Dengue fever cases are rising with the arrival of the rainy season, and with it the characteristic hemorrhages of patients—particularly children—who wait until the latest stages of the disease to seek medical treatment.
But maintaining an adequate supply of healthy blood to treat the worst cases is difficult, doctors said this week, as blood donation coordinators face high rates of infected blood and a cultural suspicion that losing blood makes the donor sick.
The dengue fever virus breaks down blood vessel walls, a process that destroys the blood’s clotting agents and decreases the body’s supply of platelets, a type of cell that helps blood to clot. As a result, patients suffering from late-stage dengue can bleed profusely from their gums, nose or stomach, said Dr Rathi Guhadasan, medical education coordinator at Angkor Hospital for Children in Siem Reap town.
At this stage, a blood transfusion may be one of the few options to save a patient’s life, but getting that blood can be a challenge.
“There are a lot of misconceptions about blood donation. People think it makes them weaker,” Guhadasan said.
People who do volunteer to donate blood rarely do it again, fearing that the initial feeling of fatigue that often happens after a donation means they have lost vital energy, said Uy Sam Onn, donor recruitment manager at the Cambodian Red Cross. As a result, only 4,000 of the 20,000 blood units needed nationwide every year come from voluntary donations, he said.
The remainder comes from patients’ families—and all too often, people who pose as family members to get cash for their blood, he said.
Professional blood donors are a big problem, Uy Sam Onn said. That group also tends to have a higher than average incidence of HIV and hepatitis B and C, he said.
To cut down on the poor people selling their blood, the Red Cross has been conducting blood drives targeted at students and monks since 2002.
Promoting blood drives among the general population is too risky, Uy Sam Onn said, because there is too much infected blood.
Angkor Hospital for Children recruits blood donors from among the tourists who flock to Siem Reap, and often asks foreign visitors who come to the hospital to donate, Guhadasan said. In 2003, 372 units of blood were collected from hospital visitors who were not related to patients. A unit of blood is 300 milliliters.
About 890 cases of dengue fever have been reported nationwide since January, about one-third of the number of cases in the same period last year, Ngan Chantha, director of the National Dengue Control program, said Tuesday. Cases increased when the rains began in April and May, he added.