Why Platelet Counts Drop in Dengue Fever and What You Can Do About It

Dengue is a common mosquito-borne illness that can cause a range of debilitating symptoms, including high fever, muscle aches, and terrible headache. But one of the most concerning issues in a patient is a sudden drop in the platelet count. Platelets are small blood cells that play a critical role in blood clotting and preventing excessive bleeding. When a person is infected with the Dengue virus, their platelet levels can drop significantly - a condition referred to as “Thrombocytopenia”. In this blog, we will provide comprehensive information about Dengue and its impact on platelet count, including understanding platelets, the reasons behind their decline, and strategies to increase their levels. But first, let’s cover some basics. 

What is Dengue?

Dengue is a viral infection transmitted to humans through the bite of infected Aedes mosquitoes, particularly Aedes aegypti and Aedes albopictus. It is prevalent in tropical and subtropical regions worldwide, including Southeast Asia, the Pacific Islands, the Caribbean, and Central and South America.

The virus has four distinct but closely related serotypes (DEN-1, DEN-2, DEN-3, and DEN-4). Infection with one serotype provides lifelong immunity to that specific serotype, but only partial and temporary immunity to the others. This means a person can be infected with Dengue up to four times in their lifetime, once with each serotype.

Symptoms of Dengue can range from mild to severe and typically appear 4 to 10 days after the bite of an infected mosquito. Common symptoms include:

• Viral fever
• Severe headache
• Pain behind the eyes
• Joint and muscle pain
• Rash
• Nausea and vomiting
• Mild bleeding (such as nosebleed or gum bleeding, or easy bruising)

The Role of Platelets in the Body

Platelets, also known as thrombocytes, are small, colourless cell fragments in the blood that play a crucial role in haemostasis, the process that stops bleeding at the site of injured blood vessels. Here’s a detailed look at their functions:

Key Functions of Platelets

• Clot Formation: When a blood vessel is injured, platelets are among the first responders to the site of damage. They adhere to the exposed collagen fibres of the vessel wall and each other, forming a platelet plug. This initial plug is crucial in preventing further blood loss.
• Release of Chemical Signals: Platelets release various chemicals that enhance the clotting process. These include ADP, thromboxane A2 and Serotonin.
• Interaction with Clotting Factors:  Platelets provide a surface for the assembly of clotting factors, which are proteins in the blood plasma that work together to form a stable blood clot. This process is known as the coagulation cascade. The clotting factors convert fibrinogen, a soluble plasma protein, into fibrin, an insoluble protein that forms a mesh, stabilising the platelet plug.
• Wound Healing: Platelets contain growth factors such as Platelet-Derived Growth Factor (PDGF) and Transforming Growth Factor-beta (TGF-β). These growth factors are released at the site of injury and play a role in tissue repair and regeneration by attracting cells that contribute to wound healing.

Read more - Dengue Haemorrhagic Fever: Symptoms, Treatment, and Prevention

Why Do Platelets Drop in Dengue?

Dengue fever's effect on platelet count is multifaceted, resulting in a significant decrease. The virus itself disrupts the normal production of platelets and also triggers events that lead to their destruction. Here's a breakdown of the two main factors:

• Disrupted Platelet Production: The dengue virus can infiltrate the bone marrow, which is the factory where platelets are produced. This infiltration disrupts the normal production process, leading to fewer platelets being released into the bloodstream.
• Increased Platelet Destruction: The dengue infection throws the immune system into overdrive. Sometimes, in its fight against the virus, the immune system mistakenly identifies healthy platelets as invaders and destroys them. This further contributes to the drop in dengue platelet count.

These combined effects can cause a significant decrease in platelets during dengue, raising concerns about potential bleeding complications.

What is the Range of Platelet Count in Dengue Fever?

In a healthy individual, the dengue platelet level typically ranges from 150,000 to 450,000 platelets per microlitre (µL) of blood. However, dengue fever can cause a dramatic drop in platelet count. Here's a breakdown of how platelet count changes in dengue:

• Normal Range: 150,000 - 450,000 /µL
• Dengue Patients: Platelet count can drop significantly, sometimes as low as 10,000 /µL or even lower.

What are the Symptoms Associated With Low Platelets in Dengue?

Dengue fever itself has a range of symptoms, but when it comes to low platelets specifically, there aren't always tell-tale signs you'll experience outwardly. This is why regular monitoring of platelet count is important during dengue. However, there are some signs that might indicate a more serious situation due to low platelets:

• Easy Bruising or Bleeding: This is the one of the most common symptoms of low platelets in dengue. You might notice small purple spots on your skin (petechiae) or larger, flat, reddish-brown patches (ecchymosis) even from minor bumps or without any apparent cause. You might also experience bleeding from your nose, gums, or even internal bleeding, although these are less common.
• Severe Abdominal Pain: Abdominal Pain can be a sign of internal bleeding in the abdomen.
• Vomiting Blood: This is a more serious sign and requires immediate medical attention.
• Black Stools or Blood in the Urine: These are also signs of internal bleeding and require urgent medical attention.

