When things were looking bleak for agriculturists, the Indian government was quick to announce the arrival of monsoon. As puddles fill our roads again, we will be welcomed by serious health problems as well, the most common being Dengue. A serious threat to locals and tourists alike, Dengue fever claims several lives each year and scars many others. This week, we explore the ins and outs of the Dengue fever.
Most common in tropical countries such as India, Dengue fever is a mosquito-borne tropical disease caused by the dengue virus. It is a kind of “break-bone” fever, because symptoms mainly include joint and muscle pains, apart from fever and headache. A characteristic skin rash that is similar to measles is also observed. In a small proportion of cases the disease develops into the life-threatening dengue haemorrhagic fever, resulting in bleeding, low levels of blood platelets and blood plasma leakage, or into dengue shock syndrome, where dangerously low blood pressure occurs. Unfortunately, commercially available vaccines for dengue are not available, due to which prevention is the only viable option. Dengue became a global problem after the Second World War and is endemic in more than 110 countries. This means that the dengue virus does not need external inputs for its sustenance; populations of tropical countries such as India, Pakistan, Taiwan and Mexico are suitable hosts for the virus.
It is very important to identify the various symptoms of dengue fever. We often confuse the symptoms with that of influenza and end up paying heavily with our health. Many people, especially children and teens, do not experience any signs or symptoms during a mild case of dengue fever. However, when symptoms do occur, they usually begin four to 10 days after the person has been bitten by an infected mosquito. Signs and symptoms of dengue fever most commonly include:
- Fever, up to 1060 F
- Muscle, bone and joint pain
- Widespread rash
- Minor bleeding from gums or nose
Most people recover within a week or so. In some cases, however, symptoms worsen and can become life-threatening. Blood vessels often become damaged and leaky, and the number of clot-forming cells in your bloodstream falls. This can cause dengue haemorrhagic fever or dengue shock syndrome, wherein patients often complain of :
- Bleeding from the nose and mouth
- Severe abdominal pain
- Persistent vomiting
- Bleeding under the skin, which may look like bruising
- Problems with lungs, liver and heart
It is imperative to consult a doctor at the earliest if any of these symptoms are consistent with one’s recent medical record. Also, a visit to the doctor is recommended to people returning from tropical countries.
Dengue fever is transmitted by the bite of an Aedes mosquito infected with a dengue virus. These mosquitoes thrive in and near human lodgings and can carry four different types of dengue viruses. When a mosquito bites a person infected with a dengue virus, the virus enters the mosquito. When the infected mosquito then bites another person, the virus enters that person’s bloodstream. Once infected, the mosquito remains infected for its life span. There is, however, no human-to-human dengue fever transmission. An important point which is often overlooked is that once you recover from dengue fever, you have immunity to the virus that infected you — but not to the other three dengue fever viruses. The risk of developing dengue haemorrhagic fever actually increases if you’re infected a second, third or fourth time.
Several cases of dengue fever are reported around monsoon, some of which are even fatal. The health department in the religious town of Varanasi has already put precautionary measures in place, with July designated as the anti-dengue month. The divisional hospital has created an eight-bed dengue ward to meet any eventuality. Cases of dengue are generally reported between mid-August and October. The Pune Municipal Corporation, too, has issued notices to five construction houses for not following sanitation norms and thereby providing breeding ground for mosquitoes responsible for spreading Dengue. Similar measures have been taken by the Delhi Government to keep the menace of Dengue at bay.
Because dengue fever is caused by a virus, there is no specific medicine or antibiotic to treat it. For typical dengue, the treatment is concerned with relief of the symptoms. Rest is of utmost importance, and so is fluid intake for hydration. Aspirin and anti-inflammatory drugs should only be taken under a doctor’s supervision because of the possibility of worsening bleeding complications. Drugs like Brufen and ibuprofen are a strict no!
In case of severe dengue fever, one might need Supportive care in a hospital and electrolyte replacement. The patient’s blood pressure needs to be monitored constantly and blood transfusion might be required to replace blood loss.
The main perpetrators of dengue are mosquitoes. Since there are no approved vaccines for the dengue virus, prevention depends on control of and protection from the bites of the mosquito that transmits it, since they are the vectors the dengue viruses require for transfer to humans. One can take the following precautionary measures against Dengue:
The primary method of controlling responsible mosquito is by eliminating its habitats. This is done by getting rid of open sources of water, or by adding insecticides or biological control agents to these areas. Since mosquitoes often breed in stagnant water, reducing open collections of water is the most common control method.
People can prevent mosquito bites by wearing clothing that fully covers the skin, using mosquito netting while resting, and/or the application of insect repellents.
It is very important to be aware of the causes and symptoms of dengue fever, else the patient’s condition worsens and the disease is bound to spread from other mosquitoes. In fact, dengue clusters have often been reported in rural India. Prevention is the only possible way to fight dengue and proper awareness is the key to good prevention and management of the endemic.