DENGUE FEVER…DIAGNOSIS AND TREATMENT

What are the common symptoms of dengue fever?

Many individuals with dengue virus may not have symptoms. If you have symptoms, fever can be up to 104 degrees Fahrenheit (ca. 40 °C). Symptoms tend to occur 4 to 10 days after a mosquito bite. Generally, the fever can last from 4 to 10 days. Other symptoms would be a severe headache, pain behind the eyes, and rash on the skin. Few may have severe muscle aches and body pains. Severe nausea, vomiting, and pain in the abdomen suggest a severe form of infection.

What are the symptoms of severe infection?

Severe abdominal pain, frequent vomiting, blood in urine, stools, vomitus, or bleeding from nose or gums recommends a severe infection. Extreme tiredness restlessness or irritability recommends a severe infection. These patients need hospitalization for immediate care. Most of these individuals are likely to be dehydrated and a low blood pressure.

What causes dengue fever?

Dengue fever is caused by one of the four dengue viruses. You get lifelong immunity against one virus. However, you may still get infected by the remaining 3 dengue viruses. The second dengue infection is always severe and lethal. Once bitten by a mosquito carrying the virus, the virus enters your body and makes many copies of itself. The virus itself and the response of the immune system cause all the symptoms. Plasma leaks from the capillaries and this causes a lowering of blood pressure. This may lead to dengue shock syndrome.

How does dengue fever spread?

Dengue virus is carried by the Aides mosquito. The same virus can also carry Zika and Chikungunya virus. Dengue fever is not contagious from person to person. The only way to get from another person is if a pregnant person gets infected, she can pass the virus to her baby during pregnancy or childbirth.

How to diagnose dengue?

The symptoms are more or less typical. Blood tests done in the early phase would reveal the NS 1 antigen positive. After a week or so, the IGM antibodies would be positive. A few weeks later, the IgG antibodies became positive. Generally, the total WBC count is on the lower side. The platelets may be reduced, Dengue fever is caused by a bite from a mosquito carrying one of the four types of Dengue viruses. The disease is generally mild with the first infection. However, if you get another infection with a different version of the dengue virus, your risk of severe complications goes up. There is no scientific evidence to prove the utility of Papaya leaves, papaya fruits, and kiwi in the management of dengue infection. The liver function tests may become abnormal. The hemoglobin may increase due to a capillary leak. Many individuals may have typical symptoms without the dengue tests being positive. This is known as a dengue-like illness. The treatment is the same as for dengue fever.

What are other diseases mimicking dengue fever?

Typhoid, scrub typhus, leptospirosis, and malaria of the falciparum type need to be evaluated. Viral hepatitis can have similar symptoms to begin with.

What are the complications of dengue fever In pregnancy?

This can be associated with miscarriage, low birth weight of the baby, or can cause premature birth. Please prevent dengue fever during pregnancy to avoid these complications.

Is there a vaccine against dengue?

Dengvaxia is recommended only if you had a dengue infection earlier. It reduces the risk of severe dengue if you get a different version of the dengue virus in the future. This vaccine is not available at present in India. Several tests are being carried out to check the effectiveness of this vaccine.

What should not be done if you have dengue?

Do not be in a panic mode, as most individuals recover. Other than Paracetamol, other fever-reducing medications interfere with platelet number and their functions. Close monitoring of blood pressure, fever range, and platelet count is recommended if the person is being managed at home.

Do papaya and kiwi fruits or their juices have my role?

There is no scientific evidence for their role in increasing platelets, and they should be best avoided.

Why do some Individuals die from dengue fever?

This infection can take a turn for the worse in individuals with poor immunity. Monitoring vital functions like temperature, pulse rate, blood pressure, platelets, and the person’s state of hydration is important. The threshold for hospitalization should be lowered in individuals not doing well even after 3 days of treatment. Inspired by major advances in medicine, dengue fever continues to affect millions of people in India. In effective mosquito control, proper sanitation, and vaccination may be the only answer.

Categories : Health

Dr Jay Deshmukh is Chief Physician and Director, Sunflower Hospital, Nagpur Honorary Physician to Honorable Governor of Maharashtra and PondicherryCentral. Dr Jay Deshmukh is an M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD From Internal Medicine – Bombay and New Delhi.

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