Published on Aug 22, 2017 and last reviewed on Jan 24, 2022 - 4 min read
Dengue fever is a self-limiting mosquito-borne viral illness that has taken a massive toll on public health. Read below and get to know the answers to the common questions about dengue fever.
It is a mosquito-borne viral illness that belongs to the flavivirus genus. It is usually a self-limiting disease that may manifest as asymptomatic (without any symptoms) to severe dengue.
Dengue fever has four serotypes DEN 1, DEN 2, DEN 3, and DEN 4. Although they are similar to each other, they do not provide cross-protection. Recovery from one type of dengue infection offers lifelong immunity, so there is always a risk of recurrence.
Yes, it has been observed that there is an exaggerated immune response during a second attack, thus increasing the chances of severe dengue.
Dengue fever commonly causes fever with body aches, which may be moderate to severe. It may present with flu-like symptoms and rashes, headache, joint pain, nausea, vomiting, and diarrhea. It may progress to severe dengue in some patients, presenting with abnormal bleeding tendencies. That is why it is also called 'breakbone fever.'
It is a mosquito-borne viral illness, and the vector is the Aedes mosquito. A fever typically occurs three to seven days after the mosquito bite.
Dengue fever is not contagious, meaning that it cannot spread from one person to another through physical contact like touching, speaking, sharing personal items, etc. The bite of a mosquito can only spread it. As mosquitoes transmit it, our efforts should stop the breeding of mosquitoes. Aedes mosquitoes breed in stagnant water. So, we should try to minimize the stagnation of water. The use of mosquito repellents, bed nets, and full-sleeved clothing, may provide personal protection.
No. There has been extensive research and clinical trials for vaccines, and the preliminary reports are encouraging. At present, there are no such vaccines or approved antivirals available against dengue fever.
Since dengue fever is a viral disease, antibiotics are not effective in treating and are not recommended.
Dengue fever is a self-limiting infection, and the platelet count usually starts falling on day three of fever, and a spontaneous rising trend is noted from day six of fever. Various other conditions also present with flu-like symptoms or a low platelet count. For example, immune thrombocytopenic purpura (ITP), vitamin B12 deficiency, etc. So, it is essential that they are differentiated and managed accordingly.
For the first five days of fever, dengue NS1 antigen test and dengue RT-PCR can be done. After five days, dengue IgM (Immunoglobulin M) and dengue IgG (Immunoglobulin G) can be done.
Yes, mild cases of dengue fever without the warning signs can be managed at home. But, they must consult a physician and take proper advice. The general recommendation is to drink plenty of fluids, take a soft diet, and take Paracetamol tablets in case of fever. Avoid Aspirin and NSAIDs (nonsteroidal anti-inflammatory drugs).
Warning signs are breathlessness, severe pain in the abdomen, persistent vomiting, abnormal bleeding, altered sensorium, and a rapid fall in the platelet count. If any of these signs are present, you must visit a hospital immediately for further management.
Two antibodies namely, IgG and IgM, are detected in an antibody test taken for dengue fever. If the IgM antibody is positive and the IgG antibody is negative, then it denotes a recent infection of dengue. In contrast, if IgG is positive and IgM is negative or positive, it indicates a past condition.
Dengue fever is often an excruciatingly painful condition, but it is not a deadly disease when proper treatment is sought. Only with the development of severe complications like dengue shock syndrome (DSS) and dengue hemorrhagic fever (DHF), are there chances of death. Even such patients can survive with proper treatment. The mortality rate is very minimal in the case of dengue fever.
Although there are fewer reports of transmission of dengue fever to the developing fetus, when it occurs, it can bring about complications in pregnancy like fetal distress, premature delivery, and low birth weight.
Blood pressure and other vital parameters need to be often checked. Platelet count and hematocrit (PCV) values should frequently be monitored among the laboratory parameters. The mean platelet volume and immature platelet fraction may give a fair idea about the rise of platelet count.
Platelets increase on their own, and there is no scientific research data to support such claims. It is a myth.
Dengue fever outbreaks are often seen after the rains and peak from August to October. It is usually the time when it is adequate for the Aedes mosquito to breed.