How to Increase Platelet Count in Dengue?

Dengue fever can cause a significant drop in platelet count, raising concerns about bleeding complications. While medications and transfusions may be necessary in severe cases, there are steps you can take to support your body's natural platelet production during recovery. Here's how:

Dietary Strategies to Boost Platelet Production

• Essential Nutrients: Focus on a balanced diet rich in vitamins and minerals that play a role in platelet production.
• Vitamin C: Citrus fruits (oranges, grapefruits), bell peppers, strawberries
• Vitamin B12: Lean meats, fish, eggs, dairy products
• Folate: Leafy green vegetables (spinach, kale), lentils, beans
• Vitamin K: Leafy greens, broccoli, asparagus
• Iron: Lean meats, beans, lentils, fortified cereals
• Platelet-Friendly Foods: Some foods have been linked to increased platelet production, although more research is needed. Consider incorporating these into your diet:
• Papaya: Avoid eating papaya leaves as they also have toxins in it. Consume papaya instead.
• Pomegranate: This fruit is rich in antioxidants and may contribute to platelet health.
• Dates: Dates are a natural source of iron and other essential nutrients.

Hydration and Fluid Management

Staying well-hydrated is crucial for overall health and can also indirectly support platelet production. Aim to drink plenty of fluids throughout the day, especially water, clear broths, and coconut water. Avoid sugary drinks and excessive caffeine, which can dehydrate you.

Medical Considerations

• Medications: In some cases, doctors may prescribe medications to stimulate the bone marrow to produce more platelets. These medications should only be taken under a doctor's supervision.
• Platelet Transfusions: If your platelet count drops critically low, and you experience bleeding complications, a platelet transfusion as a part of your dengue fever treatment may be necessary. This is a medical procedure performed by a healthcare professional.

Frequently Asked Questions

How Long Does it Typically Take for Platelet Count to Recover After Dengue?

The recovery time for platelet count after dengue can vary depending on the severity of the infection. In most cases, platelet count starts to increase within 3–4 days after the fever subsides and typically returns to normal within 7–10 days. However, for severe cases like Dengue Haemorrhagic Fever (DHF), recovery might take longer.

Are There Any Long-Term Effects of Low Platelets from Dengue?

Generally, a temporary drop in platelets during dengue doesn't cause long-term effects. However, in very rare cases, severe dengue with extremely low platelet counts can lead to complications like bone marrow problems affecting future platelet production. Consulting your doctor for follow-up care after dengue recovery is recommended.

Do I Need Medication to Increase my Platelet Count?

Not necessarily. In most cases, your body will naturally increase platelet production as you recover from dengue. However, if your platelet count drops critically low, or you experience bleeding complications, your doctor might prescribe medications to stimulate platelet production.

When are Platelet Transfusions Necessary for Dengue Patients?

Platelet transfusions are typically only needed in severe cases of dengue with very low platelet counts (usually below 20,000/µL) accompanied by bleeding complications. A physician will assess your individual situation and determine if a transfusion is necessary.

What are the Risks Associated with Platelet Transfusions?

Platelet transfusions are generally safe procedures. However, there are some potential risks, such as:

• Fever and chills
• Allergic reactions
• Infection transmission (very rare)

How Can I Prevent Mosquito Bites and Reduce my Risk of Getting Dengue?

 Here are some steps you can take to prevent mosquito bites and reduce your risk of getting dengue:

• Use mosquito repellent: Choose a repellent containing DEET, picaridin, or oil of lemon eucalyptus.
• Wear long sleeves and pants: Especially during peak mosquito hours (dusk and dawn).
• Eliminate mosquito breeding grounds: Around your home, get rid of stagnant water in containers, old tires, etc.

• Use mosquito nets while sleeping.

Are There Any Vaccines Available for Dengue?

Dengue vaccine is yet not commercially available globally and may not be 100% effective against all serotypes of the dengue virus. It's best to consult with your doctor about the latest recommendations in your region.

Conclusion

Dengue fever can be a scary illness, and the drop in platelet count is a cause for concern. However, by understanding the reasons behind this decrease and the ways to support your body's natural recovery process, you can feel informed during your battle with dengue. For a comprehensive evaluation and personalized treatment plan, contact the expert team at Max Hospitals, the best dengue fever hospital in India. Our dedicated healthcare professionals are equipped to handle all aspects of dengue care, including monitoring platelet count in dengue fever and providing necessary interventions.