Dengue Fever : Criteria, Symptoms, Treatment and Prevention

Dengue fever is caused by flavi virus. Some species of Aedes mosquito are responsible for causing dengue.

It may be Classical dengue or Dengue Haemmoragic fever. Aedes mosquitoes have several species, Aedes aegypti and Albopictus are worth mentioning for causing dengue. Dengue fever is now a global problem. People from Central America, Mexico, South East Asia and Africa are suffering a lot. Classical variety can be dealt like other viral fever with rational approaches. But Hemorrhagic variety demands intensive support, close monitoring. Although it is not obvious that all the patients of Dengue hemorrhagic fever will develop Shock.

When patient is in shock following dengue, it is called Dengue shock syndrome. And in case of shock, intensive hospital care is the only way.

What is the pattern of fever in Dengue ?
Fever appears after 3-15 days of mosquito bite. Dengue fever is a continuous and high fever that lasts for 7-8 days. usual temperature 104 F. Temperature starts to go down after 5-6 days. Recovery is slow and most of the patient get rid of fever without any complication.

How Dengue appears? What are the features of dengue?

Rash in Dengue fever
Rash in Dengue fever
  • In general, people complaints of Headache,
  • Discomfort, feeling of illness and weakness (malaise) before the onset of fever. And then fever appears after 1-2 days.
  • Not only fever but also backache and Joint pain. Therefore, Dengue is called break bone fever.
  • Watering from eye and eye ache occurs while eye moves.
  • Also there is nausea and vomiting and depression.
  • And after 1-2 days of dengue fever, faint flushing rash appears. The Pattern of the rash changes with course of the fever.
  • Some patients complaints of itching.

Features of dengue hemorrhagic fever includes:

  • All the features of classical dengue.
  • Low Blood pressure.
  • Shortness of breath.
  • Chest pain.
  • Sudden collapse 
  • loss of consciousness.
  • Accumulation of fluid in several spaces inside the body. (General people will not understand these things)
    Doctors mention them as Plural Effusion, ascites etc.
  • Most dangerous symptom is bleeding. Whether major or minor bleeding like gum bleeding, blood passes with stool or urine. Severe abdominal pain is also very common.

 

What are the investigations needed to confirm the diagnosis? 

  • Complete blood test (CBC) where Total count of white blood cells go down (leukopenia) and total Platelets count go down (thrombocytopenia).
  • Dengue NS1 antigen allows rapid detection on the first day of fever. However NS1 antigen may be negative if specimen is collected immediately or within 24-48 hours following dengue virus infection. Therefore it is good to perform NS1 antigen test 2 days after the onset of fever. This test is useless after 8-9 days of fever.
  • Measurement of antibody titre. But antibody appears after 5-6 days. So it is better to test antibody titre after 5-6 days of fever. Result is significant if titre rises to four folds.
  • By detection of virus by PCR technology.

What are the treatment of Dengue fever?

  • First of all  No Aspirin.
  • Intake adequate fluid. Oral saline, fruit juice, plain water
  • Fluid replacement is the mainstay of treatment.
  • Give Paracetamol orally to reduce fever and body ache
  • In addition if fever is high, use paracetamol in suppository form
  • Finally Steroid and antivirals are of no use.

In case of Dengue hemorrhagic fever, Intravenous fluid replacement and even Blood transfusion may be needed . Hence, Hospitalization and Intensive care is must .

Prevention:

In conclusion, Aedes mosquito choose calm and clean water. Like water cane, flower pots, inside old garbage, old tires and drums. So try to clean up water immediately after rain or watering your plants. Aedes bites on day time (6am – 8am). Therefore, Mosquito net can play valuable role to prevent Dengue fever.

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