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Dengue Infection - Prevention and Management

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Dengue Infection - Prevention and Management

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People panic soon after they hear the word dengue from the doctor's mouth.This article gives some awareness and also will calm down people.

Written by

Dr. Divakara. P

Medically reviewed by

Dr. K. Shobana

Published At February 8, 2016
Reviewed AtOctober 3, 2023

Introduction:

Dengue is a viral infection spread by mosquitoes. The mosquito which spreads dengue is active and bites during the daytime and not in the nighttime. So, it is important to take mosquito preventive measures even during the daytime.

What Is Dengue Infection?

Dengue infection is a viral disease transmitted by the bite of infected female Aedes mosquitoes. The disease affects millions of people worldwide, primarily in tropical and subtropical regions. Dengue infection causes flu-like symptoms, including fever, headache, muscle and joint pains, and rashes. Dengue hemorrhagic fever or dengue shock syndrome is a severe and fatal form of the disease.

What Causes Dengue and How Is It Transmitted?

  • Dengue infection is caused by any of the four dengue virus serotypes (DENV-1 to DENV-4) belonging to the family Flaviviridae.

  • The virus is transmitted through the bite of an infected Aedes mosquito, primarily Aedes aegypti and, to a lesser extent, Aedes albopictus.

  • The mosquitoes typically breed in stagnant water in containers, such as buckets, flower vases, and discarded tires, near human habitations.

What Are the Symptoms of Dengue Infection?

  • The incubation period for dengue infection is four to 10 days, after which the infected person may experience flu-like symptoms, such as high fever, severe headache, joint and muscle pains, and rashes.

  • Other common symptoms include nausea, vomiting, and mild bleeding, such as from the gums or nose.

  • Most people recover within two to seven days with proper care and hydration. However, in some cases, dengue infection can progress to severe dengue, which is characterized by abdominal pain, persistent vomiting, rapid breathing, bleeding, and signs of plasma leakage.

  • Severe dengue can lead to dengue hemorrhagic fever or dengue shock syndrome, which can be fatal.

What Are the Preventive Measures for Dengue Infection?

Preventive and control measures for dengue infection are essential to reduce the transmission of the virus and prevent outbreaks. Some of the measures that can be taken to prevent and control dengue infection are listed below.

  • Mosquito Control: Since the primary mode of transmission of the dengue virus is through the bite of an infected Aedes mosquito, mosquito control measures are critical in preventing dengue infection. This can be done by eliminating breeding sites, such as stagnant water containers, and applying insecticides in the vicinity of human habitations. Mosquito larvae can be killed by adding temephos granules or by cleaning the containers and scrubbing them with a brush to remove any mosquito eggs.

  • Personal Protective Measures: Individuals can protect themselves from mosquito bites by wearing long-sleeved clothes, using mosquito repellents, and sleeping under mosquito nets. Applying mosquito repellent creams or lotions containing DEET or other approved chemicals on exposed skin is an effective way to prevent mosquito bites.

  • Health Education and Awareness Campaigns: Public awareness campaigns and health education programs can help in promoting preventive measures, such as keeping the environment clean, eliminating breeding sites, and using mosquito nets and repellents. These campaigns can be carried out through mass media, posters, and community meetings.

  • Active Surveillance and Case Management: Early detection and prompt treatment of dengue cases are crucial in preventing severe dengue and reducing the risk of death. Health authorities should implement active surveillance programs to detect and manage cases of dengue infection promptly. Case management involves supportive care, such as fluid replacement and pain management, and close monitoring of patients to prevent complications.

  • Vector Control Using Biological Methods: Biological methods such as introducing mosquito larvae-eating fish, larvae-eating insects, and bacteria like Wolbachia, can also be used to control the mosquito population. Wolbachia bacteria reduce the mosquito’s ability to transmit the dengue virus.

  • Community Involvement: Community involvement is crucial in preventing and controlling dengue infection. Community members can participate in cleaning campaigns to eliminate breeding sites and report suspected cases of dengue to the health authorities. They can also collaborate with the health authorities in implementing mosquito control measures.

  • Vaccination: There is currently no specific vaccine for dengue infection, but several vaccine candidates are under development. Vaccination is an effective way to prevent the spread of dengue infection and reduce the incidence of severe dengue. Vaccination can be targeted to high-risk populations, such as children and individuals living in areas with a high incidence of dengue infection.

How Is Dengue Infection Treated?

The treatment and management of dengue infection depend on the severity of the disease. There is no specific antiviral treatment available for dengue, and treatment mainly involves supportive care and management of symptoms.

  • Symptomatic Treatment:

    • Symptomatic treatment involves managing symptoms through medication and supportive care.

    • Pain relievers such as acetaminophen can help in reducing fever and pain. Non-steroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen and Aspirin can increase the risk of bleeding, therefore they must be avoided.

  • Fluid Replacement Therapy:

    • Dengue infection can cause dehydration, which can be severe in some cases.

    • Fluid replacement therapy involves the administration of intravenous fluids to replace the fluids lost due to fever and vomiting.

    • It is essential to monitor the patient's fluid intake and output closely to ensure adequate hydration.

  • Monitoring Platelet Count and Platelet Transfusions:

    • In dengue infection, there will be a drop in the platelet count.

