Dengue fever is a self limiting viral illness but every year it creates panic among public and health care authorities. There are various reasons leading to such a furore most important are lack of public awareness which gets multiplied by misinformation, misleading treatment claims and lack of preparedness to tackle any outbreak.Its important to raise awareness about this disease and clear misconceptions.
We definitely need to be concern and careful about it but not to panic and get scared. Always consult a doctor and follow advice and avoid self treatment based on any magical claims shared over WhatsApp or Facebook.
Dengue fever is caused by dengue virus which belongs to Flavivirus genus. It's a self limited infection which may manifest without any symptoms (asymptomatic) to severe dengue infection. Most of those infected either remain asymptomatic or have mild symptoms.
How it presents?
It presents with fever which starts 3-7 days after bite of an Aedes mosquito. Apart from fever it manifests as headache, body ache, joint pain, rash and bleeding . Fever may last for 3 to 7 days. But whats everyone is worried is platelet count. So usually in dengue platelets starts falling on day 3 and by day 6 approximately rise in platelet count is observed.
What should I be careful about?
After this febrile phase, patient may go into critical phase. This is important for general public to be aware to prevent any complications. During this critical phase patient may present with danger signs. Danger/Warning signs are pain abdomen, persistent vomiting, bleeding manifestations, breathlessness due to fluid accumulation. Rise in hematocrits (PCV) and fall in platelet count are noted in this phase. It is important to recognise these symptoms to prevent from going to shock. It is highly recommended to seek to a physicians advice. This phase usually lasts for 36 to 48hrs.After this recovery starts.
Can I have Dengue again?
There are four serotype of Dengue (Dengue 1,2,3,4). All four serotypes are found in India. Although they are closely related but don't provide any immunity against another serotype. So there is always risk of dengue fever again by different subtype. During second attack of dengue fever because of exaggerated immune response there is increase risk of severe dengue.
What are the preventive measure against dengue bite?
Aedes mosquito is the vector which breeds in stagnant water and bites during daytime. This disease is prevalent in urban areas because Aedes Aegypti breeds commonly in these areas. Ideally you should take measures to prevent breeding of these mosquitoes. To avoid mosquito bite wear long sleeves clothing, use of mosquito repellants and mosquito nets.
How is it transmitted?
It is transmitted by bite of Aedes mosquito. Apart from mosquitoes there have been reports of its transmission through blood donation, organ transplantation and mother to child leading to congenital infection.
Can any other disease may have similar presentation?
Common condition which may present as dengue are Malaria, Chikungunya, Enteric fever, Influenza, Scrub typhus, leptospirosis.
What are the investigations done for dengue fever?
Basic investigation is Complete blood count which gives a fair idea about the disease. There may be low WBC count and platelet count in dengue fever. There are specific tests to diagnose dengue fever. This is important Dengue NS1 antigen - Recommended within first 5 days of fever. Dengue IgM and IgG after 5 days ( Common error of this test being negative in a patient of dengue fever is early testing within first 5 days). Dengue RT PCR can also be done during first 5 days but its costly.
What to monitor to check its progress?
Over all symptoms and vital parameters like blood pressure should be monitored. Among laboratory investigations Hematocrit (PCV) and Platelet count should be monitored. In case of development of any warning signs its advised to visit hospital immediately. Immature platelet fraction (IPF) is also being done at few centres to predict rise in platelet count.
How to increase platelet count?
It is a self limited infection and platelet increases on its own. Usually by Day 6 of fever platelets starts increasing. Those who are vegetarians they may need VIT. B12 supplements as its found naturally in animal products and its deficiency may also cause low platelet count.
Can it be managed at home?
Yes, Mild cases of dengue fever can be managed at home. They are advised to take rest, drink plenty of fluids to remain hydrated and to control fever may take Tablet paracetamol (Crocin, Dolo) 500mg and consult doctor for advice. cold/ tepid sponging can be done when temperature rises. Avoid aspirin, ibuprofen or any other NSAIDs or any intramuscular injections.