Dr. Kailash C. Behl
Dengue is a infection caused by the Mosquito, Aedes aegypti which is the primary epidemic vector. Dengue infection may occur in the form of classical dengue fever or dengue haemorrhagic fever (DHF) with bleeding manifestations or with or without shock (decreased blood pressure).
About 50 million dengue infections occur worldwide annually and about 5,00,000 people with dengue haemorrhagic fever require hospitalization in each year and out of which 2.5% of those affected die. Major endemicity of dengue fever is found in South – East Asia and Western Pacific regions.
Dengue has four virus serotypes 1-4. Mosquito Aedes aegypti and Aedes albopictus both are most important vectors for spread of dengue fever. Aedes aegypti typically breeds near human habitations and usually in fresh water like Jars, Vases, Discarded Containers, Coconut husks and old tires and this Mosquito especially bites during the day. Dengue transmission usually occurs during the rainy seasons.
The infection period of dengue fever ranges from 3 to 14 days. When dengue fever occurs in a patient, patient shows some non specific symptoms like headache, backache and generalized weakness. Some patients have pain behind the eye on movement of the eye, pain in the muscles and joints and bones. Some patients have loss of appetite, altered taste sensation, constipation, pain abdomen, sore throat and generalize depression. The fever of dengue has usually temperature between 39oC and 40oC and lasting for 5 to 7 days. Some patients have flushing eruption on face, neck and chest during 1st two or three days and at the end of the febrile period rash fades and petechiae (small reddish dots) may appear over the feet, on leg and on the hands and arms. Some patients have bleeding from nose, or from gastrointestinal tracts in the form of fresh red or black coloured stools. Some have bleeding from injection sites also. These patients which shows bleeding tendency has platelet count < 100000 cells/cum and this is called dengue haemorrhagic fever and if this is followed by decreased blood pressure then it is called dengue haemorrhagic fever with shock. This is very serious condition.
Diagnosis of dengue fever is done if the patient has signs and symptoms described above and some blood test are also available like Serology for dengue which will confirm dengue fever.
Treatment
The treatment have of dengue fever is symptomatic and supportive, there is no need to panic. Bed rest is advisable during acute phase. Antipyretic like Paracetamol or Cold sponging are required to decrease body temperature below 40oC. Asprin should be avoided because it increases bleeding tendency. Patient should be encouraged to accept oral fluids in the form of juices and ORS. But if the patient is not accepting orally and has excessive sweating, vomiting, loose motions and bleeds from nose or from any other sites, he/ she should immediately be hospitalized.
Dengue fever can be controlled by accepting Mosquito Control measures like Filling, Levelling and Drainage of breeding places of Mosquito, by application of chemicals or a synthetic insecticides (DDT, HCH). Mosquito can also be controlled by application of sprays. People can be protected from Mosquito bites by wearing full sleeves clothes, using Mosquito nets, screening and by application of Mosquito repellents.
(The author is senior resident in Deptt. of Medicine GMC Jammu.)
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