Dengue Fever

What it is Dengue Fever?

Dengue fever is a common communicable disease characterized by occurrence of high fever, severe body aches and intense headache. It is a very common disease which is endemic in most part of India, Most of the infections occurs in the rainy season. Though it may be found sporadically in other seasons as well, Wide spread outbreak occurred in 1996, 2003, 2006, 2010, 2013  2015. The disease is quite severe in young children as compared to adults.

It is a disease which occurs throughout the world except in Europe and affects a large number of people. For example, it is estimated that every year, 2 crore cases of Dengue fever occurring the world.





cause

It is caused by a virus( Dengue Virus) which has got four different types (Type 1, 2, 3, 4.) Common name of the disease is ‘break-bone fever’ because of severe body and joint pains produced.

Diagnosis

Detection of the Dengue Virus nonstructural protein 1 (NS1) has emerged as an alternative biomarker to both serologic and molecular based techniques for diagnosis of acute Dengue Virus infection. NS1 antigenemia is detectable within 24 hours and up to 9 days following symptoms onset. This overlaps with the Dengue Virus viremic phase and NS1 is often detectable prior to IgM seroconversion. Concurrent evaluation for the NS1 antigen alongside testing for IgM- and IgG-class antibodies to Dengue Virus (DENGM) provides optimal diagnostic potential for both early and late dengue disease.

Spread

Just like in malaria, Dengue fever is also spread by bites of mosquitoes. In this case, the mosquitoes are ‘Aedes Aegypti’ mosquitoes which are very tough and bold mosquitoes and bite even during day time.   This disease occurs more frequently in the rainy season and immediately afterwards (July to November in India.).                                                            .

The Dengue virus is present in the blood of the patient suffering from Dengue fever. Whenever an ‘Aedes Aegypti’ mosquito bites a patient of Dengue fever, it sucks blood along with it and 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 viruses injected into the person’s body and he /she becomes infected and can develop symptoms of Dengue fever.

Incubation Period

It means the time between bite of an infected mosquito and appearance of symptoms of dengue fever in the bitten person, commonly it is 5-6 days. However it can vary from3-10days.

Symptoms of Dengue Fever

Symptoms depend upon the type of Dengue fever. There are three types of Dengue fever-

  1. Classical (Simple) Dengue Fever
  2. Dengue Hemorrhagic Fever (DHF)
  3. Dengue Shock Syndrome (DSS)





The classical (Simple) Dengue fever is a self-limiting disease and does not kill. However, the other types( i.e. DHF  &  DSS) can prove fatal if prompt treatment is not started,  It is important to recognize whether Dengue Fever is Simple or DHF or DSS.

The following symptoms will be in diagnosis- 

 Classical (Simple) Dengue Fever
  • Sudden onset of high fever with feeling of chills.
  • Severe Headache, Pains in muscles and joints.
  • Pain behind the eyeballs especially on pressing the eyes or on moving the eyeballs,
  • .Extreme weakness, loss of appetite, feeling of nausea.
  • Change in taste sensations in mouth
  • Pain in abdomen by itself or on touching.
  • Mild pain in throat.
  • Patient feels generally depressed and very sick.
  • Rash on the skin : Pinkish red rash appears on the skin in the form of diffuse flushing, mottling or    pinhead eruptions on the face, neck and chest.    Later on, the rash may become more prominent.

The entire duration of Classical Dengue fever lasts for about 5-7 days and the patient recovers.

      Dengue Hemorrhagic Fever (DHF)

It should be suspected if with above mentioned symptoms of Classical (Simple) Dengue Fever, one or more of the following symptoms appear.

  • Bleeding (hemorrhagic) 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.
  • lf a health worker carries out a Tourniquet Test, It is positive.
  • Certain laboratory investigations carried out on a blood sample also confirm DHF.
Dengue Shock Syndrome (DSS)

All symptoms as mentioned above DHF are present plus the patient also develops a condition called ‘shock’. Symptoms of shock in  a Dengue affected case are –

  • The person is very restless and the skin feels cold and clammy despite high fever.
  • The person may start losing consciousness.
  • lf you examine the pulse rate of the patient it is weak and rapid. Similarly, blood pressure will be low.

