Shivam Hospital

Dengue Fever – A Seasonal Illness but not without Lethality

With the arrival of monsoons, the number of dengue cases also rise significantly every year. The disease can range from mild symptoms to severe complications leading to even death in some cases. Over the last decade, Dengue has become quite prevalent in India and if we are to adequately combat this illness, it becomes essential to know a few important points.

What is Dengue fever?

Dengue fever is a viral infection which is caused by bite of the aedes mosquito that acts as a vector for the dengue virus. Owing to collections of water in small areas around and nearby residential settlements, the mosquitoes breed and multiply rapidly, leading to the seasonal explosion in dengue cases. This is a disease that can be caused by any one of the four related dengue viruses i.e DEN-1, DEN-2, DEN-3, or DEN-4. This disease is prevalent in many countries across the world, especially in South-East Asia, India, China, Africa, and Central America. In humans, recovery from infection by one dengue virus provides lifelong immunity against that particular virus serotype. However, this immunity confers only partial and transient protection against subsequent infection by the other three serotypes of the virus. Studies have also shown that sequential infection increases the risk of developing severe dengue.

How does it spread and What are the symptoms?

The transmission of the dengue virus takes place through an infected Aedes mosquito. It only spreads when an Aedes mosquito bites an infected person and then bites someone else. Often known as the break-bone fever owing to it affecting the muscles and bones of the patient severely, causing a pain that feels almost like the breaking of bones. Other symptoms may be :-

• Very high fever and Intense muscle pain

• Pain and burning sensation behind the eyes

• Persistent nausea and vomiting with diarrhea

• Upper Abdominal Pain and Discomfort

• Weakness and Headache

• Skin rashes or bruises

• Bleeding from nose

When to visit a Physician?

In case of :-

• Severe abdominal pain with Persistent vomiting and/or Diarrhea

• Bleeding from nose or gums, blood in vomit, urine or black colored stools

• Skin bruising

• Difficulty breathing

• Cold or pale skin

How is it diagnosed?

Diagnosing dengue fever can be difficult, because its signs and symptoms can be easily confused with those of other diseases such as malaria. Clinically the patient would present with some of the classical symptoms as mentioned above. Thrombocytopenia or low platelet counts are the most common finding and specific tests for dengue are now also available.

What is the Treatment?

Although there is no specific treatment for dengue fever, some important measures which limit the course of the disease and prevent complications are :-

• Rest with plenty of fluids

• Paracetamol as advised by the physician for fever

• Avoiding aspirin and other painkillers

• Avoid mosquito bites, to prevent the spread of the disease

• For severe dengue presenting with shock due to dehydration, prompt admission

with medical care and intravenous replenishment of lost fluids will help to prevent progression of the disease and aid recovery

• For patients with a very low platelet count, platelet transfusions are indicated to prevent spontaneous bleeding and death.

What can be the complications?

If the patient does not get tested and diagnosed on time, dengue can progress to a severe form very quickly leading to Dengue Haemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS), both of which can be life-threatening and lethal. Another major risk associated with severe dengue fever is the sudden drop in blood platelets which can present as bleeding from the nose, gums or mouth, as well as bluish-red bruising pattern on the skin.

What can you do to prevent dengue through safety precautions?

It is important to protect yourself from mosquito bites. Dengue-causing mosquitoes breed in stagnant water. During the monsoon, rainwater accumulates in potholes, garbage dumps, cracks and crevices around your house. Some of the preventive measures which are helpful are :-

• Drain the water that may stagnate in coolers and empty containers when kept inside/outside the house.

• Spraying larvicide to kill mosquito larvae in your locality.

• Install special mosquito nets at your windows. Zip up the nets during those times of the day when mosquitoes come in from outside.

• Use of mosquito repellent creams on exposed skin.

• Wear full clothes when stepping out.

• Sleep inside a mosquito net.

• To prevent the spread of the virus from the infected person to the mosquito and then to other people, patients who are already infected with the dengue virus should be protected against the mosquito. If a member of family has dengue fever, more precautions should be taken to prevent the spread of the infection.

What is the take-home message then?

The first and foremost aim should be maintaining a clean and hygienic environment around our residential areas and avoid water logging in small open spaces. With the onset of monsoon season, regular larvicidal spraying and the use of mosquito bed nets is absolutely essential. If bitten by a mposquito, the initial symptoms should not be ignored, and a nearby physician should be visited as soon as possible. Many lives can be saved from the perils of dengue infection, if only we are proactive and swift in our approach to control this disease.