Dengue fever is just like all viral fevers, but sadly it can quickly turn into a deadly disease as the complications occurs very fast.
Transmission
It is caused by a virus and mode of transmission is a mosquito Aedes Aegypti which mainly breeds in fresh water stored in uncovered container. It inhabitats dwelling and bite during the day, not in the night.
Infected humans are the main carriers and multipliers of the virus, serving as a source of the virus for uninfected mosquitoes. The virus circulates in the blood of infected humans for two to seven days, at approximately the same time that they have a fever; Aedes mosquitoes may acquire the virus when they feed on an individual during this period.
Though it can occur in all seasons but incidence increases in hot rainy season.
Types of Dengue Fever
There are three types of Dengue fever
a) Classical Dengue
b) Dengue hemorrhagic fever (DHF)
c) Dengue shock syndrome
Classical dengue presents with fever, headache, backache with severe myalgia so it is also called “break bone fever”. Fever last for a week and some maculo papular rash can occur beginning from the trunk. Epistaxis and bleeding from Gums can also be a feature.
Dengue hemorrhagic fever is the start of complication and as the name suggests there is internal bleeding leading to fall in blood pressure and shock, platelet count is reduced and ultimately lead to shock causing Dengue shock syndrome.
How to diagnose Dengue Fever
Dengue Triad
The presence of fever, rash, and headache (and other pains) is particularly characteristic of dengue. Other signs of dengue fever include bleeding gums, severe pain behind the eyes, and red palms and soles.
Any fever leading to pain in bones and muscles with abdominal pain, Dengue should be suspected, and if there is any rash or bleeding, an urgent attention is required.
Generally it is diagnosed serologically by detecting Dengue IgM for acute infection which usually appears on 4th day of fever and chronic infection by Dengue IgG.
Platelet count is must and reduced platelet count is very much suggestive of Dengue hemorrhagic fever. The clinical laboratory findings of dengue fever include low levels of white blood cells (leukopenia) and platelets (thrombocytopenia) and, often, an elevated level of the enzyme serum aminotransferase.
Treatment for Dengue Fever
There is no specific treatment for dengue fever.
Because dengue fever is caused by a virus, there is no specific medicine or antibiotic to treat it. For typical dengue, the treatment is purely concerned with relief of the symptoms .Rest and fluid intake for adequate hydration is important. Aspirin and nonsteroidal anti-inflammatory drugs should only be taken under a doctor’s supervision because of the possibility of worsening hemorrhagic complications. Paracetamol may be given for severe headache and for the joint and muscle pain.
As in other viral fever treatment here too is supportive which includes rest, plenty of fluid and close observation. If during observation any sort of bleeding is noticed from gums, nose or under skin or black stool or if the skin is cold and clammy, immediate platelet count should be done and patient should be admitted.
Blood transfusion and Fresh frozen plasma or sometimes Platelet transfusion is required.
Prevention
The only way to prevent dengue virus transmission is to combat the disease-carrying mosquitoes. The mosquito flourishes during rainy seasons but can breed in water-filled flower pots, plastic bags, and cans year-round. One mosquito bite can inflict the disease.
Prognosis
Typical dengue is fatal in less than 1% of cases. The acute phase of the illness with fever and myalgia lasts about one to two weeks. Convalescence is accompanied by a feeling of weakness (asthenia), and full recovery often takes several weeks.
What is dengue hemorrhagic fever?
It causes abdominal pain, hemorrhage (bleeding), and circulatory collapse (shock).
DHF starts abruptly with high continuous fever and headache.
There are respiratory and intestinal symptoms with sore throat, cough, nausea, vomiting, and abdominal pain. Shock occurs two to six days after the start of symptoms with sudden collapse, cool, clammy extremities (the trunk is often warm), weak pulse, and blueness around the mouth (circumoral cyanosis).
In DHF, there is bleeding with easy bruising, blood spots in the skin, spitting up blood, blood in the stool, bleeding gums, and nosebleeds (epistaxis). Pneumonia is common, and inflammation of the heart -myocarditis- may be present.
Patients with DHF must be monitored closely for the first few days since shock may occur or recur precipitously (dengue shock syndrome). Cyanotic (bluish) patients are given oxygen. Vascular collapse (shock) requires immediate fluid replacement. Blood transfusions may be needed to control bleeding.
The mortality (death) rate with DHF is significant. It ranges from 6%-30%. Most deaths occur in children. Infants under a year of age are especially at risk of dying from DHF.
