Dengue Infection - Prevention and Management

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.