Warning Signs

  • Severe abdominal pains
  • Persistent vomiting
  • Rapid breathing
  • Bleeding gums
  • Fatigue
  • Restlessness
  • Blood in vomiting
  • Poor intake
  • Cold extremities
Treatment

If it is classical (Simple) Dengue Fever, the patient can be managed at home. As it is a self-limiting disease treatment is purely supportive and symptomatic –

  • Keep the fever low by giving paracetamol tablet or syrup as per health worker’s advise,
  • Use only Paracetamol tablet or syrup and no other pain killers or anti fever drugs like aspirin, disprin, ibubrufen etc.
  • If fever is more than 1020F, carry out hydrotherapy to bring down the temperature.
  • Give plenty of fluids water to the patient.
  • Continue normal feeding. In fever, the body, in fact, requires more food.
  • Allow the patient to rest.
  • if any of the symptoms indicative of  DH F 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.
Prevention

Prevention of Dengue  is simple and better, What is required are some simple measures for-

  • Preventing breeding of ‘Aedes Aegypti’ mosquitoes
  • Protection from ‘Aedes Aegypti’ mosquitoes bites.

For protection against mosquitoes- 



Mosquitoes breed only in water sources such as stagnant water in drains and ditches, room air coolers, broken bottles, old discarded tyres, containers and similar sources.

  • Don’t allow water to remain stagnant in and around your house. Fill the ditches. Clean the blocked drains. .
  • Do not keep tyres, containers and empty utensils outside and around your house to prevent rain  water collection.
  • Dispose off old containers, tins and tyres etc. properly.  Don’t litter. Keep the surrounding clean.
  • Keep the water tanks and water containers tightly covered so that 1he mosquitoes cannot enter  them and start breeding.
  • Empty the room air coolers and flower vases completely at least once In seven days and let them dry before you fill them again. Wherever it is not possible to completely drain the  wafer off from room cooler, water tanks etc. it is advised to put about two tablespoon 30 ml. of petrol or kerosene oil into them for each 100 liters of  this will prevent mosquito breeding.
  • You can also put some types of small fish (Gambusia, Lebister) which eat mosquito larvae   into these water collections. These fish can be obtained from  the  local  administrative  bodies (.e.g., Malaria Officer’s office in the area).
  • Clean the bird’s water container daily before you refill again.
  • Must change the water of pots, money plants and feng-shui plants once a week.  Also clean the water collection tray at the backside of  fridge once a week.
  • Use mosquito repellent sprays, creams, coils, mats or liquids to drive away or klll the mosquitoes. Use of   googaI smoke is a good indigenous method for  getting rid of mosquitoes.

  • Mosquito bite can be prevented by using mosquito Sinetrola oil is also very effective to shoo-away the mosquitoes.
  • Use insecticidal sprays in all areas within the house at least once a week.
  • Don’t forget to spray behind the photo-frames, curtains, calendars, corners of house, stores. While spraying cover your face with   cloth and keep all the eatables covered.
  • Whenever possible, practicable and affordable,   prevent entry of mosquitoes into the house    by keeping wire mesh on   windows   and
  • If fencing of the doors and windows is not possible   due to any reason, spray the entire house daily   with pyrethrum solution. .
  • Wear clothes which cover the body as much as possible. This is more relevant in case of children. Nickers and T-shirts are better avoided during the season of Malaria and Dengue fever.
  • children and adults should wear full sleeves clothes and pant to prevent mosquito bite.
  • Don’t allow wild herbs etc. to grow around your house.
  • They act as hiding and resting places for mosquitoes.

  • Do inform and take help from your local health centre, panchayat or municipality in case you notice abnormal density of mosquitoes or too many cases of fever occurring in your area.
  • It is good to remember that Aedes mosquitoes may bite even during daytime and hence you should take precautions against their bite during day time also.
  • Dengue fever occurs most frequently in India in the month of July to November because this season   provides very suitable conditions for breeding of   Hence all these preventive steps must   be taken during the season.  Prevent doing outside activities when mosquitoes are active.

 

 

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