KARACHI – “Endemic Infections must not be overlooked. COVID pandemic and endemic infections together may increase the number of patients requiring intensive care and mechanical ventilation. Diagnostic work-up before treatment is absolutely essential.”
Dr. Bushra Jamil Ali, Professor at Aga Khan University, and President Medical Microbiology & Infectious Diseases Society of Pakistan (MMIDSP), expressed these views while speaking at the online public awareness seminar on “Fever in Covid Pandemic: Endemic Infections must not be overlooked ” held at the Dr. Panjwani Center for Molecular Medicine and Drug Research (PCMD), University of Karachi on Friday.
Dr. Panjwani Center organised the seminar with an objective to raise public awareness about the most important current challenges, which our nation is facing.
The lady professor said that many important infections were endemic. Dengue, typhoid, malaria, and influenza all exhibit seasonal variation and should be considered in the differential diagnosis of a febrile patient even during Covid-19 pandemic, she said.
She mentioned, “Diagnostic work-up before treatment is absolutely essential, as wrong treatment has its consequences.”
Management and therefore outcomes can be substantially improved if guidelines are followed, she said, adding that effective vaccines are available for some of the highly prevalent conditions and should be prescribed.
Talking about typhoid, Prof. Bushra Ali pointed out that typhoid had been with us for a long time. In both endemic areas and in large outbreaks, most cases of typhoid fever are seen in those aged 3–19 years, she said, adding that a large majority of clinicians rightly suspect typhoid in any patient who presents with prolonged fever (more than three days duration).
The highest incidence occurs where water supplies serving a large population are contaminated, she said.
She pointed out, “Inhabitants of the Punjab and Sindh provinces of Pakistan are at the highest risk of developing typhoid.”
Situation is complicated from time to time with rising and fall in the number of dengue, chikungunya, malaria, acute hepatitis, and influenza, she said.
“More than one infection can coexist in a patient in an endemic setting.” The professor said. COVID-19 can have serious consequences not only for elderly patients with comorbid conditions but also for healthcare workers, she observed.
She said, “Diagnostic screening is imperative to recognize and separate infected individuals and to discontinue transmission in the community”.
Dengue should be suspected when a high fever (40°C/104°F) is accompanied by 2 of its symptoms, including severe headache, nausea, vomiting, etc, during the febrile phase.