The monsoon season in tropical countries has brought back with it the next outbreak of dengue, creating fear and panic in the minds of the people.
In developing countries with a tropical climate, the death toll due to seasonal outbreaks of infectious diseases is on the rise. The hospital wards are full of patients diagnosed with various tropical infections and dengue surpasses them all. Its prevalence is much higher than the data provided by healthcare departments as many of the cases go unreported due to a lack of public awareness. Some of the common questions and answers about Dengue Fever are explained here.
Dengue fever is an infection caused by a virus from the arbovirus group, and this virus is transmitted to humans by the bite of the infected Aedes mosquito (also called the tiger mosquito) which grows in a freshwater habitat close to human dwellings. So, it is not surprising that 'dengue fear' surpasses all the other panic syndromes. Within a few days, the person starts experiencing severe headache, backache, and body ache. There may also be joint pains along with ahigh-grade fever and a typical rash. Dengue is a dehydrating fever with no known cure yet.
A vast majority of the public still do not realize the importance of hospitalization during the illness. While dengue by itself is not a dangerous disease, the improper management of the symptoms can be fatal. Supportive medications such as intravenous saline and antipyretics are used along with symptomatic care. Dengue fever may cause severe dehydration, dizziness and giddiness and even syncopal falls leading to injuries.
Dengue is a typical biphasic illness with distinct acute and chronic phases. In the acute phase, the fever lasts for a couple of days and subsides. But, the real panic starts after that. On the fourth day of the illness, the platelet count begins to drop, with a progressive fall till the seventh day rising again spontaneously after that.
The diagnosis of dengue is again such a situation where patients are in a constant dilemma. Within the first three to four days, the dengue NS1 antigen test results come positive, and from the sixth day onwards, the antibodies start developing. This can lead to many patients with symptoms consistent of dengue be labeled falsely as negative. As per my clinical experience, there is no requirement of platelet transfusion in this illness as it causes more harm than good. One may consider a platelet transfusion when the count drops below 20,000/cu mm along with clinical manifestations such as nasal bleed, blood in stools or urine. 95 % of the patients recover on their own without any additional supplements such as steroids injection given by some physicians.
There are many myths doing the rounds regarding papaya leaf extracts, kiwi fruit and goat milk improving the platelet count in dengue. But, they have not been medically proven and are not recommended forms of treatment. In fact, a reduced platelet count may not be the real danger sign in simple dengue fever. We must look for reduced urine production, giddiness, severe headache with persistent vomiting, diarrhea, abdominal pain, and breathlessness which are more ominous signs.
Unaware of having dengue, many pop fever medicines for prolonged periods and land up in a shock-like state which may injure their internal organs such as kidneys. With proper IV fluid resuscitation, they do show good recovery.
Not every patient needs to be hospitalized after being diagnosed with dengue fever. The mild cases can be effectively managed at home if the patient ensures rehydration with different means - ORS (oral rehydration salts), juice, plenty of water, as well as adequate rest and fever medicines.
But, I must draw your attention to those severe cases who despite good treatment show signs of complications and even succumb to their illness due to multiorgan failure even after being treated at the best intensive care setup. One may not identify those unlucky individuals. Hence prevention stands up to be the best protective measure.
Immunity against dengue is another such wonderful phenomenon. Contrary to our belief, a previous episode of dengue will not impart good protective immunity and the second episode of dengue may turn more dangerous due to some immune complex mechanisms.
So one must understand that dengue still remains a dramatic illness with variable clinical presentations and unexpected results. So, stop panicking and act smartly to avoid untoward consequences.
For more information consult a dengue fever specialist online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician/dengue-fever
Last reviewed at:
20 Sep 2019 - 3 min read
Query: Hi, My son is a 5 year old boy. He had high fever two days back and the temperature touched 104.9. We have been giving Meftal and Paracetamol for the last two days with water bath to bring the fever down. We have also been giving Zifi 100 twice a day as prescribed by our physician. This has helped t... Read Full »
Query: Hi doctor, My sister has been suffering from dengue for the past four days. She has got this fever for the second time now. The first time being eight years ago. Her platelet count today is 2.6 lakhs, PCV is 34 and WBC TC is 1900. She is being given saline along with Sumol, Ondem, Levazeo and Milk o... Read Full »
Query: Hi doctor, I am a 25 year old female, who weighs 24 kg and 5.3 feet tall. I have had a fever since last week. The fever was between 38 to 40o C. I also had headaches and lower back pain. Today I got tested for dengue, but that was negative. However, on my torso, neck, and face, there are these red r... Read Full »
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