Key Information About Dengue
Dengue (pronounced DENgee) is a severe flu-like illness. This common and important disease is also known as breakbone fever. It is painful, debilitating and can be fatal.
Today about 2.5 billion people, or 40% of the world’s population, live in areas where there is a risk of dengue transmission.
A billion people will be newly exposed to diseases like Dengue fever due to global warming.— PLOS Neglected Tropical Diseases
Dengue is caused by the mosquito-borne dengue viruses (DENVs), consisting of four serotypes (DENV 1 to 4), which are members of the flaviviridae family, genus flavivirus.
Dengue virus is not transmitted (spread) from person to person. Only infected mosquitoes transmit this virus. These mosquitoes (Aedes aegypti and Ae. albopictus) can easily adapt and proliferate in new areas, resulting in the wide spread of dengue worldwide.
The mosquito contracts the virus when it bites an infected person. The mosquito is then infective for the rest of its life and can spread the virus every time it bites someone.
Although dengue has a low mortality, it has very debilitating symptoms.
Symptoms of dengue include high fever, headache, rash, muscle pain and joint pain.
Severe symptoms of this serious arboviral disease include dengue shock syndrome (DSS) and dengue hemorrhagic fever (DHF). These usually require hospitalization.
Generally, younger children and those with their first dengue infection have a milder illness than older children and adults.
Dengue causes flu-like symptoms and lasts for 2-7 days. Dengue fever usually occurs after an incubation period of 4-10 days after the bite of the infected mosquito.— WHO
The mainstay of dengue treatment is timely supportive therapy to tackle shock due to hemoconcentration and bleeding.
Close monitoring of vital signs in critical period (between day 2 to day 7 of fever) is very important.
Increased oral fluid intake is necessary to prevent dehydration. Supplementation with intravenous fluids may be necessary to prevent dehydration and significant concentration of the blood if the patient is unable to maintain oral intake.
A platelet transfusion is recommended in rare cases if the platelet level drops significantly (below 20,000) or if there is significant bleeding.
Presence of melena usually indicates internal gastrointestinal bleeding, which requires platelet and/or red blood cell transfusion.
“There are thousands of viruses changing rapidly with no methodology to check them. These viruses are not new but 10-20 per cent of them have mutated DNA, composition and protein. I have had 20-25 cases of such dengue-like symptoms. The course of treatment remains the same, with anti-viral medicines, managing dehydration, platelet count and joint pain,” said Dr Anantha Padmanabha, Internal Medicine, Consultant, Fortis Hospital.
Even though exclusion from childcare, preschool, school or work is not needed, patients should not be in an environment where they may be bitten by mosquitoes.
If this is not possible they should stay at home until they have no fever and are therefore no longer infectious (usually 3 to 5 days).
There is no vaccine to prevent human infection by this virus.
Personal protection and environmental management of mosquitoes are important in preventing this disease.
Protect yourself from mosquito bites at all times in dengue locations. Wear long-sleeve shirts and long pants.
Treat clothes with repellents like permethrin. Use EPA-registered mosquito repellent like DEET. Use mosquito nets always.
Researchers have been artificially infecting mosquitoes with wolbachia and exploring if such mosquitoes may be released for controlling dengue.
Wolbachia is a genus of gram-negative bacteria that infects arthropod species, including a high proportion of insects, and also some nematodes.
Fortunately health departments of various governments, and other local bodies have taken dengue seriously.
From building awareness to conducting workshop for officials and common man, these authorities are taking steps to contain the spread of this vector-borne disease.
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This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2019 Srikanth R