Preventive healthcare: Dengue and its treatment

Every year we are witnessing an increase in the number of dengue cases in India and in the last month, ekincare also received a lot of doctor consultations for a few common symptoms of Dengue, like fever, headache, pains, etc. There is extreme panic in society due to the past deaths that have happened. Awareness about dengue and a few facts about dengue fever need to be spread in society to control dengue outbreaks, and for better management of the condition. 

Dengue fever is caused by a virus that belongs to the genus Flavivirus. There are 4 stereotypes of dengue viruses namely Dengue 1, Dengue 2, Dengue 3, and Dengue 4. These viruses are transmitted from one infected person to another by mosquitoes that belong to the Aedes species.

Dengue is called ‘breakbone fever’ because of severe muscle aches experienced by the infected person. However, it is no longer a mandatory symptom for the diagnosis of dengue since dengue is diagnosed with even less obvious symptoms. In some cases, it subsides without a diagnosis due to milder symptoms.

Though there are worries and panic due to dengue deaths, most people with dengue infection recover with no complications.

Only a few cases progress to a severe condition called dengue hemorrhagic fever. Any anticipation or indication of this condition requires hospitalization of the person and a close follow-up with regular testing of hematocrit and platelet counts.

Common symptoms of Dengue

• Fever
• headache
• Body pains and joint pains
• Pain behind the eyeballs
• Nausea, vomiting

Testing and diagnosis

• Depending on the time when the person is seeking care, appropriate tests are done by trained healthcare professionals.
• In the first 5 days of fever occurrence, the Dengue NS1 Antigen test can aid in the diagnosis.
• After that time period, Dengue IgM and Dengue IgG would aid in its diagnosis.

Alarming symptoms of Dengue

• Shortness of breath
• Abdominal pain
• Bleeding from mucosal surfaces like gums
• Altered mental status or confusion
• Weakness, dizziness
• Vomiting
• Low platelets in the blood tests

Requirement for hospitalization 

Hospitalization is required when alarming symptoms are present to closely monitor the person and repeat testing of the lab critical parameters. Though there is no definitive treatment for dengue infection, maintaining hydration with proper supportive care and monitoring for complications constitutes the usual care.

Low platelets and panic

Though drops in the platelet count need to be closely monitored with follow-up tests, this is not always a matter of panic. Platelet transfusions are not required in most cases. 

Transfusion of platelets is required if platelets drop to below 20,000 along with bleeding or below 10,000 with no bleeding.

Mosquito control and protection from mosquito bites

The old saying ‘prevention is better than cure’ truly holds good for dengue infection. Keeping a check on mosquito menace is the best way to prevent infection.

Some measures that work are:

• Making sure there is no stagnant water in and around your household premises. 
• Wearing clothes that cover most of your body.
• Using mosquito nets at night.
• Mosquito-repellent oils & creams do help to some extent when applied to the exposed parts of the body.

Some facts about Dengue

• Not all mosquito bites cause Dengue.
• Dengue infection does not spread from person to person directly.
• Not all Dengue infections are life-threatening.
• A modest drop in platelet count doesn’t require a platelet transfusion.
• Children, the elderly and pregnant women need to be monitored closely.
• When the fever is subsiding, people might feel a sense of security when in reality, they are not completely out of risk for complications. 
• There is no vaccine for the prevention of dengue at this point.
• Prevention of mosquito breeding and prevention of mosquito bites is the best way to prevent dengue. 

In short, early diagnosis and management of symptoms is critical in saving the life of a Dengue patient. Reaching out to a trained medical doctor when symptoms first start to appear can also help with an early diagnosis.