ABOUT DENGUE FEVER

What is Dengue

Dengue is fever condition which is caused by mosquito bite that transmits Dengue virus to the person it bites. The mosquito that transmits the dengue virus is a day active, day biting mosquito known as Aedes Mosquito. This mosquito is found in abundance in tropical reasons of this world. Dengue fever is also identified as a tropical viral fever commonly found in Indian sub continent.

Symptoms

Symptoms of Dengue begin around three to four days after a person has been infected by dengue virus. This starts with fever, may be high fever. It may be associated with severe headache, vomiting, muscle pains and joint pains. Later, a characteristic skin rash may appear. Symptoms may subside after seven days.

In some cases, Dengue takes a worse turn and develops into a life threatening condition called Dengue Hemorrhagic Fever. This causes bleeding in a patient, with low level blood platelets and blood plasma leakage from body. This may develop into Dengue Shock Syndrome where blood pressure of the patient may fall to a dangerously low level.

Dengue virus transmission

Dengue is transmitted by several species of Aedes type mosquitoes. The causative virus generally is of five different types. It is an auto immune disease. Infection with one type of virus produces lifelong immunity from that virus but short time immunity from other four strains of virus. Subsequent infection with a different type increases the risk of severe complications in the patient.

Clinical Course of infection

The incubation time is between 3 to 14 days the fever and pain in head and all over the body with joint pain takes 2 to 7 days. Measles like rash may occur in 4 to 7 days. Internal bleeding, fall in blood platelets count and blood plasma leakage is a secondary complication developing after 7 days taking the patient to a critical condition. This may result in fluid accumulation in chest and abdominal cavity of the patient with depletion of fluid from circulation and decreased blood supply to vital organs. This may result into multiple organ failure of the patient and severe bleeding. Shock and hemorrhage may occur from gastro intestinal tract of the patient which might be fatal.

Associated problems

Dengue can cause several other body system problems. This may be either in isolation or classic dengue symptoms which is attributable either to inflammation of brain by the virus or indirectly as a result of impairment of vital organs, for example. A decreased level of consciousness occurs in 0.5–6% of severe cases, ie the liver. Some neurological disorders also appear with Dengue. Cases of infection of the heart and acute liver failure have also been reported.

Recovery phase

Recovery starts within 7 days time .Body starts resorpting of leaked fluids in blood streams. This process may take 2 to 3 days, with striking improvement in conditions. This may be associated with slow heart rate and severe itching in body. In some cases repeat rash may occur with peeling of the skin. Adults may experience feeling of fatigue lasting for weeks.

Diagnosis

Diagnosis of Dengue us done clinically on the basis of clinical examination and physical examinations. However, early disease can be difficult to differentiate from other viral infections. Warning signs as abdominal pains, ongoing vomiting, Liver enlargement, mucosal bleeding, Low platelets, restlessness, and findings of fever plus two of the following: nausea and vomiting, rash, generalized pains, calls for the alarm.

The earliest change detectable on laboratory investigations is a low white blood cell count, which may then be followed by low platelets and metabolic acidosis. In severe disease, plasma leakage results in hem concentration (as indicated by a rising (hematocrit) and hypo albuminemia. Dengue shock syndrome is present if pulse pressure drops to ≤ 20 mm Hg along with peripheral vascular collapse.

Treatment

There are ongoing efforts of developing antiviral drugs that can treat Dengue fever and prevent complications. But they are yet to be developed. Generally patients are put on absolute bed rest, continuous intravenous irrigation, dosage of paracetamol to control fever and replace blood platelets by transfusion methods. Blood plasma is also transfused if need arises. High concentration nutritious diet that is readily digestible is given to patients to boost their body immunity and resistance. The patient starts recovering within7 days with careful nursing and support system.

Prevention

Prevention of Dengue is control of and protection from the bites of the mosquito that transmits it. The World Health Organization recommends………………

Social mobilization to strengthen the public health bodies.
Collaboration between health and other sectors.
Integrated disease control.
Intervene to counter disease in time.
Adequate response to local situations.

The only method is to control Aedes mosquitoes. This is done by getting rid of open sources of water, or if this is not possible, by adding insecticides or biological control agents to these areas. People can prevent mosquito bites by wearing clothing that fully covers the skin, using mosquito netting while resting, and/or the application of insect repellent .However, urbanization appear to increase the habitat of Aedes. Climate change is also a major factor for expansion of Dengue.

The ultimate remedy is public awareness and consistent mosquito eradication program to be implemented.