The horrible twins – Dengue & COVID | Print output


By Kumudini Hettiarachchi and Ruqyyaha Deane

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Dr. Upul Dissanayake

It was the two viral diseases COVID-19 and Dengue that the consulting doctor Dr. Upul Dissanayake from the National Hospital of Sri Lanka (NHSL).

A strong suggestion that dengue fever is on the rise came from Dr. Dissanayake when he said dengue fever has been pushed back on their minds as people’s attention is mainly focused on COVID-19. The number of dengue cases increases sharply every four years. The last time it was in 2017 and now the country may be at the beginning of the next surge.

He talks about the soil situation on his ward:

Of the 40 beds, 10-15 are occupied by dengue patients. Of these 10-15 dengue patients, between 1/3 and half develop dengue hemorrhagic fever (DFH).

Regarding COVID-19, the number of approvals has decreased. Right now it could be around 40 across the NHSL, compared to 800 a few months ago. Of these, between 1/3 and half are dependent on oxygen. Most of them are either not vaccinated or vaccinated, but their immune response is poor due to inherent problems such as chronic diseases.

To differentiate between COVID-19 and dengue fever, Dr. Dissanayake:

COVID-19 – fever, severe back pain, headache and bone pain. A runny nose and cough can also occur, while loss of taste and smell and loss of appetite occur. You may also have difficulty breathing.

Dengue – Symptoms similar to COVID-19 and pain under the eyes, but no loss of taste and smell, although loss of appetite could occur. You may also experience a runny nose and cough, although these are not symptoms of dengue and may be due to another infection. Difficulty breathing can also occur if the person suffers from dengue shock.

He stressed that a person who is vomiting and cannot eat / drink needs to be hospitalized immediately, as well as if the person has pain on the right side of the stomach as it could mean severe dengue fever.

How can one differentiate between these twin virus diseases?

“To diagnose whether it is dengue fever, we need to do a complete blood count (FBC) and a dengue NS1 antigen test. It’s important to remember that on day 1 or 2 of the fever, even if the NS1 antigen test is negative, it is not confirmation that the person is dengue-free. This is because the NS1 antigen test is about 98% positive in first time dengue patients, but about 40% of second time patients do not test positive, ”he said, adding that an FBC is also important and the reports should be given in a few hours instead of a day as this would delay diagnosis and treatment.

Some advice from Dr. Dissanayake for dengue patients:

A health department circular recommends that a person should be hospitalized if the platelet count drops below 130,000. This is because there have been cases where a patient’s platelet count was 150,000 one day but dropped dramatically to 80,000 the next day, causing him / her to go into shock.

It is important to do FBCs in the morning and in the evening and get the reports soon.

If a person is suspected of having dengue fever, it is very important to stay home, keep bed rest, and drink adequate fluids (2,500 ml of fluid for adults and as recommended by a doctor for a child).


Dr. Dissanayake says the area inside and outside should be thoroughly cleaned and mosquito breeding areas destroyed. The dengue mosquito is a day biter and it doesn’t help to sleep under a mosquito net at night.

“Wear long-sleeved clothing when you go out, especially if dengue sufferers have occurred near you, and use a mosquito repellent like citronella oil,” he suggests.

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