DENGUE FEVER AND DENGUE HAEMORRHAGIC FEVER
What is it?
It is an infection caused by the Dengue Virus, which is an Flavivirus.
How do you get it?
The virus is transmitted by Aedes aegypti mosquito when it bites an uninfected person after biting an infected person.
What are it’s signs and symptoms?
Following the transmission of the virus, the newly infected person may show no signs of the illness for about 3 to 14 days. This is called the incubation period. In many, the infection is so mild that no apparent signs or symptoms are seen. In those who are symptomatic, the illness can range from a mild non-specific viral illness to a severe illness causing haemorrhagic complications.
The Classical form is mostly seen in adults and older children. In the young child the illness is usually mild.
The usual signs and symptoms are: sudden onset fever, headache, chills, eye pain, bodyaches, muscular and joint pains. A rash may be seen over the trunk around the 3rd to 5th day of illness. Nausea, vomiting, lymph node enlargement, anorexia, constipation, and altered taste sensation are common. Occasionally, petechiae (bleeding under the skin) are seen on the feet, legs, hands, arm pit, and palate late in the illness. The illness generally lasts 5 to 7 days, after which recovery is complete, although convalescence may be prolonged.
Decrease in white cell count with a relative increase in lymphocytes and decrease in platelets may occur. Liver enzyme levels may be elevated, and bleeding manifestations may occur. Neurologic manifestations such as encephalopathy and seizures may occur during the disease's febrile stage.
How do you diagnose it?
Diagnosis of dengue infections should be based on clinical signs and symptoms and on epidemiologic information such as travel history. Laboratory testing is useful only for confirmation of the clinical diagnosis.
What is safe home care?
Fever may be initially managed at home with oral Paracetamol. The patient should be given bed rest, plenty of oral fluids; not just plain water. If the patient becomes acutely unwell especially with altered conscious state and or cold hands and feet; urgent care should be sought.
Certain pain relieving medications (Ibuprofen and diclofenac) are not routinely recommended and can be potentially dangerous.
How do you treat it?
There is no specific treatment for Dengue fever. Anti-viral medications have not been seen to be effective. Management consists of supportive fluid therapy and close monitoring for progress of disease and complications.
How do you prevent it?
Prevention depends on mosquito control and decreasing mosquito exposure.
DENGUE HAEMORRHAGIC FEVER
Dengue hemorrhagic fever (DHF) is a severe form of dengue infection that is most commonly observed in children younger than 15 years. Although the risk of DHF is higher in patients are being infected a second time, it also occurs in patients who have primary infections.
Signs and symptoms:
DHF is characterized by sudden onset of fever, usually lasting 2 to 7 days, and nonspecific signs and symptoms. The critical stage of DHF occurs between 24 hours before and 24 hours after the patient's temperature falls to or below normal. During this time, bleeding manifestations usually occur, and signs of circulatory failure may appear. The patient may become restless or lethargic, experience acute abdominal pain, and have cold extremities and decreased urine output, usually on or after the third day of illness.
Clinical laboratory tests at this time will show low platelet counts, a low serum total protein level, a low albumin level, and a rise in hematocrit. Another indication of vascular leakage is pleural effusion (collection of fluid in the space just outside the lungs).
Loss of intravascular volume may result in hypovolemia, shock, and death if not corrected. The most common bleeding manifestations are bleeding under the skin, but bleeding from the nose, bleeding gums, gastrointestinal bleeding, and blood in urine may occur.
Treatment:
There is no vaccine for dengue/DHF. Treatment is supportive. Currently, disease prevention depends exclusively on mosquito control and personal protective measures such as mosquito repellents.
