Dr Cecilia Anthonysamy graduated from UKM in 1993 and spent many years enjoying the flying doctor service in the interior of Sarawak. She has the distinction of being the only woman doctor to have served so far in the Belaga Health Clinic near the Bakun dam in Sarawak.
To maximise her love for adrenaline rush, she studied Masters in Emergency Medicine in USM. She is currently a Senior Consultant Emergency Physician in Hospital Serdang serving her 28th year in government service . She has special interest in pain management, geriatrics and making the world a better place to live in.
The ageing population around the world is increasing dramatically. In Malaysia, the elderly population account for about 7 % of the population in 2020. Dengue cases among elderly are slowly increasing. All age groups are susceptible to dengue but elderly with co-morbidities are more likely to develop severe dengue.
It is important to distinguish important signs and symptoms of dengue in elderly that are atypical. This often cause delay in early recognition and difficulty in making a diagnosis.
The elderly may present initially with fever alone. They present less with the typical fever syndrome described in the WHO Dengue 2009 guideline.
Elderly patients with dengue may not follow the pattern of being relatively well in the febrile phase, afebrile and ill in critical phase and then recovering. There are reports of prolonged fever, with risk of severe dengue occurring in all three phases among the elderly. So, the sensitivity of the WHO 2009 dengue guideline decreases with increasing age.
Elderly dengue patients are at risk of concurrent bacterial infection and may have leucocytosis. They generally have higher systolic and diastolic blood pressure, especially with underlying hypertension, often causing delay in recognising hypotension. There are a number of case control studies examining independent risk predictors to severe dengue and mortality in elderly.
With an increasing ageing population, it is important to prepare early to recognise and manage well more elderly with dengue in the future, in order to reduce dengue mortality.
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