Dengue Fever

Dengue Fever: Synonyms, Classification Types, Symptoms, Diagnostic Tools, Causes, Diagnosis, Complications, Treatment and Prevention

What is Dengue Fever?

Dengue Fever is an infectious disease common in many tropical and sub-tropical nations, caused by a flavivirus. It is widely transmitted by the bite of Aedes aegypti mosquito.

Dengue Fever: Introduction

Dengue Fever is an infectious disease caused by a virus commonly prevalent in tropical and sub-tropical nations. It is widely transmitted by the bite of Aedes aegypti mosquito. It is a febrile condition, which has become an international health concern because of its rapid spread. A large number of deaths occurring among children are attributed to dengue in many Asian countries.

Four virus types cause dengue. The lethal DHF was first identified in 1950 in Thailand and Philippines. 

Dengue fever was formerly known as break bone fever on account of extreme joint and muscle pain experienced during the course of illness.

The mosquito bites and transmits the virus in a susceptible host. One bite of Aedes mosquito is sufficient to inflict the disease. Usually, the female Aedes is a carrier and transmits the virus from one host to another. It is seen that this mosquito bites during the daytime. The female Aedes bites the infected person and gets the virus, which after incubation period of 8-10 days becomes capable to get transmitted to the other individual, again via mosquito bite. 

Dengue virus is not at all contagious and never spreads by contact with each other. The only route of infection is person-to-mosquito-to-another-person. It is commonly seen to occur during or shortly after the rainy season because the environment favors rapid mosquito growth.

Dengue Fever: Synonyms

The significant and popular alternative names of dengue fever are:

  • Breakbone Fever
  • Dandy Fever
  • Aden Fever
  • Bouquet fever
  • Date Fever
  • Polka Fever
  • Dengue Haemorrhagic Fever
  • Exanthesis arthrosia
  • Scarlatina rheumatica 
  • Solar fever 

DengueFever: Classification/Types

Classification of dengue fever:

The important types of the fever are listed as under:

  • DEN-1
  • DEN-2
  • DEN-3
  • DEN-4
  • Dengue Haemorrhagic Fever (without shock)
  • Dengue Shock Syndrome

Dengue Haemorrhagic Fever (DHF)

The condition is very common in south-east Asia. It is characterized by fever, bleeding may occur with petechiae (red or purple blisters under the skin), ecchymoses, epistasis, and melaena. It is a potentially serious complication which may prove to be lethal.  Enlargement of liver and failure of blood circulation is also seen in severe cases.

(DHF)  is life threatening and may precipitate as dengue shock syndrome.

Dengue Shock Syndrome (DSS)

In addition to the symptoms similar to that of DHF, here shock is also manifested by rapid and weak pulse and hypotension.

Dengue Fever: Signs and Symptoms

The clinical manifestations of dengue are enumerated as:

  • Malaise with headache
  • Fever-continuous or ‘saddle-back’  with break on 4th or 5th day usually lasting for 7-8 days
  • Backache
  • Severe joint and muscle pain ( myalgia and arthralgia)
  • Generalized pains
  • Painful red eyes
  • Lymphadenopathy
  • Lacrimation
  • Anorexia
  • Nausea
  • Vomiting
  • Bradycardia
  • Prostration
  • Depression
  • Scarlet rash on hands and feet 

Dengue Fever: Diagnostic Tools/ Tests

Certain tests can be done to find out the presence of virus in blood sample:

Blood Tests:

CBC for WBC count, platelet count, haematocrit, Serum Proteins, Serum Albumin

Liver Function Test:

The test reveals the level of raised liver enzymes

Urine Test:

For haematuria (blood in urine)

Dengue Antibody Blood Test:

The Dengue IgM antibodies indicates the presence of active infection. The IgG antibodies are seen in secondary infection.

Dengue Fever: Complications

Probable Complications of Dengue Fever:

If left untreated, it may advance to dengue haemorrhagic fever, which is a fatal condition. The complications are generally related to dengue haemorrhagic fever and dengue shock syndrome.

