What exactly Happen in Dengue?

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What is dengue?

Dengue, or dengue fever, is a viral illness transmitted by the bite of any of dengue viruses. Patients with dengue usually present with fever, headacherash, nausea, vomiting, aches and pains.

Dengue is a viral infection transmitted by the bite of an infected mosquito. There are four closely related but antigenically different serotypes of the virus that can cause dengue (DEN1, DEN 2, DEN 3, DEN 4).Dengue has a wide spectrum of infection outcome (asymptomatic to symptomatic).

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Risk Areas

Dengue infection is the most common cause of systemic febrile illness in travelers returning from the Caribbean, Latin America, and Southeast Asia. The incidence of dengue is usually higher during warm and humid seasons.

Type of Dengue Fever:

  1. Dengue fever or break bone fever with no serious complications
  2. Dengue hemorrhagic fever with bleeding, low platelet and plasma leakage
  3. Dengue shock syndrome with low blood pressure

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CAUSES

Dengue refers to a tropical disease caused by four different types of virus. It is usually transmitted by an Aedes mosquito that is infected with a dengue virus. Here are some of the common risk factors of dengue you need to be aware of —

  • Living in a dengue-prone area
  • Been infected before
  • Low immunity
  • Low platelet count

The main focus of the program is on:

  • Prevention
  • Early Diagnosis
  • Uniform and standard care
  • Effective and live case reporting

Symptoms

Dengue fever is a severe, flu-like illness that affects infants, young children and adults, but seldom causes death. Symptoms vary according to the age of the patient and range from a fever with rash, mild fever or high fever, severe headache, pain behind the eyes, muscle and joint pains, and a rash.

Deadly dengue

According to the directorate of the national vector-borne disease control programme (NVBDCP), dengue killed 226 Indians in 2017, and 245 in 2016. A total of 1.54 lakh cases were reported across India last year, with 22,197 reported in Tamil Nadu alone.

Value of Full Blood Count (FBC/CBC)
OPD level:

  • FBC is mandatory on all fever patients – from day 3 onwards
  • Special patient categories – FBC on day 1 or first day of visit/contact (Pregnancy, Infancy, elderly, those with co-morbidities, etc.)
  • FBC daily from day 3 if platelet (plt) count ≥150,000/ mm3
  • Admit all patients with platelet count ≤100,000/ mm3

Classic dengue fever

  • Incubation period2–14 days
  • Children are usually asymptomatic
  • Starts with fever and malaise that lasts ∼ 1 week
  • Severe arthralgia and myalgia (often referred to as “break-bone fever”)
  • Severe headache and retro-orbital pain

Epidemiology

  • 3.9 billion people are at risk in over 128 countries. Each year, 390 million people are infected, of which 96 million people show clinical symptoms
  • An estimated 500,000 people with severe dengue require hospitalization each year, and about 2.5% of those affected die from dengue.

Keep safe

Indoors:

  • Stay in places with screens on windows and doors. Turn on the air conditioning if you have it as cool air keeps mosquitoes away.
  • Use insect sprays indoors when mosquitoes are around.
  • Use mosquito coil

Outdoors:

  • If you use both sunscreen and insect repellent, apply the sunscreen first and then the repellent.
  • Wear protective clothing such as long-sleeved shirts, long pants and hats. Clothing can be treated with repellent.
  • Use screens on tents.

Panic reactions:

The public must not pressurize the doctors to hospitalize patients whose illness can be better managed at home. Also platelet transfusion must be done only after diagnostic conclusions and in consultation with a physician to avoid undue complication.

Symptoms

Children and teenagers may not exhibit signs or symptoms in mild cases of infection. The symptoms normally surface 4 – 10 days after the person has been bitten. Signs and symptoms to watch out for:

1. High Fever (106F or 41C)
2. Pain behind the eyes
3. Headaches
4. Bone, Muscle, and joint pain
5. Rash all over the body

Dengue is most dangerous when a person is infected a second (or subsequent) time. Studies have shown that giving the vaccine to people who have never been infected before can leave them vulnerable to a severe reaction if they are subsequently infected. (The vaccine doesn’t confer full protection to the virus.)

WHAT ARE DENGUE FEVER AND DENGUE HEMORRHAGIC FEVER?

Dengue fever is a viral illness that you can get from a mosquito bite. It is also known as breakbone fever because of the severe joint and muscle aches it causes.

Usually dengue fever is a relatively mild illness, especially for younger children. Two forms of the illness called dengue hemorrhagic fever and dengue shock syndrome are more serious and sometimes deadly forms of the infection.

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Dengue Treatment

Basically, in the time Dengue was at it’s strongest; my immune system had gotten too low to be out doing what I was. I had bacteria and infections galore and I was told by 3 western doctors and the head Indian one I needed to stay at least three days in hospital for treatment. They wanted to start me on IV antibiotics immediately.

Mode of transmission

Dengue fever is transmitted to humans through the bites of infective female Aedes mosquitoes. When a patient suffering from dengue fever is bitten by a vector mosquito, the mosquito is infected and it may spread the disease by biting other people.

Diagnosis

Diagnostic studies include acute and convalescent serologic testing, antigen detection, and PCR of blood. Serologic testing involves hemagglutination inhibiting or complement fixation tests using paired sera, but cross-reactions with other flavivirus antibodies are possible. Antigen detection is available in some parts of the world (not in the US), and PCR is usually done only in laboratories with special expertise.

Can dengue, Zika, and chikungunya be fatal?

There is a severe form of dengue fever – known as dengue haemorrhagic fever – which can cause bleeding and collapse, and can be fatal. This is more common in people who get dengue fever more than once. Dengue haemorrhagic fever is fatal in about five percent of cases, mostly among children and young adults. This risk is important for Pacific peoples who may make a number of visits back to their home country over the years, and so risk repeat infections.

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