Dengue fever is an acute mosquito-borne viral infection. It is more common in tropical and subtropical climates. It is also known as break-bone fever.
Types of Dengue & Symptoms
Dengue fever can have three spectrums of the disease. Classical dengue fever, Dengue hemorrhagic fever and Dengue shock syndrome. Most people with dengue have mild illness (Classical dengue fever) and will get better in 1-2 weeks. Rarely, dengue can be severe and lead to death. The symptoms usually begin 4 -10 days after infection and last for 2-7 days. Common symptoms of Dengue fever are high fever (40°C/104°F), severe headache, pain behind the eyes, muscle and joint pains, nausea, vomiting, swollen glands, rash. Individuals who are infected for the second time are at greater risk of severe dengue. Severe dengue symptoms are severe abdominal pain, persistent vomiting, difficulty in breathing, bleeding gums or nose, fatigue, restlessness, blood in vomit or stool, being very thirsty, pale, and cold skin.
How Dengue Happens
The virus is transmitted to humans through the bites of infected female mosquitoes, primarily the Aedes aegypti mosquito. Other species within the Aedes genus can also act as vectors, but their contribution is secondary to Aedes aegypti. Mosquitoes can become infected by people who are viremic with Dengue virus. Human-to-mosquito transmission can occur up to 2 days before someone shows symptoms of the illness, and up to 2 days after the fever has resolved. The risk of mosquito infection is positively associated with high viremia and high fever in the patient; conversely, high levels of DENV-specific antibodies are associated with a decreased risk of mosquito infection. Most people are viremic for about 4–5 days, but viremia can last as long as 12 days.
How Dengue Spreads
Aedes aegypti mosquitoes breed in fresh and stagnant water. It is a day biting mosquito. Most common collections of the breeding areas like artificial collection of water in houses like flower vases, coconut shells, aquariums etc. Community’s risks to dengue also depend on population’s knowledge, attitude, and practice towards dengue, as well as the implementation of routine sustainable vector control activities in the community. Consequently, disease risks may change and shift with climate change in tropical and subtropical areas, and vectors might adapt to new environment and climate.
How to protect yourself
The mosquitoes that spread dengue are active during the day. Lower the risk of getting dengue by protecting yourself from mosquito bites by using clothes that cover as much of your body as possible. Mosquito nets if sleeping during the day, ideally nets sprayed with insect repellent, window screens, mosquito repellents (containing DEET, Picaridin or IR3535), coils and vaporizers.
Treatable at Home
Patients who are diagnosed to be having Dengue fever can be managed at home. They should consume plenty of water, fluids, use acetaminophen (paracetamol) for pain, avoid non-steroidal anti-inflammatory drugs, like ibuprofen and aspirin. They should watch for severe symptoms and contact the doctor as soon as possible if they notice any. There is no specific treatment for dengue. The focus is on treating pain symptoms. Acetaminophen (paracetamol) is often used to control pain. Non-steroidal anti-inflammatory drugs like ibuprofen and aspirin are avoided as they can increase the risk of bleeding. For people having severe symptoms can be admitted. Packed cell volume and platelet count should be monitored regularly. Low platelet count is often seen in many patients. Platelet transfusion is recommended only if platelet count is less than 10,000/dL or in presence of bleeding manifestations.
At Ramaiah Memorial Hospital we treat patients with dengue and monitor their health 24/7 if admitted with severe symptoms. All facilities like blood platelets are available in the hospital itself.
Dr. Aswin Kulkarni
Department of General Medicine