It rained H1N1, dengue cases, but malaria was worst killer

Mumbai: The disease pattern in the city has been springing a surprise every year and 2012, too, is no different. As the almost four-month monsoon — often associated with a spike in ailments — prepares to retreat, records show H1N1 giving the chills to the city's population showing a more than 50-fold jump in cases over last year and malaria emerging as the most lethal, claiming 30 lives despite a 62% drop in cases from 2011.      But the disease that has even doctors worried is dengue, which emerged at the fag end of the monsoon and seems likely to peril Mumbaikars for longer. Dengue cases continued their march, rising almost four fold since 2010 (see box). The volume of malaria cases and deaths      remained much      higher than dengue,      but the threat from      the second vectorborne disease seems      much greater, given that a higher percentage of patients needed hospitalization and some even ICU care.      Consultant physician and chief intensivist of P D Hinduja Dr Khusrav Bhajan labelled dengue as the most challenging of the surprises sprung by this monsoon. "Dengue patients have been arriving with chills and shivering thatare classic symptoms of malaria. It is also affecting the liver, a rare complication associated with dengue," he said. Though showers have drastically come down, Bhajan has been treating four to five dengue cases every day. "Out of those patients, at least 50% need hospitalization as the platelet count tends to fall drastically," he said.      If H1N1 showed the most wildly swinging statistics with 353 cases and four casualties in the city so far this year as against only six cases and no deaths in 2011, a strange picture of contrasts was thrown up by malaria — incidence dropped by 79% from 2010 and 86 fewer deaths were reported, yet it has been the worst killer in the city so far this year with 30 casualties.      In a story similar to malaria's, the second most lethal disease turned out to be jaundice. It recorded a 40% drop in cases from 2011, but has led to the death of seven persons in the city so far this year.      Virologists say the H1N1 influenza took everyone by surprise and would possibly take the slot of top killer at the state level. "The virus did give us a scare but we have to accept that more positive cases are because of more awareness leading to more people going in for testing," said state epidemiologist Dr Pradeep Awate.