More asking for dengue tests at clinics as numbers rise

AS DENGUE numbers continue to climb in Singapore, more patients at some private clinics are asking for blood tests to diagnose the disease.

Such tests cost at least $40 at private clinics The Straits Times spoke to, but those with fever seem to want to play it safe. This, despite doctors saying dengue blood tests are accurate only if a fever persists for a few days.

At the Healthway clinic in Tampines Street 71, about four in 10 patients with fever have been asking for these tests to find out if they have the disease, resident doctor Philip Koh said. This is in contrast to last year, when Dr Koh saw virtually no such requests.

"Patients used to be taken aback when we asked them to do blood tests; now, they are receptive and some have even been asking for it," he said. "More are concerned because our clinic is in a major dengue hot spot."

At Eden Family Clinic in Jurong West Street 41, two in 10 patients with a persistent fever have asked to be tested for dengue, said Dr Elias Tam.

Singapore is in the grip of what could be its worst dengue epidemic, with 9,693 cases diagnosed so far this year. From Sunday till 3pm yesterday, there were 397 new cases of dengue.

Early dengue symptoms include fever and joint aches, which are similar to those of the flu. Obvious symptoms, such as rashes, may appear only three to five days after a fever starts.

Most doctors said they recommend a dengue test only after two to three days of persistent fever. "The index of suspicion for dengue is higher in this season. Details like whether the patient stays in a hot spot or not will be taken into account," said Dr Lee Chong Han from Raffles Medical in Jurong East.

Doctors generally advise against testing too early, as doing so on the first day of fever might not be cost-effective.

Patients might have to repeat tests at a later stage should initial ones turn out negative and their fevers persist, Dr Lee said.

"We do not routinely test for dengue on the first day of fever as it might be caused by a number of possible infections, such as the flu," said Dr Felix Tan of Parkway Shenton's clinic at UE Bizhub Changi.

But clinical judgment is also important. "If the patient looks clinically very unwell,we will do the test even if he says it is the first day of the fever," said Dr Tam.

About a third of the 20 patients ST spoke to said they would initiate a dengue blood test if they had a fever for two to three days.

"I would insist on it if I had a fever of about 39 deg C for more than two days," said senior logistics assistant Phua Bee Lian, 51, who lives in Tampines, a dengue hot spot. "Two people in Singapore have died from dengue, so it is better to be safe than sorry."

kashc@sph.com.sg

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