Dengue Fever

Dengue Alert

Prevention And Personal Precaution

The best way to prevent dengue fever is to take special precautions to avoid contact with mosquitoes.

To control the growth of Dengue the environment should be cleaned up and get rid of water holding containers such as discarded tins, empty pots, broken bottles, coconut shells and similar other collections of water. Proper care must be taken so that water accumulation in unwanted places should not last for 5 days. To protect the human body from the mosquito bite we can use various materials such as spray, mat, mosquito net etc.

In addition by the use of mosquito net for the Dengue patient is helpful to prevent spreading of Dengue from a diseased a person to healthy person. As Aedes mosquito bite mainly in the morning and late evening. So it is better to use mosquito net during sleep not only at night but also in both morning and late evening to protect the human body from mosquito bite.

While there are many methods of mosquito control, experts now recommended an “Integrated approach” that is an approach which tries to combine one or more methods with a view to obtaining maximum results with minimum input and also to prevent environmental pollution with toxic chemicals and development of insecticide resistance.

Treatment

At first proper Bed rest is required. In febrile phase only paracetamol tablet may be taken to reduce the body temperature. Tepid sponging with water at room temperature is proved to be good to reduce the fever. If fever is associated with profuse and frequent vomiting then the patient should be given plenty of water as well as liquid diet (such as normal saline, fruit juice, green cocnut water, etc.) to correct the water loss from the body.

The patient should be properly observed for 48 hours after subsidence of fever for early detection of complication of Dengue syndrome.

If the following symptom such as severe abdominal pain, passage of blackish, soft, foul smelling stool, passage of blood through the vagina, vomiting of blood, bleeding from nose or gum, cold clammy skin of leg and hand present alone or in combination, then patient must be referred to hospital for proper management under evaluation. In case of infant and children. If there is convulsion or even there is a history of convulsion, then the patient must be referred to hospital for better management.

Dengue haemorrhagic fever proper fluid therapy is required both through the mouth and intravenous route to maintain the fluid and electrolyte balance of the body. In case of intravenous fluid normal saline is proved to be better than others. If platelet count in patient in blood is less than 10,000/mm3 of blood, then the platelet concentrate is required to prevent and reduce the uncontrolled, spontaneous bleeding. If the platelet concentrate is not available then the fresh blood may be given in lieu of platelet concentrate.

Clinical Features

Generally all the physical sign, symptom and alteration of all the biochemical events in the human body produced by Dengue virus are collectively called “Dengue syndrome”. For the better management purpose this Dengue syndrome is further divided into three groups. These groups are –

I) Classical Dengue fever
ii) Dengue haemorrhagic fever and
iii) Dengue Shock syndrome.

Dengue fever usually starts suddenly with a high fever, rash, severe headache, pain behind the eyes, and muscle and joint pain. The severity of the joint pain has given dengue the name “Break-bone fever.” Nausea, vomiting, and loss of appetite are common.

A rash usually appears 3 to 4 days after the start of the fever. The illness can last up to 10 days, but complete recovery can take as long as a month. Older children and adults are usually sicker than young children.

Most dengue infections result in relatively mild illness, but some can progress to dengue hemorrhagic fever. With dengue hemorrhagic fever, the blood vessels start to leak and cause bleeding from the nose, mouth, and gums. Bruising can be a sign of bleeding inside the body. Without prompt treatment, the blood vessels can collapse, causing shock (dengue shock syndrome). Dengue hemorrhagic fever is fatal in about 5 percent of cases, mostly among children and young adults.

Do’s And Don’t s

Aspirin and other NSAID drugs should not be used in Dengue to reduce the fever. Because they can cause a dangerous condition named “Ryes syndrome” in children.

They can also cause gastric irritation as well as bleeding from stomach that may complicate the Dengue fever. Any antibiotic should not be used, because the use of antibiotic may complicate the Dengue fever more. In case of Dengue shock syndrome, the use of Dopamine, corticosteroid and carbazochram for treatment are not successful.

Transmission

The disease is transmitted from one infected person to another healthy person by Aedes aegypti and Aedes albopuctus, species of Aedes genus of mosquito.

It usually breeds in artificial accumulations of water in and around human dwellings, such as water found in discarded tins, broken bottles, fire buckets, flower pots, coconut shells, earthen pots, tree holes and the like. They are most abundant during rainy seasons and bite chiefly during the day.

Diagnosis

For diagnosis of Dengue physician’s clinical suspicion is enough. But for prognostic purpose, some laboratory tests are important.

As there are no significant biochemical changes appear in Dengue on first three days, it is better to done the laboratory test after 3-5 days of the dengue fever for confirmation of diagnosis. The base line laboratory test for dengue fever is complete blood count including platelet count as well as PCV (Packed Cell Volume). In addition to above tests total leukocyte count is also important.

Definition, Alternative Names, Causes, Incidence, And Risk Factors

Definition

Dengue fever is a virus-based disease spread by mosquitoes.

See also: Dengue hemorrhagic fever

Alternative Names

O’nyong-nyong fever; Dengue-like disease; Breakbone fever

Causes, incidence, and risk factors

Dengue fever is caused by several related viruses (four different arboviruses). It is spread by the bite of mosquitoes, most commonly the mosquito Aedes aegypti, which found in tropic and subtropic regions.

This includes parts of:
• Southeast Asia
• Indonesian archipelago into northeastern Australia
• Sub-Saharan Africa
• South and Central America

Dengue fever is being seen more in world travelers. It is generally lasts a week or more. Although uncomfortable, it is not deadly. The proper diagnosis depend on whether you tell your doctor about any visits to areas of the world where dengue fever is known to occur.

Dengue fever should not be confused with Dengue hemorrhagic fever, which is a separate disease and frequently deadly.

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