Dengue
Dengue fever is considered one of the most common tropical viral infections seen in India.
Dengue fever (DENG-gey) is a mosquito-borne illness that mostly affects tropical and subtropical countries. A high temperature and flu-like symptoms are common signs of dengue fever. A severe form of dengue fever, dengue hemorrhagic fever, can cause substantial bleeding, a drop in blood pressure (shock), and fatality.
It commonly occurs in the post-monsoon period. Dengue is caused by 4 closely related serotypes of the dengue (Flaviviridae family) virus. It is transmitted by Aedes aegypti mosquitoes, which typically bite during day times. The incubation period ranges from 2-7 days.
The spectrum of presenting complaints in Dengue infection varies from subclinical to simple fever to severe shock and multi-organ dysfunction syndrome (MODS).
Types Of Dengue
Dengue affects around 40% of the population in the 100 countries where it is endemic. It is divided into three categories based on the intensity and symptoms experienced by the host.
- Mild Dengue Fever
- Dengue Haemorrhagic fever
- Dengue Shock Syndrome
Symptoms Of Dengue Fever
Symptoms of dengue fever generally appear four to ten days after the initial infection. They are similar to flu or other illness symptoms. Young children and persons who have never been infected may endure a less severe sickness than older children and adults.
Symptoms of dengue fever generally appear four to ten days after the initial infection. They are similar to flu or other illness symptoms. Young children and persons who have never been infected may endure a less severe sickness than older children and adults.
High-grade fever with chills, retro orbital pain, joint pains, body aches, headache, severe generalized weakness, diffuse flushing red color rash initially after 1-2 days of fever, later petechial rash seen over trunk, legs, and arms, conjunctival redness, etc.
Severe symptoms include severe breathlessness, low heart rate, recurrent vomiting, cold clammy extremities, jaundice, decreased urine output, severe headache and abdominal pain, spontaneous or uncontrolled bleeding episodes, heavy sweating, altered sensorium, neck stiffness, etc.
Common symptoms generally last for 2 to 7 days. They can include:
- Sudden, high fever (up to 106°F or 41°C)
- Severe joint and muscle pains
- Severe headache
- Skin rash (appearing between 2 and 5 days after the initial fever)
- Swollen lymph glands
Symptoms of severe dengue can include :
- Belly pain and tenderness
- Vomiting blood or blood in stool
- Mild bleeding from the nose or gums
- Mild to severe vomiting (three times in 24 hours)
- Fatigue, restlessness, or irritability
When to see a doctor?
Dengue fever is a serious medical condition that can be fatal. If you've recently visited a location where dengue fever is known, you've had a fever, and you've developed any warning signs, seek medical help immediately. The doctors will inquire about their health status, medical history, and previous trips. The doctor may request a blood sample to screen for the illness. Severe stomach discomfort, vomiting, trouble breathing, blood in your nose, gums, vomit, or stools are all warning signals.
Doctors at Medicover can help you get the right treatment for any kind of Viral Fever and disease.
Causes
One of four dengue viruses causes dengue disease. When you are bitten by a mosquito carrying the dengue virus, the virus can enter your bloodstream and replicate itself. You may become ill due to the infection and your immune system's response. The virus can harm sections of your blood that form clots and give your blood vessels shape. This, along with specific chemicals produced by your immune system, can cause blood to flow out of your vessels, resulting in internal bleeding. This causes severe dengue fever, which can be fatal.
Risk Factors
If you have dengue fever or a more severe version of the disease, you're more likely to get it.
Living in or travel to a tropical location :
Being in tropical and subtropical climates increases your chances of contracting the dengue fever virus. Southeast Asia, the western Pacific islands, Latin America, and Africa are high-risk zones.
You've previously got dengue fever :
If you've had dengue fever earlier, you're more likely to have severe symptoms, if you get it again.
Complications
The complications of Dengue Haemorrhagic Fever include:
- Bleeding under the skin
- Cough and sore throat
- Bloody Spit
- Bleeding on the skin
- Patchy skin
- Bloody Stool
- Weariness
- Excessive sweating
- High fever
- Sudden chills
- Bloody vomit
- Irregular urine discharge
- Dry eyes
Preventions
No vaccination can prevent people from dengue. It can only be avoided by avoiding mosquito bites. There are various methods to avoid being bitten if you live in or go to an at-risk region.
Clothing:
Wearing long pants, long-sleeved shirts, and socks, as well as tucking pant legs into shoes or socks and wearing a hat, reduces the amount of skin exposed.
Mosquito repellents:
Use a repellent containing at least 10% diethyltoluamide (DEET) or a greater concentration for prolonged exposure. DEET should not be used on children under the age of six.