    • A normal platelet count is 1,50,000 to 4,00,000. In dengue infection from the first day of fever till six to seven days there will be a drop in platelet count irrespective of what kind of treatment is given. After the sixth or seventh day, there will be an increase in the platelet count. An increase in platelet count indicates an improvement in the disease.

    • During the time of illness, platelet count monitoring has to be done because it can fall to a very low level and patients may require platelet transfusion in that case.

  • Monitoring for Complications:

  • Dengue infection can cause severe complications such as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS).
  • It is essential to monitor patients closely for signs of these complications, such as bleeding, low blood pressure, and organ failure.

  • Early detection and prompt management of complications are crucial in preventing severe dengue and reducing the risk of death.

  • Rest and Recovery:

    • Dengue infection can be physically and emotionally exhausting, and patients require rest and recovery time.

    • Patients should avoid strenuous activities and get enough rest to allow their bodies to recover from the infection

  • Follow-up Care:

    • Follow-up care is essential to ensure that patients recover fully from dengue infection and do not develop any long-term complications.

    • Patients are advised to consult their doctor if they experience any recurring symptoms after recovery from dengue.

Conclusion:

Dengue infection is a significant public health problem that affects millions of people worldwide. Early diagnosis and timely treatment are very important to prevent complications and reduce the risk of death.

Frequently Asked Questions

1.

What Are the 4S of Dengue Prevention?

The 4S of dengue prevention stands for search and destroy mosquito-breeding sites, seek early consultation, self-protection measures like wearing long pants and long-sleeved shirts, and support fogging/spraying only in hotspot areas.

2.

What Is the Most Effective Way to Prevent Dengue?

The fastest and most effective way to prevent dengue is to use insect repellent, wear long-sleeved shirts and long pants to avoid mosquito bites, and control mosquitoes inside and outside your home.

3.

How Is Dengue Caused?

Dengue is a viral infection transmitted to humans by the bite of infected mosquitoes such as Aedes aegypti (more common) or Aedes albopictus (less common) mosquitoes. And the virus responsible for causing dengue is called dengue virus (DENV).

4.

What Are the Alarming Signs of Dengue?

The alarming signs of dengue include abdominal pain, persistent vomiting, clinical fluid accumulation, bleeding from the nose or gums, blood in urine, stools, or vomit, and feeling tired, restless, or irritable.

5.

What Is the Ideal Time for the Dengue Test?

Two types of tests are done in dengue - Direct (antigen tests) and indirect (antibody tests). The direct test should be done within five days during the initial phase of infection and starts to show false negative results after seven days. Indirect antibody tests are done at different periods for specific antibodies, such as IgM - after the 4th day of infection and IgG - in the later phase 14-21 days of infection.

6.

When Is the Dengue Mosquito Most Active?

The dengue mosquito Aedes aegypti mainly bites during the daytime. The most active time for mosquitoes is two hours after sunrise and several hours before sunset. However, it can also bite at night in well-lit areas.

7.

Who Has a Higher Chance of Getting Dengue?

People who live or have recently traveled to tropical and subtropical areas are at higher risk of getting dengue fever. Moreover, people who had dengue fever in the past can develop severe symptoms if they get it again.

8.

How Is Dengue Diagnosed?

In case of infection, a blood test can be done to check the presence of the dengue virus. Although the diagnosis of dengue fever is complicated based on its signs and symptoms as they resemble other diseases such as malaria, typhoid fever, and chikungunya.

9.

When Is Hospitalization Required for Dengue?

The patient with the following symptoms needs to be admitted to the hospital: 
- Severe abdominal pain.
- Persistent vomiting.
- Lethargy.
- Restlessness.
- Rapid changes in body temperature from high to low. 
- Looking pale.
- Limbs become cold and clammy.

10.

What Is the Platelet Count In Dengue?

The normal platelet count in the body ranges from 1.5 to 4 lakhs, which can go down to as low as 20,000 to 40,000 in dengue patients. The platelet count below 20,000 is the critical level.

11.

What Is the Cure for Dengue Fever?

As such, there is no cure or specific treatment for dengue. However, patients can be admitted to the hospital or rest at home as the treatment is aimed at relieving the symptoms until the infection is gone.

12.

How to Rapidly Increase the Platelet Count?

The platelet count can be increased by making some dietary changes or taking supplements such as eating more green leafy vegetables, increasing folate consumption, eating food rich in vitamins B12, C, D, and K, and eating more citrus and iron-rich foods.

13.

What Is the Recovery Time of Dengue?

The incubation period of dengue ranges from three to 14 days. And the symptoms of dengue fever typically last two to seven days. And most people recover from dengue in about seven to ten days.

14.

What Can Happen if Dengue Is Not Treated on Time?

In case of untreated dengue, the fever can cause internal bleeding and organ damage; therefore, blood pressure can drop to dangerous levels leading to shock and can also be fatal.

15.

What Are the Indications of Recovery From Dengue?

Most people with dengue recover on their own without any complications. In the recovery phase, the patient's vital signs and gastrointestinal symptoms improve, the fever subsides, and appetite normalizes.
Source Article IclonSourcesSource Article Arrow
Dr. Divakara. P
Dr. Divakara. P

Internal Medicine

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