I refer to the letter written by Ahmad Sobri where he claimed that the government is not doing enough to end the dengue scourge in Subang Jaya. His letter was also riddled with inaccuracies on the treatment of dengue.

Despite a declining platelet count in the presentation of dengue, transfusing platelet is often times unnecessary unless the patient presents uncontrolled spontaneous bleeding. Moreover, platelet transfusions carry with it the risk of infections and transfusion-related reactions.

The major danger of dengue comes from the fact that this infection increases the leakage of plasma from the blood capillaries during which time, the patient is in danger of losing blood volume leading to dengue shock syndrome which has high mortality figures.

The mainstay of treatment remains fluid replenishment to maintain a good blood volume during which time the patient should spontaneously recover. Transfusing platelet unnecessarily will no doubt deplete the stores in blood banks and is an incorrect practice. Getting this fact correct is important to avoid concern among patients with dengue who are not transfused with platelet.

Diagnosing dengue remains a challenge and one needs a high index of suspicion. The diagnosis is arrived from the presenting of clinical symptoms and signs, backed by current geographical distribution of the disease. On many occasions, dengue mimics a viral infection and may pass undetected.

Rapid test kits have never been proven to be useful in places where dengue infection is endemic. Some studies suggest a low sensitivity of these kits to detect IgM which usually signifies an acute infection, that is, even if the test is negative, it does not necessarily rule out dengue. The presence of IgM also needs to be correlated with the clinical scenario and an absolute level may mean nothing in a dengue endemic population like Malaysia.

One way of fighting dengue is to understand the transmission of this disease. Depending solely on the authorities to maintain hygienic practices is foolish and naive. To defeat dengue, we need a collective, responsible mindset from the population in question, in this instance the residents of Subang Jaya. Keeping their premises free of aedes breeding grounds is the responsibility of the owners. In fact, ensuring that drains surrounding their premises are not clogged should also be the responsibility of these respective owners.

The persistence of dengue, in my opinion, highlights the lackadaisical attitude of Subang Jaya residents and their refusal in assuming the responsibility of keeping their premises clean. Relying solely on the authorities to weed out mosquito-breeding sites will only spell defeat in this fight against dengue.

Doctors can diagnose but not contain the problem. However, I agree with one statement in Sobri's letter in that we need to focus on this problem and cannot be apathetic. A lapse in focus will cost lives and this point should be directed at the residents of Subang Jaya themselves.