In lieu of the controversial vaccine, there is a better way to beat dengue among those who are already infected with the virus. The simple solution: drinking water.
“It’s simply water-in versus water-out issue,” explained Dr. Richard T. Mata, a pediatrician whose clinic is in Panabo City, Davao del Norte. “Dengue is about hydration,” he pointed out, referring to the process of providing an adequate amount of water to body tissues of a patient.
Known for his anti-dengue advocacy, the boyish-looking physician makes his own website – which he updates regularly – to educate thousands of people around the world on the truth about dengue fever.
Dengue, he said, is one of the most misunderstood diseases in this planet today. “In my years of practice, I have discovered a lot of things that are so important about this disease but it’s not yet written in medical textbooks or in any website, thus I made it an advocacy to teach it in the simplest way possible as Albert Einstein said, ‘If you can’t explain it simply, you don’t understand it well enough.’”
Most people are terrified of dengue because when the blood platelets decrease, it causes severe bleeding and ultimately death. This thinking, he said, is very wrong. “That’s a misconception maling akala, ayun nga sa Eraserheads, maraming namamatay sa maling akala,” he surmised.
According to him, not too many Filipinos know what really transpires when the dengue virus enters the human body. “When the mosquito bites you, the dengue virus will enter your blood vessels and it will cause plasma leakage, or what I call as butas ang mga ugat. It’s like you have thousands of pinpoint holes in your blood vessels that causes it to leak with water that will cause dehydration,” he said.
But it’s not only water, which is contained in plasma, that comes out but platelet as well. “This is the reason why the platelet decreases because it comes out of the holes of the blood vessels,” he explained.
According to him, the blood vessel holes, just like an ordinary wound, heal within six days. “That’s why in dengue, the platelet is observed to have decrease until the sixth day of fever and from there, the platelet starts to increase again as the holes begin to close,” he said.
What really kills a person with dengue is not due to low platelet counts but dehydration. It occurs when a person loses more fluid and his body doesn’t have enough water and other fluids to carry out its normal functions. “Dehydration is the killer,” he declared, “low platelet is only secondary.”
Dr. Mata pointed out that even if the platelet continuous to decrease each day for as long as the patient is fully hydrated with dextrose and oral fluids, the patient is safe. “The best indication the patient is fully hydrated is that he keeps on urinating with an interval of one to three hours,” he said. “If the patient does not urinate for than 5 hours, he can be in a brink of either hypotension (low blood pressure) or kidney failure.”
As a proof that it’s not low blood platelet that kills a person with dengue, Dr. Mata showed a video of a two-year old girl with a disease called idiopathic thrombocytopenic purpura (ITP), a disease in which antibodies form and destroy the body’s platelets. It is not caused by dengue virus.
The video presentation showed the patient has a platelet count of only 10; the normal count is 150 and above. “Although the ITP patient had only 10, you can notice that she is smiling and playing around,” he said.
According to Dr. Mata, even though the platelet is low, the patient is not dehydrated because there is no plasma leakage in ITP. As such, she can still play around. In comparison, he said that in dengue the platelet is low but there is also dehydration due to the plasma leakage.
“That’s why a person with dengue looks weaker,” he pointed out. “So, if you can correctly replace water being lost in the case of dengue, the patient can reach to a level where even if the platelet is low the patient can still be awake and alert.”
Dr. Mata considered dengue just like “a secret diarrhea.” He said: “That’s why it’s dangerous because you cannot see the fluids that comes out of the vessels unlike in loose bowel movement where it’s obvious. So, it’s easy to estimate the needed amount of hydration in diarrhea than that of dengue. All the worst if you don’t even know its dehydration.”
Dr. Mata said dehydration causes shock, “dahil naubos na ang tubig, wala ng pressure. Kaya nga tinawag na dengue shock.”
Dehydration also causes intestinal ulcer that causes bleeding. “And because the platelets are low, the bleeding becomes severe. But if there was no dehydration, there will be no ulcer and thus no bleeding – even if the platelets are low,” he explained. “So, it still boils down to dehydration.”
Dehydration also causes kidney failure, which result from the decrease in urine output. “This causes the water to be retained in the lungs thereby creating congestion that can kill the patients,” he said.
Many people believe congestion is caused by over hydration. “But the truth is, it is caused by kidney failure due to dehydration,” he said. “That’s ironic, right?”
Dr. Mata suggested that doctors should focus on improving the knowledge and the management on hydration. By doing so, he said, “we will save thousands of patients from those complications of dehydration and even from dying.”
If only the scientists got it right from the start, it should have been called dengue dehydration fever and not dengue hemorrhagic fever. “Imagine how many people we could have saved by proper understanding,” he said.
“So how will you know if you are well hydrated,” he asked. “Dengue patients must be well-hydrated with Oresol and dextrose. If the patients are well hydrated, they will always urinate. With an almost clear color (of the urine)!
“Those who urinate small with longer intervals and with dark colored urine are in danger of severity. The good news is that the quality of the urine can warn us before the blood pressure drops and thus can be hydrated early and save the patient,” Dr. Mata said.
“If people will know the truth,” he said, “the chances of surviving from the disease will greatly increase. In fact, there may come a time when dengue deaths worldwide can become zero.”
No, it’s not the durian fruit, which most people from Davao believe. Nor it is “tawa-tawa” (known in the science world as “Euphorbia hirta”). It’s not even the exotic “balut,” which most foreigners frown upon seeing a dead duck embryo ready to be eaten. It is just clean water.
For all his efforts, Dr. Mata named as one of the five recipients of the Third Health Exemplar Awards given by the Manila-based Health and Lifestyle magazine.
“(He) works patiently one barangay and one community at a time, as he envisions that each and every region of the country will be empowered with the proper knowledge and skills to significantly curb the rising prevalence of this potentially serious infection which cuts short the lives of hundreds of Filipino children annually,” said a statement released during the awarding ceremony. (To be continued)