Mosquito traps and nets:
Insecticide-treated nets are more effective; otherwise, a mosquito can bite through the net if a person stands near it. The pesticide will kill mosquitoes and other insects, and insects will be kept out of the room.
Door and window screens:
Structural barriers, such as screens or netting, help keep mosquitos out of doors and windows.
Camping gear:
Clothing, shoes, and camping gear should be treated with permethrin, or pretreated clothing can be purchased.
Timing:
Avoid being outside between the hours of dawn, dusk, and early evening.
Stagnant water:
Clean, stagnant water is where the Aedes mosquito breeds. Stagnant water should be checked for and removed to reduce the risk.
Diagnosis
A blood test detects dengue infection by looking for the virus or antibodies against it. Inform your doctor if you fall ill after visiting a tropical place. This will help your doctor determine whether your symptoms result from dengue infection. Doctors use blood tests to look for antibodies to the dengue and phlegm viruses.
Various diagnostic tests are available and includes a rapid immunochromatographic test (Dengue Rapicheck). ELISA for Dengue is the commonly used confirmatory test.
Investigations include Hemogram, RFTs, LFTs, CUE, Chest X-ray, USG scan whole abdomen, etc.
A few tests done to diagnose dengu are listed below:
Virological test:
This test looks for viral components directly. Because this testing frequently necessitates specialised equipment and a technically skilled team, it may not be offered in all medical institutions.
Serological test:
Antibodies in the blood are detected to confirm a current or recent infection. If you get dengue symptoms after travelling outside the nation, you should consult a doctor to ensure you don't have the virus.
Treatment
Secondary infections are known to be more severe in nature, with more chances of development of DHF/DSS. If treatment is delayed, patients can land into DSS, which can lead to life threatening consequences.
Platelet level and Hematocrit should be regularly monitored. A fall in Hematocrit level is suggestive of impending shock syndrome.
Management is mainly symptomatic and supportive. Maintaining hydration (with isotonic NS) is very important to maintain blood pressure. Platelet transfusion is indicated only if there is severe thrombocytopenia (<20,000/mm3) / overt bleeding.
Treatment options for milder forms include:
Preventing dehydration:
Dehydration can be avoided by avoiding a high temperature and vomiting. Clean water, preferably bottled rather than tap water, should be consumed. Minerals and fluids can also be replaced using rehydration salts.
Pain medications like Tylenol or paracetamol can help reduce heat and pain:
Aspirin and ibuprofen are non-steroidal anti-inflammatory medicines (NSAIDs), which might increase the risk of internal bleeding.
Dengue fever in its most severe variants may require:
- TIntravenous (IV) fluid supplementation, or a drip if the person cannot take food orally.
- Patients with extreme dehydration may require blood transfusions.
- If the patient's symptoms worsen, hospitalisation will allow for thorough monitoring.
Lifestyle Changes and Self Care
Avoiding mosquito bites and reducing the mosquito population are the greatest ways to protect yourself. When in a high-risk location, you should take the following precautions when in a high-risk location:
- Stay away from densely crowded residential areas.
- Mosquito repellent should be used both indoors and outdoors.
- Wear long-sleeved shirts and slacks with socks tucked in.
- Instead of opening the windows, turn on the air conditioner.
- Make sure the screens on your windows and doors are secure and that any holes are fixed.
- If your sleeping space isn't screened, use mosquito netting.
Dos and Don’ts
Dengue is curable and manageable if the patients receive the necessary treatment. However, following the prescribed dos and don'ts can help you avoid the disease's serious consequences. Some guidelines are:
| Do’s | Don’ts |
| Drain excess water from plant pot plates | Eat fried, processed, junk, spicy, and greasy foods. |
| Eat protein-rich foods. | Consume caffeinated, alcoholic, and carbonated beverages such as coffee, chocolate, and tea. |
| Monitor platelet counts and hematocrit by repeating blood tests as needed. | Self-medicate in the lack of supervision. |
| See a doctor if dengue symptoms start. | Take stress and engage in physical activities when sick. |
| While sleeping, use mosquito nets on the mattresses. | Allow water to stagnate in open areas and the surrounding area. |
Dengue is not a fatal condition if caught and treated early. By following precautions, we can avoid its serious repercussions.
Dengue Care at Medicover Hospitals
We have the best team of general physicians and specialists at Medicover who treat Dengue fever precisely. Our highly trained physicians use the most up-to-date diagnostic techniques and procedures to run tests, diagnose, and treat dengue in adults and infants. Our experts work closely with the patients to monitor their health and treatment progress to achieve a faster and more sustained recovery.
