Dengue Fever : Causes, Symptoms, Diagnosis, Treatment and Prevention
Monsoon season, also known as flu season, is considered to be the most fertile breeding season for pathogenic microorganisms. Since humidity, mud, and stagnant water serve as breeding grounds for multiple viruses and bacteria, the risk of infection is higher than in other seasons.
Therefore, every year, vector-borne diseases surge in the rainy season in India. More than 190 cases of dengue fever were recorded in the capital city of Delhi this year. Following a pandemic, people are more prone to such diseases as it weakens the immune system further. Therefore, even a slight change in body temperature shouldn’t be neglected these days.
Worldwide, around 400 million people get infected with dengue every year, but only 80 million people show signs and symptoms of dengue; the rest are asymptomatic. A tiny mosquito can potentially make a healthy man sick by transmitting the dengue virus into his bloodstream.
What Causes Dengue Fever?
Dengue fever is caused by any one of the four closely related dengue viruses (DEN-1, DEN-2, DEN-3, and DEN-4) which replicate after entering the bloodstream. This microscopic creature weakens the immune system, resulting in a feeling of sickness.
In severe dengue or dengue hemorrhagic fever, the virus infects the platelets (cells that form clots and give structure to blood vessels), resulting in internal bleeding. Since there are not enough platelets to stop the internal leakage of blood, this can result in shock, organ failure, and even death.
Symptoms of dengue fever
Only 80% of dengue fever cases are symptomatic. The remaining 20% show no signs or symptoms of the disease. When the symptoms do occur, they are mistaken for other illnesses like the flu. The symptoms usually begin four to ten days after being bitten by an infected mosquito. The patient may experience the following:
- High Fever(104 F)
- Headache
- Muscle, bone or joint pain
- Vomiting
- Pain behind the eyes
- Swollen glands
- Nausea
- Rash
Usually, people with strong immune systems recover in a week or 10 days, but in people with compromised immune systems, symptoms worsen and can become lethal. This can lead to severe dengue, dengue hemorrhagic fever, or dengue shock syndrome.
The symptoms usually begin a day or two after the fever subsides and may include:
- Bleeding in gums or nose
- Blood in urine, stools or vomit
- Bleeding under the skin which may appear like bruises
- Severe stomach pain
- Vomiting
- Dehydration
- Lethargy or confusion
- Cold or clammy extremities
- Rapid Weight Loss
- Restlessness
- Fatigue
If one notices any of the symptoms mentioned above, it is recommended to immediately seek medical attention before it’s too late.
Internal bleeding, organ damage, or a dangerous drop in blood pressure are all complications of severe dengue fever.
How is dengue fever diagnosed?
Dengue fever can be diagnosed with blood tests to check for antibodies to the dengue virus or the presence of infection. The following are the diagnostic approaches for dengue fever:
Molecular Testing: It helps in checking for presence of genetic material of the dengue virus and also helps in knowing its serotype. If the test is negative but symptoms show otherwise then an antibody test is recommended to establish the diagnosis.
Antibody Testing: It detects the presence of antibodies created by the body to fight the virus. The two different classes of antibodies that are detected are IgM and IgG. Antibody testing shows more accurate results if performed at least a week after the exposure.
How is dengue fever treated?
There is no specific treatment for dengue fever. It is recommended to drink plenty of fluids. The doctors may prescribe certain over-the-counter(OTC) medications to relieve the symptoms, like paracetamol to reduce muscle pain and fever. However, it is advised to avoid certain OTC pain relievers like aspirin, ibuprofen, naproxen sodium, etc, as these can increase the risk of internal bleeding complications.
In cases of dengue hemorrhagic fever or severe dengue fever, the patient may need:
- Adequate medical care
- Intravenous(IV) fluid and electrolyte replacement
- Monitoring of blood pressure
- Transfusion to replace blood loss
How can dengue fever be prevented?
Two means by which one can protect himself from dengue fever are avoiding mosquito bites and vaccination.
- Dengue Vaccine: The FDA has approved a new dengue vaccine called Dengvaxia in 2019. It is approved for people aged between 9 to 45 with at least one prior history of dengue fever. The vaccine is given in 3 doses over the span of 12 months.
- Avoiding mosquito bites: The best way to avoid the disease is to avoid the disease-causing organism. Avoiding mosquito bites can protect against not only dengue fever but also other diseases such as malaria and chikungunya. Therefore, it is very important to take certain precautions to protect ourselves from being bitten by mosquitoes. Some preventive measures include:
- Reducing the mosquito population by getting rid of stagnant water in the nearby surroundings, like bird baths, empty planters, cans, etc.
- Maintaining cleanliness to avoid mosquito breeding.
- Killing mosquito larvae at breeding sites by spraying DDT regularly.
- Using mosquito repellents indoors and outdoors.
- Avoiding heavily populated residential areas.
- Using mosquito nets during the daytime while sleeping.
- Make sure the doors and windows are screened well.
- Wearing fully covered clothes while going out.
Certain diseases are inevitable. No matter how hard one tries to avoid a mosquito bite, it may happen at some point. Therefore, one must be strong from within. One must strengthen their immune systems with a healthy diet and regular exercise. A strong immune system will help to fight against any foreign organism that enters our body. Lastly, don’t ever miss the signs and symptoms of a disease. Consult a doctor immediately to avoid unfavourable outcomes in the future.
About Author –
Dr. Arshad Punjani, Consultant Physician & Diabetologist, Yashoda Hospital, Hyderabad
MD, DNB, DM (Gastroenterology)
