Pune: Nov 2024 turned out to be unusual for Maharashtra with Pune, Nashik and Ahilyanagar districts experiencing cold wave or near cold wave conditions, and hospitals registering several cases of hypothermia in infants — a rare development for this time of the year. Hypothermia is a condition that occurs when core body temperature drops below 95° Fahrenheit (35°C).
The three districts are the first ones to get a cold wave forecast this season in India. Isolated parts of these districts experienced “near cold wave conditions” the last three days. On Friday, Shivajinagar’s minimum temperature dropped to 9.5°C, marking the third consecutive day of single-digit temperatures, IMD data showed. Ahilyanagar recorded a cold 8.3°C and Nashik 10.6°C.
IMD, Pune, scientist S D Sanap said the country’s northern parts have not recorded any cold wave conditions so far this season. “However, Pune and Nashik have recorded near cold wave conditions (with negative departures near the threshold -4.5°C in minimums in the last 2-3 days). Ahilyanagar recently recorded cold wave conditions at isolated places.” Cold wave is declared when the minimum temperature is less than or equal to 10°C in plains, and the temperature departure is 4.5-6.4°C below normal.
Doctors said such weather conditions are not conducive for infants as their body temperatures drop, which is more dangerous than a rise, especially in newborns.
Dr Pradeep Suryawanshi, director and head of the department of paediatrics and neonatology at Sahyadri Hospitals, said the hospital has seen two cases of hypothermia in the past three days, involving infants barely eight days and 12 days old. “The infants were making grunting sounds, which indicated breathing problems, along with changes in skin color and a drop in oxygen levels. We had to stabilize their body temperatures using warmers,” he said.
“The infants’ body temperatures had fallen below 95°F, a critical threshold for newborns. Low birth weight increases the risk of hypothermia. Newborns weighing less than 2.5 kg are particularly vulnerable, and those under 2kg require even more caution. Delayed treatment can be life-threatening,” he said.
“The respiratory rate in those infants rose to 50 or 60 breaths per minute. We addressed this by providing oxygen and using CPAP (Continuous Positive Airway Pressure) machines to stabilize breathing and temperature,” Dr Suryawanshi said.
Dr Deepali Ambike, head of the department of paediatrics at the Postgraduate Institute, YCM Hospital, Pimpri, said, “Several infants and paediatric children referred from other hospitals to us have been arriving in a hypothermic state. This has been particularly in case of govt ambulances, which lack proper heating facilities. For instance, we recently received a referral from Akkalkot, beyond Solapur. The baby travelled for eight hours and arrived late at night in a severely hypothermic state.”
She said, “Hypothermia can affect all infants, but is especially dangerous for neonates. Hypothermia is a condition that occurs when core body temperature drops below 95°F (35°C). It is a type of cold injury and medical emergency. In this case, the baby’s temperature was 34°C. Low body temperature slows blood circulation, reduces cardiac output, and can lead to multi-organ failure. Despite our efforts, the baby developed kidney damage and required dialysis, but couldn’t survive.”
Dr Ambike said hypothermic referrals from rural areas, including Manchar and other peripheral regions, have increased in recent days due to the sudden drop in temperatures. “We have received several hypothermic cases, mostly in neonates and infants under six months. While we have saved most, some succumbed to complications caused by hypothermia,” she said, adding, “Ambulances must be equipped with adequate heating devices to prevent such outcomes. The sudden onset of cold weather this Nov has been unprecedented. We usually see such cases in Dec or Jan,” she said.
Dr Amita Kaul, head of paediatrics at Surya Mother and Child Super Speciality Hospital, said, “We have seen a couple of such cases in the last few days where parents have brought low birth weight babies with symptoms of poor feeding and lethargy. On examination, they were found to be hypothermic. Hypothermia causes a cascade of symptoms in small babies like drop in sugar levels, depressed respiration and also poor feeding.”
Dr Yellappa Jadhav, medical superintendent of B J Medical College and Sassoon General Hospital, told TOI, “We have instructed the hospital staff to take all necessary precautions, including use of incubators and radiant warmers, to prevent hypothermia in neonates, especially in light of the sudden drop in temperature.”
Dr Sagar Lad, senior neonatologist and pediatric intensivist at Jehangir Hospital, highlighted a related concern. “There has been a recent surge in mycoplasma pneumonia cases in children, likely triggered by the abrupt dip in temperatures. We have treated four-five paediatric patients, especially school going children, in the last week with mycoplasma pneumonia presenting with large lobar pneumonia of lungs. This can be serious. If not detected and treated early, this can cause serious complications.”