Some major complications of dengue can be:

  • Bleeding or haemorrhage
  • Hypotension (low blood pressure)
  • Bradycardia
  • Liver damage
  • Neurological complications such as seizures and encephalitis
  • Thrombocytopenia- decreased platelet count
  • An unusual complication is postviral phrenic neuropathy and diaphragmatic paralysis
  • v  Myocarditis- the inflammation of cardiac muscles

Dengue Fever: Treatment

Being a viral infection, dengue has no specific antiviral medicine available. The treatment is entirely dependent on the control of symptoms.

  • Analgesics are administered for relieving excruciating muscular pain.
  • Antipyretics are advised for fever and body ache.
  • Rest is advised as the patient feels discomfort and malaise.
  • Plenty of fluid should be taken to combat dehydration.
  • If the condition worsens and progresses towards, dengue hemorrhagic fever or dengue shock syndrome, then hospitalization becomes necessary.
  • Intravenous infusions (normal saline or 5% dextrose) are given to overcome shock.
  • At present no specific vaccine is available. Rigorous researches are going on to develop one and the scientists will soon develop one very soon.

Dengue Fever: Alternative Therapy

The Unani System of medicine claims to have effective treatments in combating this notorious infection.

For proper line of treatment, consultation with a Unani physician is a must.

Some important Unani formulations found to be highly efficient in treating dengue are:

  • Sheera Tukhm Khurfa – 10 gm in lukewarm water
  • Qurs Tabasheer and Sharabat Bazoori
  • Sharbat Deenar– 40 ml twice a day.

Dengue Fever: Prevention

The prevention can be achieved by adopting and religiously following listed measures:

  • Use mosquito repellants to avoid mosquito bites.
  • Promoting use of mosquito nets.
  • Avoiding collection of stagnant water which acts as breeding grounds for the mosquito and increases chances of dengue infection.
  • Full-sleeved neutral coloured upper clothing and pants should be encouraged, to avoid mosquito bites.
  • Do not store water in open vessels. Always use containers with lids to collect water.
  • Do not let water collect in coolers and dry them if they are not being used.
  • Keeping the water storage containers clean and regular washes should be done as a routine practice.
  • Regular disinfection of the main water storage tank should be done to avoid development of mosquito larvae.


Dengue Fever: Prognosis

Some important points about the prognosis of dengue fever are as follows:

  • People with dengue, generally recuperate within few weeks. However, some may take a little longer.
  • Recovery is facilitated by aggressive fluid and electrolyte intake.
  • The individuals may have post-recovery weakness and depression.
  • Generally recovery from dengue is quite good; however the mortality rate may be as high as 15% in absence of proper medical concern.
  • Seek proper medical attention if dengue is suspected.

Dengue Fever: Glossary 

  • DHF: Dengue Haemorrhagic Fever
  • DSS- Dengue Shock Syndrome
  • Encephalitis- inflammation of Brain
  • Neuropathy- damage of nerves of the peripheral nervous system
  • Antipyretics- anti fever medicines
  • Analgesics –painkillers
  • Thrombocytopenia- decreased platelet count
  • Myocarditis- inflammation of cardiac muscles
  • Myalgia- muscular pain
  • Arthralgia- joint pain
  • Incubation Period- it is defined as the time interval between invasion of an infectious agent and the appearance of first signs and symptoms of the disease in question.

Dengue Fever: FAQs 

How can I differentiate dengue from other fevers?

The significant features that make it different from other fevers are presence of pain behind eyes, severe pain in joints and muscles, and skin rashes.

After suffering from dengue can I it get again?

Yes. You can suffer from dengue again as there are four different strains of viruses. Infection from one strain does not prevent the occurrence of infection from the other.       

Is Dengue transmitted from another person?

No. Dengue is not transmitted from one individual to the other. The only mode of spread is via mosquito bite.

References:

  • Dengue | CDC (https://www.cdc.gov/dengue/index.html)
  • Dengue and severe dengue – WHO | World Health Organization (https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue)