Aditi tandon
Tribune news service
New Delhi, October 13
The government said Tuesday that Covid could coexist with a variety of seasonal diseases and asked hospitals to prepare to treat a possible high burden of severe dengue / malaria cases alongside Covid.
Issuing guidelines for the community and physicians on how to deal with Covid co-infections, the Health Ministry said that, given the seasonal pattern of epidemic-prone diseases seen each year in the country, diseases such as dengue, malaria , seasonal influenza, leptospirosis, chikungunya, and enteric fever can not only present a diagnostic dilemma, but can coexist in cases of Covid.
“This poses challenges in the clinical and laboratory diagnosis of Covid, and has an influence on clinical management and patient outcomes,” the ministry said in issuing the guidance document that seeks to provide guidelines on the prevention and treatment of Covid co-infections with diseases such as dengue. , malaria, seasonal influenza (H1N1), leptospirosis, chikungunya.
The government said that malaria and dengue could coexist with other infections, so the confirmation of malaria and dengue infection does not rule out the possibility that the patient does not have Covid and there must be a high index of suspicion for malaria and dengue. when a fever case is diagnosed as Covid, particularly during the rainy and post-rainy season in areas endemic for these diseases.
Both Covid and seasonal influenza can also present as influenza-like illness, so all of these cases in areas reporting Covid cases should be evaluated and tested for both Covid and seasonal influenza, if both viruses are circulating in the population under consideration.
The ministry says that chikungunya leads to the acute onset of continuous moderate to high-grade fever and general malaise followed by skin rash, myalgia and arthralgia. Respiratory failure can occur in late stages. Co-infection with Covid can be suspected in chikungunya endemic areas, in monsoon months.
Leptospirosis, in addition to presenting as a febrile illness, also has a tendency to manifest as an acute respiratory illness, causing respiratory distress and shock. In areas where leptospirosis is known to cause outbreaks during the monsoon and after the monsoon, the possibility of co-infection should be considered, the guidelines say.
They add that the scrub typhus prevalent in the foothills of the Himalayas in Jammu and Kashmir, Himachal Pradesh, Sikkim, Manipur, Nagaland, Meghalaya has also been seen in the recent past in Delhi, Haryana, Rajasthan, Maharashtra, Uttarakhand, Chhattisgarh, Tamil Nadu and Kerala.
“The clinical picture consists of sudden high fever, severe headache, listlessness, myalgia, and generalized lymphadenopathy. A maculopapular rash can appear first on the trunk and then the extremities and fades within a few days. Patients can develop complications including interstitial pneumonia. Scrub typhus infection can coexist with Covid, as can bacterial infection, ”the ministry said, recommending diagnostic and treatment techniques and calling on all secondary and tertiary level hospitals to be prepared to handle severe cases of dengue and Covid.
The government said a concerted effort is required in the prevention, surveillance, communication for behavior change and management of co-infections.
Alert vigil, a high index of suspicion, and constant awareness of the possibility of co-infections can help clinicians avoid the adverse outcome of coinfection cases, he said.