Mosquito repellants which contain Picaridin or DEET (diethyltoluamide or diethyl-methyl benzamide) are safe to be used. Do check the safety label before using a mosquito repellant. Repellents containing PMD (para-menthane-3,8-diol) or (OLE) oil of lemon eucalyptus are not recommended in children.
The Aedes mosquito breeds in stagnant water and bites daily, most often from 7 AM to 11 AM. It is primarily found in urban areas, in and around human dwellings. It most commonly bites below the elbows and the knees. That is the reason full-sleeved clothing is recommended.
When you live in endemic areas where dengue fever is prevalent, take all precautionary measures to prevent the occurrence of dengue fever. Dengue fever can be best treated when treatment is sought at the correct time. If you experience any symptoms of dengue fever, do reach out to a healthcare provider at the earliest. Also, preventing dengue fever is possible by containing mosquito breeding areas and avoiding the bite of mosquitoes.
The primary target of the immune-mediated response in dengue infection is the liver. Dengue causes hepatocyte apoptosis, hypoxic damage, liver perfusion dysfunction, fluid leakage, oxidative stress, and immune-mediated injury.
The patients enter the critical stage about 3 to 7 days after the onset. There is an additional critical phase that rapidly deteriorates the health after 24 to 48 hours of onset.
The most common complication of dengue is a hemorrhagic fever that can precipitate dengue shock characterized by low blood pressure, weak pulse, cold, clammy skin, and restlessness. This can cause severe internal bleeding, damage to internal organs, and, ultimately, death.
Dengue is primarily caused by the dengue virus (DENV) and is a vector-borne infection which means that the virus is transmitted by a mediator organism. In this case, Aedes mosquitoes act as vectors for viral transmission.
LFT or liver function test determines the liver's health by measuring serum bilirubin, serum albumin ALT (alanine transaminase), and AST (aspartate transaminase) levels in the blood. Since the liver is the most commonly affected organ in dengue infections, the determination of liver health is essential to estimate the prognosis and dengue progression.
A dengue vaccine (CYD-TDV) is the first vaccine in third-phase trials. The vaccine is recommended in a three-dose series (0-6-12), which means that the second and third doses are given six months and twelve months after the first dose.
There is no cure for dengue; a management protocol is followed against the presenting symptoms.
- Paracetamol is prescribed against fever. Aspirin or Ibuprofen are contraindicated as they can increase the risk of dengue hemorrhage.
- Proper hydration.
Dengue first originated in monkeys and was restricted to Africa and Southeast Asia around 1000 years back. The viral infection spread to humans around 800 years back through infected mosquitos.
Dengue brings high fever and constant body and joint pain. As with most viral infections, rest is one of the most important parts of the treatment protocol. Fatigue, lack of appetite, and body pain can make the patient extremely weak. The patient is advised complete bed rest to recover the lost strength and should also consume the recommended diet.
Dengue fever results in decreased extracellular fluid in the blood, and the skin enters recovery mode due to the wounds caused by rashes. Itching may also indicate the susceptibility of the vessels to the circulating cytokines. These factors result in pruritus or itching.
To quickly recover from dengue:
- Maintain the body’s hydration.
- Keep symptoms under control.
- Avoid drugs like Aspirin, Ibuprofen, Diclofenac, Naproxen, and Mefenamic acid.
- Prevent bleeding.
- Complete rest.
- Avoid raw, greasy, fatty, and spicy foods.
Dengue has been reported to cause widespread neurological manifestations, like brachial neuritis and opsoclonus-myoclonus syndrome. A Brazilian study reported short-term memory loss in persistent dengue symptoms.
Dengue fever develops after an incubation period of 4 to 10 days and usually lasts for 2 to 7 days. High-grade fevers over 104° F or 40° C are quite common and can be managed by antipyretics. The fever mimics the common flu and usually does not last more than a week. Unresolved fevers beyond a week may require hospitalization.
Untreated dengue can result in the following:
- Internal bleeding.
- Organ damage.
Dengue presents flu-like symptoms, and most cases resolve within a week. It is of utmost importance to seek medical attention if the symptoms do not regress after a week or worsen. Unattended and unresolved dengue can cause serious complications, including death.
Last reviewed at:
24 Jan 2022 - 4 min read
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