Dengue Fever

Dengue is the second most common mosquito borne infection after malaria. It is seen mostly in tropical and sub-tropical countries. We will explain how it spreads, the common symptoms and what can be done to prevent this painful infection.

What causes Dengue?

Dengue or ‘break bone fever” is caused by a virus with 4 variants and is transmitted by a mosquito called Aedes Aegypti which bites in the daytime. Dengue Hemorrhagic Fever (DHF) is a more severe version, with bleeding into the skin and internal bleeding. Dengue is seen in many countries and up to 100 million people can be infected every year.

In India, there are frequent outbreaks in many regions. Dengue occurs in urban and rural areas and the Aedes mosquito tends to breed in containers or collections of water around dwellings.

What are the symptoms of Dengue?

• Symptoms start 3-14 days after the bite of an infected mosquito.
• The illness last 2-7 days and there is fever, severe headache, severe eye pain and severe muscle and joint pain, hence the name “break bone fever”.
• Small red spots are seen on the skin and there can be bleeding episodes like nose bleeds or bruising under the skin. In severe cases, there can be bleeding into the gut, shock and collapse. This condition is called Dengue Shock Syndrome. Urgent hospital treatment is needed if there is severe abdominal pain, vomiting of blood or signs of shock.

Dengue can be fatal but with good treatment, the mortality rate can be kept under 1%.

However, outbreaks in Delhi in recent years have had mortality rates in the region of 4%.

Dengue is becoming a major health problem in India and is becoming entrenched in many cities. Outbreaks occur during the monsoons and soon after, as water collects in numerous containers.

What tests need to be done?

The blood is tested for the platelet count. Typically, platelet cells drop to low levels. The white cell count is also low. If dengue is suspected, within 5 days blood is collected for virus isolation. After 6 days, an IgM antibody for Dengue will give a specific diagnosis.

How is it treated?

• There is no specific treatment although some anti-viral drugs have some effect.
• Fluid intake must be kept up and painkillers given.
• Aspirin and ibuprofen must be avoided because they may increase the bleeding tendency.
• Severe infections must be treated in hospitals and blood transfusions may be needed.
• How can Dengue be prevented?
• There is no vaccine although some are being tested.
• The key to prevention is by mosquito control. The female mosquito transmits the virus and eggs are laid in water.
• All households should cover water containers and ensure that containers which collect rain water are cleared once a week.
• Personal prevention against mosquito bites in the daytime include repellents like DEET, protective clothing and screening windows.
• If there is an infected person in the household, extra precautions must be taken to prevent the patient from being bitten.
• Clothing can be impregnated with permethrin.

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