Dengue fever is otherwise called as Break bone fever. This Mosquito-borne disease is common in tropical & sub-tropical region of the world like India. Millions of cases are recorded each year in many parts of the world but most of the time, recovery from Dengue fever is good without any serious problem. Fatality rate is 0.8% to 2.5% but with proper treatment, it is less than 1%. This article is to create awareness about Dengue.

Causes & Transmission of Dengue

Dengue does not transmit by direct contact. It is transmitted from Human to Human through dengue infected Female Aedes Mosquitoes. Mosquito bites the infected person, the virus then enters into mosquito and when this infected mosquito bites another person, they will become infected. So you can’t get dengue by being around the infected person.

Dengue virus has 4 serotypes: DENV-1, DENV-2, DENV-3 & DENV-4. If you get infected by one type, you will get long term immunity for that particular type of virus but that doesn’t mean you won’t get dengue. You may get infected by other types of virus.

Symptoms

Symptoms usually begin after 3 to 14 days of infection. Initial dengue infection may be asymptomatic, mild case mimics like Flu. Subsequent infection may become worse which results in Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS).

Dengue Fever

– High fever (104’F)

– Headache

– Vomiting

– Muscle and Joint pain 

– Pain behind the eyes

– Swollen glands

– Rash

These symptoms usually respond to treatment and recovery will be good. Certain cases may become worse and lead to DHF & DSS.

Severe symptoms start within a day or two after the fever goes off. It happens when your blood vessels and capillaries become damaged and leak with your platelet count dropping down which leads to bruises, internal bleeding, shock, organ damage and even death.

Warning signs

– Bleeding under the skin (Bruises)

– Bleeding gums & nose

– Persistent vomiting

– Severe stomach pain

– Blood in urine and stools

– Difficult and rapid breathing

A small subset of DHF will develop in to DSS, that is with the  features of circulatory collapse like

– Rapid & weak pulse,

– Hypotension,

– Restlessness, and

– Cold clammy skin.

Complications

For Dengue fever, DHF and DSS are the main complications. Women who get dengue during pregnancy may spread the virus to the baby during childbirth. Babies of women who get Dengue during pregnancy have the possibility of preterm birth, lower birth weight and Fetal distress.

Management

– Early identification and early management is crucial in order to avoid complications

– Continuous monitoring of the patient

– Proper hydration

– Avoiding NSAIDS & Anti-Platelets (As per Dr’s advice) because it has risk of Hemorrhage

– Perform regular Hemodynamic assessments, baseline Hematocrit testing and platelet counts

– IV fluids, if orals not allowed

Continue to monitor closely during Defervescence. Remember, critical phase of dengue begins with defervescence and lasts for 1 to 2 days.

Prevention

– Avoid being bitten by mosquitoes

– Control mosquito population

– Well screened housing wall

– Wear protective clothing and use mosquito repellants

– Take measures to evacuate the unnecessary water stagnation

– Focus on boosting Immunity

Vaccination is not advised for people who have been infected with Dengue.

WHO – “Vaccine is not an effective tool on its own to reduce dengue fever in areas where the infection is common.”

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Author: Dr. Raji Arabi