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Dengue Fever
Dengue fever is a communicable disease. It is also called "break-bone" fever because it sometimes causes severe joint and muscle pain that feels like bones are breaking, It is a very common disease that occurs in epidemic form from time to time. The disease is quite severe in young children as compared to adults.
Dengue is prevalent throughout the tropics and subtropics. Outbreaks have occurred in the Caribbean, including Puerto Rico, the U.S. Virgin Islands, Cuba, and Central America. Cases have also been imported via tourists returning from areas with widespread dengue, including Tahiti, the South Pacific, Southeast Asia, the West Indies, India, and the Middle East.

Dengue fever is carried by the female mosquitoes "Aides Aegypti”. It normally feeds during the daytime, and is transmit their virus to humans through their bite.It is more likely to occur after rainy seasons.

How it spreads?

The Dengue virus is present in the blood of the patient suffering from Dengue fever. Whenever an Aedes mosquito bites a patient of Dengue
Fever, it sucks blood and along with it, the Dengue virus into its body. The Virus undergoes further development in the body of the mosquito for a few days. When the virus containing mosquito bites a normal human being, the virus is injected into the person’s body and he/she becomes infected and can develop symptoms of Dengue fever.
Dengue fever can be caused by any one of four types of dengue virus: DEN-1, DEN-2, DEN-3, and DEN-4. You can be infected by at least two if not all four types at different times during your lifetime, but only once by the same type.
There are few another reasons of the epidemic.
  • Poor Public health systems.
  • More usage of in non-biodegradable plastic packaging and discarded tires
  • There are no effective mosquito control methods.
  • Poor sanitation facilities are also responsible
Symptoms depend upon the type of Dengue fever. There are three types of Dengue fever-
1. Classical (Simple) Dengue Fever
2. Dengue Haemorrhagic Fever (DHF)
3. Dengue Shock Syndrome (DSS)
  1. Classical (Simple) Dengue Fever :
This type is self-limiting and does not kill.Symptoms of typical uncomplicated (classic) dengue usually start with fever within 4 to 7 days after you have been bitten by an infected mosquito and include
  • Sudden high fever with shivering.
  • Nausea and vomiting
  • Severe joint and muscle pain.
  • Pinkish red rashes on the skin
  • Retro-orbital (behind the eye) pain
  • Feeling of depression
  • Extreme weakness
  • Change in taste sensations in mouth
The entire duration of Classical Dengue fever lasts for about 5-7 days and the patient recovers.
  1. Dengue Haemorrhagic Fever – (DHF) –These symptoms are almost same as the classic dengue. There are some additional symptoms.
  • Bleeding (haemorrhagic) manifestations: Bleeding from nose, gums, blood in the stools or in vomiting, bleeding spots on the skin which are seen as dark bluish-black, small or large patches.
  • . Marked damage to blood and lymph vessels
This type of dengue can prove fatal if not diagnosed early.
Dengue Shock Syndrome (DSS): It is most severe3 form of dengue includes all of the symptoms of classic dengue and dengue hemorrhagic fever, plus
The patient also develops a condition called ‘shock’. Symptoms of shock in a Dengue Fever case are –
  • Loss of consciousness
  • Feeling of restlessness
  • Fluids leaking outside of blood vessels
  • Rapid low pulse rate
  • Very low blood pressure
  • Massive bleeding
This form of the disease usually occurs in children (sometimes adults) experiencing their second dengue infection. It is sometimes fatal, especially in children and young adults.
Classical (simple dengue fever):
In this type there is no specific treatment and most of the people recover within 2 weeks.
There are some recommendations for treatment. Keep the fever low by giving paracetamol as per doctor’s prescription.
  • Avoid giving Aspirin or Disprins tablets to the patient
  • Complete bed rest
  • Give plenty of foods in addition to patient’s normal diet
If fever is more than 102°F, carry out hydrotherapy to bring down the temperature.
If any of the symptoms indicative of DHF or DSS develop, rush the patient to the nearest hospital at the earliest where necessary treatment will be carried out.
Diagnosis is made on the basis of clinical symptoms and blood test. The earlier detection is the only cure for this illness. Diagnosis is done by two blood tests, 2 to 3 weeks apart. The tests can show whether a sample of your blood contains antibodies to the virus
In case of classical (simple dengue fever)
As it is a self limiting disease, the patient can be managed at home. Here are some guidelines for it.
  • Keep the fever low by giving paracetamol tablet or syrup as per health worker’s advice.
  • Avoid giving Aspirin or Dispirin tablets to the patient because medicines like aspirin reduce platelet count.
  • If fever is more than 102°F, carry out hydrotherapy to bring down the temperature.
  • Give plenty of fluids water, shikanji etc. to the patient.
  • Continue normal feeding. In fever, the body, infact, requires more food.
  • Allow the patient to rest.
If any of the symptoms indicative of DHF or DSS develop, rush the patient to the nearest hospital at the earliest where appropriate investigations will be carried out and necessary treatment instituted, e.g., transfusion of fluids or platelets (a kind of blood cells which become low in DHF and DSS). Please remember that every patient does not require blood platelet transfusion.
The best way to prevent dengue virus infection is to take special precautions to avoid being bitten by mosquitoes. Because Aedes mosquitoes usually bite during the day, be sure to take precautions, especially during early morning hours before daybreak and in the late afternoon before dark. Aedes aegypti breeds primarily in man-made containers like earthenware jars, metal drums and concrete cisterns used for domestic water storage, as well as discarded plastic food containers, used automobile tyres and other items that collect rainwater. Discard or dry these items
  • Avoid heavily populated residential areas.
  • Avoid mosquito bite even during day time.
  • Discard items that can collect rain or run-off water, especially old tires.
  • Eliminate mosquito breeding sites around homes.
  • Regularly change the water in outdoor bird baths and pet and animal water containers.
  • Sleeping area should have mosquito netting over the bed.
  • Stay in well-screened areas.
  • Use long clothes to cover the body to avoid mosquito bite
  • Use mosquito repellents on skin and clothing.
  • When indoors, stay in air-conditioned or screened areas. Use bednets if sleeping areas are not screened or air-conditioned.
  • When outdoors during times that mosquitoes are biting, wear long-sleeved shirts and long pants tucked into socks.
Most people who develop dengue fever recover completely within 2 weeks. Some, especially adults, may be tired and/or depressed for several weeks to months after being infected with the virus.

The more clinically severe dengue hemorrhagic fever and dengue shock syndromes can result in vascular (blood vessel) and liver damage, and can be life-threatening.

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