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Dengue

Dengue

Introduction

Dengue or Dengue fever is a painful, debilitating mosquito-borne disease that is caused by the dengue virus. There are four dengue viruses that are closely related to each other.

Dengue is also called as dandy fever or breakbone fever due to the severe joint pain associated with the fever.

The symptoms of dengue fever begin to surface within 3 to 14 days after the infection. The symptoms include a severe headache, high-grade fever, vomit, joint and muscle pain, as well as a characteristic skin rash.

Recovery from the infection could take 2 to 7 days. But, in some cases, severe complications may occur. The complication can be life-threatening and hence, dengue fever is considered one of the deadliest diseases.

Prevalence of Dengue Fever

If numbers are to be believed, about 390 million dengue infections are reported worldwide every year. Out of these cases, around 96 million cases result in illness.

Dengue is a tropical disease. Majority of cases are reported in the tropical areas. The major risk areas include:

  • Southeast Asia
  • Indian Subcontinent
  • Southern China
  • Pacific Islands
  • Taiwan
  • Caribbean (with an exception of Cayman Islands and Cuba)
  • Africa
  • Mexico
  • Central America as well as South America (except Paraguay, Argentina, and Chile)
  • In the United States of America, the majority of dengue cases occur due to people traveling abroad. However, the southern United States and Texas-Mexico border are considered as risk areas for dengue

Causes/Pathogenesis

The causative agent of dengue fever is an Aedes mosquito, which is infected by the dengue virus (DENV).

Dengue is caused particularly by A. aegypti mosquito. This mosquito usually bites during early mornings and in the evenings. A person can get infected with a single bite.

There are other species of Aedes mosquito too that also transmit the infection. They include A. scutellaris, A. polynesiensis, and A. albopictus.

The primary host of the virus is human. The mosquito gets infected when it bites someone who is carrying the dengue virus in his blood. However, the virus also circulates in some non-human primates.

There are other sources of transmission too. The infection can be transmitted by infected blood products, or organ donation. There are also some cases of vertical transmission, i.e. transmission of infection from mother to her child during the course of pregnancy or at the time of birth of the child.

Although rare, there are some very unusual cases of person-to-person transmission.

Signs and symptoms of dengue fever

It is hard to believe that about 80% of people infected with the dengue virus are asymptomatic. These people might not show any symptom at all or may present with mild, uncomplicated fever. Only 5% of people infected with dengue virus pose with severe illness and in some very rare cases, the illness becomes life-threatening.

The symptoms begin to surface 4 to 6 days after the infection and may last for up to ten days. The symptoms are:

  • Sudden, high-grade fever
  • Severe headache
  • Severe muscle and joint pain
  • Pain behind eyes
  • Nausea
  • Vomiting
  • Fatigue
  • Typical skin rash appearing 2 to 5 days after the occurrence of fever
  • Mild bleeding (like bleeding gums, nosebleeds, easy bruising)

The characteristic symptom of dengue is the presence of high fever, headache, and typical itchy rash. This is known as the dengue triad.

The symptoms of dengue can be very mild. Sometimes, the symptoms are mistaken for the symptoms of flu or other viral infections.

Children present with the symptoms resembling the symptoms of the common cold as well as gastroenteritis. They are more susceptible to complications.

Complication

In some cases, rare complications may develop. The complication, known as dengue hemorrhagic fever, is characterized by the presence of high-grade fever, damage to the lymph, as well as blood vessels, bleeding gums and nose, liver enlargement, and circulatory system failure.

People who have a weak immune system or those who present with second or subsequent infection are more susceptible to dengue hemorrhagic fever.

In some cases, symptoms can progress to excessive bleeding, following shock, and ultimately death. This is known as DSS or Dengue Shock Syndrome.

Diagnosis

In the endemic areas, the diagnosis is done by physical examination based on the signs and symptoms.

Doctors ask the patient to undergo a blood test to confirm the presence of antibodies.

Treatment of Dengue Fever

The saddest part is that there is no specific medication indicated for the treatment of dengue infection. The doctors generally prescribe pain relievers containing acetaminophen. Taking medications with aspirin are contraindicated as they exacerbate bleeding.

The person who is infected is advised to take a lot of rest and ample of fluids.

Prevention of Dengue Fever

Vaccination to prevent dengue fever is under development. The apt way for the prevention of dengue fever is to prevent the bites by the infected mosquitoes.

People who are traveling to or are living in the tropical areas must excise extra caution.

Here are some effective measures to prevent mosquito bites:

  • Wear long-sleeve uppers, as well as long pants, when moving outdoors. Tuck the pants into the socks to prevent bites.
  • Make it a point to use mosquito repellents not just outdoors but also indoors.
  • Use air conditioning when indoors.
  • The windows, as well as door screens, must be secure with appropriate netting.
  • Use mosquito nets while sleeping.
  • Keep the surroundings neat and clean to prevent breeding of mosquitoes. Water accumulated in flower pots, cans, tires, etc is a breeding ground for the mosquitoes. Do not let water accumulate.
  • Keep the birdbaths as well as water dishes of the pets clean. Regularly change the water.
  • If you experience any of the above-mentioned symptoms, see the doctor immediately. Let your doctor know if you are traveling to any tropical area.

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