HCMC, said the hospital had recently admitted a 16-year-old female patient from HCMC diagnosed with dengue who, after only a few days, developed severe shock, acute respiratory failure, multiple organ failure, heart failure and electrolyte disturbances.
Although she was intubated and placed on mechanical ventilation, her condition did not improve, forcing doctors to use veno-venous extracorporeal membrane oxygenation (VV-ECMO), an artificial heart-lung support technique. After more than a month of treatment, the patient underwent multiple ECMO membrane replacements and received blood and blood products, while infections were treated with multiple antibiotics.
However, because of the exceptionally complex condition, which required a series of advanced intensive-care measures and newer-generation antibiotics, the total treatment cost reached VND862 million. Of this amount, health insurance covered VND560 million.
Vague symptoms, rapid progression to severe disease
According to Dr. Nguyen Thanh Phong, the number of patients with severe dengue requiring hospitalization over the past week was higher than during the same period last year. In some cases, dengue progresses to severe disease very quickly, particularly during the critical period from the third to the seventh day after the onset of fever.
What initially appears to be an ordinary fever can quickly develop into shock, respiratory failure and multiple organ failure, and can even become life-threatening. “If patients are careless, complacent or mistake the initial symptoms of dengue for those of an ordinary fever or cold, they may miss the window for timely monitoring and intervention,” Dr. Nguyen Thanh Phong said.
Dr. Le Hong Nga, deputy director of the HCMC Center for Disease Control, said dengue circulates year-round and affects people of all ages. According to epidemiological patterns, dengue cases typically increase and peak around October.
The increase during the rainy season stems from the biological characteristics of the Aedes mosquito, the vector that transmits the disease. Unlike other mosquitoes, Aedes mosquitoes lay eggs only in clean, stagnant water that collects in household items such as buckets, basins, flower vases and water bowls, as well as outdoor containers that collect rainwater.
Therefore, environmental control is necessary, including eliminating mosquitoes, mosquito larvae and pupae, and using measures to prevent mosquito bites. Dengue vaccination should also be used to help provide the body with active and lasting immunity against the disease.
