by S Sharma | 06 OCT 2017
Dengue fever is most common post monsoon and the disease has spread rapidly. Dengue (DENG-gey) fever is a mosquito-borne disease that occurs in tropical and subtropical areas of the world. Mild dengue fever causes a high fever, rash, and muscle and joint pain. A severe form of dengue fever, also called dengue hemorrhagic fever, can cause severe bleeding, a sudden drop in blood pressure (shock) and death.
The transmission of both Malaria and Dengue fever has increased predominantly in both the urban and semi-urban areas. New cases as well as recurring outbreaks have been recorded from Andhra Pradesh, Delhi, Goa, Haryana, Gujarat, Karnataka, Kerala, Maharashtra, Rajasthan, Uttar Pradesh, Odisha, Pondicherry and West Bengal. India ranks third in the world having the highest cases of malaria and deaths due to the disease. While Zika virus is a growing concern for the world, dengue and malaria still rule the roost and are yet to see a decrease in occurrence.
According to the World Health Organization (WHO), there are about 390 million cases of dengue fever worldwide, and of the total number of cases, 96 million require medical treatment. India also saw a doubling up of cases of dengue from 2014 to 2015 and the worst hit city was Delhi with over 1800 cases of the fever. 2016 isn't expected to be any better and this has become a cause of concern for the country.
“Millions of cases of dengue infection occur each year. Researchers are working on dengue fever vaccines. For now the best prevention is to reduce mosquito habitat in areas where dengue fever is common,” says Dr M. Govardhan, Sr Consultant General Medicine, CARE Hospitals.
Talking about the symptoms, Dr Shaeq Mirza, consultant physician, Apollo Hospitals says, “Symptoms range from slight fever to high grade fevers with chills, red eyes, severe myalgia, aches and pains.”
“Many people, especially children and teens, may experience no signs or symptoms during a mild case of dengue fever. When symptoms do occur, they usually begin four to seven days after you are bitten by an infected mosquito,” explains Dr M. Govardhan.
Dengue fever causes a high fever — 104 F degrees — and at least two of the following symptoms:
Muscle, bone and joint pain
Pain behind the eyes
“Most people recover within a week or so. In some cases, symptoms worsen and can become life-threatening. Blood vessels often become damaged and leaky. And the number of clot-forming cells (platelets) in your bloodstream drops. This can cause a severe form of dengue fever, called dengue hemorrhagic fever, severe dengue or dengue shock syndrome,” adds Dr M. Govardhan.
Signs and symptoms of dengue hemorrhagic fever or severe dengue — a life-threatening emergency — include:
Severe abdominal pain
Bleeding from your gums or nose
Blood in your urine, stools or vomit
Bleeding under the skin, which might look like bruising
Difficult or rapid breathing
Cold or clammy skin (shock)
Irritability or restlessness
WHEN TO SEE A DOCTOR
“Detection is by clinical diagnosis first followed by testing for dengue antigen (NS1) and then after 5 days of fever testing for antibody igM. Normally we see the rise during the rainy season or monsoons here in India with peaks during September-October,” says Dr Mirza.
“Dengue fever is known to occur and you develop emergency symptoms, such as severe abdominal pain, vomiting, difficulty breathing, or blood in your nose, gums, vomit or stools. If you develop a fever and milder symptoms common to dengue fever, see the doctor,” says Dr Govardhan.
As it's a viral fever no treatment exists for the virus directly but symptomatic treatment including good hydration is the key of management. “It can get worse if it converts into dengue hemorrhagic fever or dengue shock syndrome involving the other organs of the body. Monitoring of platelets and hematocrit is done in hospitals regularly. Special precautions needed for children and pregnant females,” says Dr Mirza.
Adding to this, Dr Govardhan says, “Your doctor may recommend that you drink plenty of fluids to avoid dehydration from vomiting and a high fever. While recovering from dengue fever, watch for signs and symptoms of dehydration.”
Call your doctor right away if you develop any of the following:
Few or no tears
Dry mouth or lips
Lethargy or confusion
Cold or clammy extremities
Acetaminophen (Tylenol, others) can alleviate pain and reduce fever. Avoid pain relievers that can increase bleeding complications — such as aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve, others).
If you have severe dengue fever, you may need:
Supportive care in a hospital
Intravenous (IV) fluid and electrolyte replacement
Blood pressure monitoring
Transfusion to replace blood loss
“Dengue fever is caused by any one of four types of dengue viruses spread by mosquitoes that thrive in and near human lodgings. When a mosquito bites a person infected with a dengue virus, the virus enters the mosquito. When the infected mosquito then bites another person, the virus enters that person's bloodstream,” says Dr Govardhan.
After you've recovered from dengue fever, you have immunity to the type of virus that infected you — but not to the other three dengue fever virus types. The risk of developing severe dengue fever, also known as dengue hemorrhagic fever, actually increases if you're infected a second, third or fourth time.
Factors that put you at greater risk of developing dengue fever or a more severe form of the disease include:
Living or traveling in tropical areas. Being in tropical and subtropical areas increases your risk of exposure to the virus that causes dengue fever. Especially high-risk areas are Southeast Asia, the western Pacific islands, Latin America and the Caribbean.
Prior infection with a dengue fever virus. Previous infection with a dengue fever virus increases your risk of having severe symptoms if you're infected again.
If severe, dengue fever can damage the lungs, liver or heart. Blood pressure can drop to dangerous levels, causing shock and, in some cases, death
Diagnosing dengue fever can be difficult, because its signs and symptoms can be easily confused with those of other diseases — such as malaria, leptospirosis and typhoid fever.
Your doctor will likely ask about your medical and travel history. Be sure to describe international trips in detail, including the countries you visited and the dates, as well as any contact you may have had with mosquitoes.
Certain laboratory tests can detect evidence of the dengue viruses, but test results usually come back too late to help direct treatment decisions.
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