• Shruti GOCHHWAL

Dengue

Primary overview

Meta: What is Dengue and how can you prevent yourself from falling victim to it?

Dengue (pronounced DENgee) is caused by a virus carried by mosquitoes. Dengue is widespread around the world, commonly in tropical and subtropical countries.

There are two types of dengue; Break Bone Fever and the more severe type, Dengue Hemorrhagic Fever (DHF), which is life-threatening. Early diagnosis is the key to an effective cure and quick recovery.

Dengue is considered deadly because it shows flu-like symptoms, which can become severe within a few hours.

This may be the reason for more deaths of children due to dengue. Pregnant women, infants, and people who have suffered earlier from dengue are more likely to catch dengue infection.

In India, most cases are reported from July to November after the monsoon season.

North Indian States Where Dengue is Reported More Often:

  1. Delhi

  2. Rajasthan

  3. Haryana

  4. Punjab

  5. Chandigarh

Central and South Indian States Where Dengue is Reported More Often:

  1. Maharashtra

  2. Karnataka

  3. Tamil Nadu

  4. Pondicherry

Symptoms

Dengue is spread by the female mosquitoes of the Aedes Species. Symptoms include:

Main symptoms of dengue (the “dengue triad”)

  1. Sudden fever

  2. Rash

  3. Headache

Other symptoms of Dengue includes

  1. Pain behind the eyes

  2. Bone, Joint and muscle pain

  3. Chills (shivering and/or sweating)

  4. Facial flushing

  5. Nausea and/or vomiting

  6. Fatigue and loss of appetite

  7. Sore throat

  8. Bleeding (bleeding nose, bleeding gums and/or blood in your urine)

In most cases, symptoms last up to 10 days with complete recovery. However, in some cases, the symptoms worsen with the drop in platelet count due to damage to lymph and blood vessels.

This causes a severe form of dengue, dengue hemorrhagic fever (DHF) reported more frequently in children with following additional symptoms

  1. High fever

  2. Feeling irritable, restless, or tired

  3. Bruises due to bleeding

  4. Vomiting (3 times a day or more) or blood in the stool

  5. Abdominal Pain (Stomach or belly pain)

  6. Swelling in the Liver and lungs or abdomen

Dengue hemorrhagic fever (DHF) requires immediate medical treatment. If not treated timely, may lead to dengue shock syndrome (DSS) causing massive bleeding, shock, and death.

Caption: Picture of dengue fever rash on legs

Possible cause

Dengue is caused by any one of Dengue Virus 1, 2, 3, & 4. This is why a person can develop dengue four times in a lifetime, and a person previously infected with dengue has a greater risk of dengue infection.

Risk of severe dengue hemorrhagic fever (DHF) is high in:

  1. People with weak immune systems

  2. Second or subsequent dengue infection

Diagnosis & Test

Dengue medicine being sprayed in a city

Early diagnosis is very important in dengue for treatment and quick recovery. Dengue is often confused with other flus, and viral disease hence can be difficult to diagnose.

Many other conditions like flu, influenza, measles, malaria, typhoid fever and viral diseases show similar symptoms. Also, some mosquito species are found to transmit viral diseases such as chikungunya, yellow fever, and viruses like zika virus, west nile virus.

Due to this, a blood test is the only way to confirm the diagnosis. Depending upon the severity of symptoms, one or more of the following tests are done:

Complete Blood Count: It is used to examine the rapid decrease in platelet count or thrombocytopenia (<1 lakh/cmm). It can also be used to examine an increase in hematocrit (20% or more).

Antigen-NS1 Test (Non-Structural Protein 1): Detects Antigen-NS1 in blood and is useful for dengue fever diagnosis in the first week of the illness.

Antibody Test (Serology Tests): These tests are used to detect IgG and IgM antibodies that are produced by the body in response to a dengue fever infection. This test is done to diagnose a recent infection.

Following antibody tests are used for diagnosis:

  1. Rapid Diagnostic Test: It is used to detect both IgG and IgM antibodies. The test can detect all four serotypes of dengue.

  2. MAC-ELISA: It is used to detect IgM antibodies five days or more after the onset of fever. As per WHO, ELISA (Enzyme-linked immunosorbent assay) is better than rapid tests for dengue fever diagnosis.

  3. IgG ELISA: It is used to detect both recent and past dengue infection. These tests are not in wide use.

Polymerase Chain Reaction (RT-PCR) Test: It is considered the most reliable diagnosis and involves a PCR test to detect the presence of the virus (Nucleic acid detection) in the blood after 5 days of symptoms.

Treatment/Remedies / Cure

Immediate medical treatment is necessary for dengue hemorrhagic fever (DHF) within 24–48 hours of development of symptoms.

There is no specific treatment or vaccine for dengue; it often requires general intensive care.

As there is no specific medicine or antibiotic, the treatment is directed toward relief of the symptoms (symptomatic treatment).

For mild and less severe dengue, which lasts 8 to 10 days, usually, rest and fluid intake (oral rehydration) are advised until symptoms subside.

The use of pain reliever medicines (avoid containing aspirin) is advised only under a doctor’s supervision because of the possibility of bleeding.

If the condition does not improve after 3-5 days or you start to feel worse in the first 24 hours after your fever goes down, you should get admitted to a hospital.

Treatment of severe type of dengue fever (hemorrhagic and shock syndrome) involves IV fluid hydration, platelet transfusions, blood transfusions, blood pressure support, and other intensive care measures.

PreventionThe best way to prevent dengue is by avoiding mosquito bites. Another way involves protecting yourself and making efforts to keep the mosquito population down.

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