A three-year-old girl in Andheri East died of dengue on Thursday afternoon. Manasvi Devrukhkar breathed her last in the private-run Holy Spirit Hospital at 2.55 pm. She was admitted to the paediatric intensive care unit (PICU). Doctors at the hospital confirmed that the ailing girl was brought to the casualty ward of the hospital on Wednesday.

"She was wheeled into the casualty in a state of shock. She was in a state of stupor and appeared to be in an advanced stage of the illness. She succumbed to the disease Thursday afternoon," said the casualty medical officer.

dna has the death certificate of the girl which mentions that she died of dengue shock syndrome and thrombocytopenia. Doctors say dengue shock syndrome adversely hits children below 10 years of age.

"The shock occurs suddenly after 2-6 days of high fever, as platelets drop drastically causing capillaries of the body to lose water and bleed out," said Dr Suhasini Nagda, director of the BMC-run medical colleges in Mumbai.

While a normal person may have a platelet count of 1.5-2 lakhs, in thrombocytopenic conditions, the platelets drastically reduce to 10,000 and even lower, leading to bleeding.

In another incident on Thursday, in Pune, 12-year-old Shweta Chaskar succumbed to dengue. Chaskar who had high fever was ill for a week and was being treated at a small nursing home in Nigdi, where she resided.

"She was shifted to Aditya Birla Hospital in Khergaon on Wednesday. She succumbed the next day," said a relative. In Nashik, 42-year-old Jitendra Kulkarni also died of dengue on Thursday.

The toll of dengue deaths in the state is estimated to have reached 27. However, the directorate of health services (DHS) has maintained that an inquiry will be conducted to 'confirm' the three deaths that occurred on Thursday.

"While we maintain a database of dengue cases and deaths in rural and district hospitals, we are yet to collate the data to include deaths in municipal corporations of cities," said Dr Satish Pawar, director, DHS.

Even as the death certificate of Manasvi indicates that she died of dengue, BMC epidemiologist Dr Mangala Gomare maintained that the BMC has verified and confirmed only eight dengue deaths in the city so far.

"The death of Manasvi, 20-year-old Shubham Tewari and 33-year-old Sandeep Gaikwad are being inquired. The expert committee will restudy the medical history and files to decide if the deaths are dengue-related," said Dr Gomare.

Even though hospitals issue death certificates on behalf of BMC, the civic body doesn't accept the cause of death, prima facie. The civic body conducts its own inquiry before confirming the cause of death. As a result, dengue statistics vary.

BMC health commissioner Sanjay Deshmukh said there exists a disparity in numbers, primarily because dengue is not certified as a 'notifiable' disease. The BMC has moved a proposal to the state to make dengue 'notifiable,' in which case every private hospital in the city will have to report all dengue cases to the BMC for better tracking and maintenance of records.

Mumbai has emerged as a hotbed of dengue. BMC's executive health officer Dr Padma Keskar said that breeding sites of aedes aegypti mosquito was discovered in the high rises of Prabhadevi area as well as Andheri, Ghatkopar and Bhandup, among other areas.

"In plush localities of Santa Cruz and Vile Parle, mosquito breeding was spotted in coconut shells around gardens. Leaking airconditioned plants in certain apartments also lead to breeding," said Dr Keskar.