HEALTH TALK: Dengue fever

I’m not going to deal with mosquitoes and all that.  The good people of the Environmental Health Department have been doing that and will continue to do so.  By the way, they’ve done a great job.  So my little contribution will be short and, hopefully, sweet.

SO WHAT IS DENGUE?

Dengue fever is an infectious disease, an illness like the flu but a little more severe with worse complications.  It is caused by the dengue virus, of which there are four serotypes or strains, belonging to the Flavivirus group.  The disease used to be called ‘break-bone fever’ because of the severe joint and muscle pain it can sometimes cause.  The virus is carried by the Aedes aegypti, and also by the Aedes albopictus mosquitoes.

SO TRANSMISSION……..

…………is not by person to person contact – it is NOT contagious.  You get dengue by being bitten by a mosquito which is carrying any one of the four strains.  Remember viruses are these terrible things which, even when magnified a few million times, will not be enough to occupy the head of a straight pin.  They cause things like Ebola, HIV, Chicken pox and a number of illnesses which are not curable.

IS DENGUE COMMON?

Well, if you consider  50 million to 100 million cases occurring per year worldwide, according to the WHO, as common, I guess it is.  And the only region of the world that seems to be spared is Europe.  Mind you, dengue is not a new kid on the block, it has been known for more than 200 years.

WHAT ARE THE SYMPTOMS?

Symptoms of classical dengue usually start with fever 4 to 6 days after being bitten by an infected mosquito.  The range is 3 to 14 days after the bite.  What you get are:

•    Severe headache
•    Retro-orbital (behind the eye) pain
•    Severe joint and muscle pain
•    Nausea and vomiting
•    Glands in your neck, groin and above the elbows
•    Rash which may appear over most of your body 3-4 days after the fever begins
•    High fever, up to 105 degrees Fahrenheit

This fever may persist for 2-3 days, after which it breaks causing you to sweat profusely.  Then, there’s a feeling of well-being for about 24 hours, after which there is another bout of fever and rash.  Usually the rash will not extend above the neck.

ANY COMPLICATIONS?

There is what is called DENGUE HEMORRHAGIC FEVER OR SYNDROME and this includes all of the symptoms of classic dengue plus

•    Marked damage to blood vessels and lymph vessels
•    Bleeding from the nose, gums, or under the skin, causing purplish bruises or purpura.

This complication can cause some deaths, but not to the extent that many of you are worried about. If a person has been infected with any of the four strains of dengue virus before, then dengue hemorrhagic syndrome is a bit more likely to occur the next time around.

By the way, one can only be infected once with any of the four dengue strains.  So theoretically one can be infected no more that four times in one’s life, unlike the cold or flu which you may get hundreds of times, as you know.

Then there is DENGUE SHOCK SYNDROME – the most severe form of dengue – which includes all the symptoms of classic dengue AND dengue hemorrhagic syndrome, PLUS

•    Fluids leaking outside of blood vessels
•    Massive bleeding
•    Shock

Pleases note that this form of the disease usually occurs in children (sometimes adults) experiencing their second dengue infection. The fatality rate is 5 to 15 percent.

DIAGNOSIS

The typical signs and symptoms are usually enough to make a diagnosis, especially if we’re in the middle of a known epidemic.  Two blood tests, 2 to 3 weeks apart, may need to be done to confirm a case.  So please, if you are asked to do this, go ahead and do it.  It would be good for you to know for sure, anyway, so that you can know if you are at higher risk of the complications from a second infection.

HOW DO YOU TREAT DENGUE, DOC?

There is no specific treatment for classic dengue fever.  Like most people, you will recover completely within two weeks.  Of course, if you get either of the complications mentioned, we are dealing with a situation that is serious, and may need emergency treatment.

The people who are most prone to problems are babies, young children and the frail and elderly.  So folks, don’t worry, don’t panic and don’t get paranoid.

Ordinarily, like most viral illnesses, you’ll be advised to

•    Take medicine to reduce fever and pain – Tylenol, Paracetamol, etc.  We advise against Aspirin.  Take note.
•    Drink lots of fluids
•    Get plenty of bed rest.

PREVENTION

As I said, the Environmental Health people will deal with this.  You need to avoid getting bitten by infected Aedes mosquitoes.  So listen to the experts and apply common sense and knowledge about how to prevent breeding of mosquitoes.

See you next week.

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2 Comments

  1. August 3, 2013

    What’s up mates, its great article about tutoringand fully explained, keep it up all the time.

  2. Tolerance Advocate
    October 6, 2011

    Thanks for the information doc.

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