In Sorocaba (SP), the oral serum used to hydrate patients with dengue fever is missing. The Sorocaba Health Department states that oral serum is in short supply throughout the national market.
A Sheet, the city’s municipal secretariat stated that, in all care units, intravenous serum is applied, when prescribed by doctors, and the use of homemade serum is recommended. The forecast, according to the agency, is that oral hydration serum will be distributed in all units by the end of May.
When contacted by the report, the Health Department of the State of São Paulo stated that “the purchase of basic inputs, such as serum, is the responsibility of the municipalities” and that, in February this year, “to assist municipalities in the fight against dengue, SES anticipated the payment of R$ 205 million from IGM SUS Paulista to the 645 municipalities in the state”.
Lifar Laboratory, which produces the Fixidrat oral serum, stated that “sales growth accelerated exponentially in April, much higher than expected, which resulted in shortages throughout this month.” The laboratory also informed that it is working with its supplier to start the month of May with normalized stocks.
Natulab, which produces Hidraplex, states that it has implemented “measures to expand our manufacturing capacity, by adding another shift to our production line. This measure aims to meet existing demand within two to three months.”
Carla Kobayashi, infectious disease specialist at Sírio Libanês hospital, understands that “at this most critical moment, we will have to opt for an alternative, which would be to make a homemade serum. It’s better than the patient not following adequate hydration.” The infectious disease specialist explains that the oral hydration serum is indicated for patients in groups A and B, who undergo outpatient treatment, without hospitalization.
According to Kobayashi, especially in the first days of dengue fever, hydration with a specific volume of liquids is recommended, which is calculated based on the patient’s weight: 60 ml/kg per day. “But this total amount of liquids per day has to be divided into one third of liquid with oral rehydration salts and the other two thirds with other liquids”, explains the doctor.
In addition to hemoglobin and platelets, blood is made up of electrolytes such as sodium, potassium and chloride. When hydration is done only with other liquids, “the patient may not have an adequate concentration of electrolytes for recovery. The idea of this rehydration serum is that it has specific concentrations of these electrolytes”, says Kobayashi.
Take care
Science, habits and prevention in a newsletter for your health and well-being
According to the infectious disease specialist, rehydration can also be done with homemade serum, “the only issue is that this measurement ends up being more imprecise at home”. According to the Ministry of Health, to prepare a homemade serum it is necessary to mix a small spoon (like a coffee spoon) of salt and a large spoon (like a soup spoon) of sugar in a liter of mineral water. Mix well and offer the patient in small spoonfuls throughout the day.
Some of the warning signs for dengue are: intense and continuous abdominal pain, persistent vomiting, bleeding of mucous membranes, drop in blood pressure, enlarged liver, lethargy or irritability, accumulation of fluids in body cavities (ascites, pleural effusion, effusion pericardium), progressive increase in hematocrit and postural hypotension (dizziness when standing up).
A recent article published by the Center for Strategic Studies at Fiocruz analyzes dengue deaths and also points out that lack of assistance and inattention to the potential worsening that patients may experience are the main reasons associated with dengue deaths.
