In the last few weeks, I have had a fair few patients require dengue fever treatment.
The condition, while just slightly worrying, like any other medical condition is associated with significant morbidity and mortality.
That does not mean, however, that if you are diagnosed with dengue fever that you need to start panicking.
Those of you who read my blog will be aware that I am a big believer of patient empowerment. Information – the right one – in such a situation, is invaluable.
So today, I thought I would talk about dengue fever symptoms and treatment, concentrating mostly on what you should do if you (or a loved one) are diagnosed with this condition.
What Is Dengue Fever?
Dengue fever is a viral illness that is spread to humans through mosquitoes. It is prevalent in tropical countries, and is particularly common in India. Only recently, an epidemic of Dengue was declared in Bangkok, Thailand.
How Does It Spread?
They spread through mosquitoes. I hate those little critters.
The striped Aedes aegypti and Aedes albopictus mosquitoes are the ones that carry the virus. They bite an infected person, transport the virus in their full bellies, then bite another person, transmitting the virus to them.
However, do note that the virus cannot transmit from person to person. It is not like the common cold.
Without mosquitoes, dengue cannot spread. It probably would not affect humans.
Now, if you have been bitten by a mosquito, how long would it take for dengue to develop?
Once you have been bitten by a mosquito carrying the dengue virus, it takes between 3 to 15 days for dengue to manifest.
This means the virus takes that long to multiply in the body, leading to symptoms of dengue.
Dengue Fever Symptoms
Before we delve into dengue fever treatment and prevention, let’s take a brief look at the symptoms of dengue fever.
This is the first dengue fever symptom. It starts with high fevers of around 102 – 104 degrees F and can fluctuate over a course of 4 to 5 days. After that, the temperature begins to settle down.
Associated with the fever is a feeling of being unwell. Non specific body pains and even headache can accompany the fever. In my experience, I have generally found dengue fever patients to have a headache that affects the front of their head (over the forehead).
Low Back Ache
As a part of the body aches, low back ache is also a common problem. In some cases, it can be unbearable.
Bleeding from the gums, nose and throat may be seen, especially if the platelet count (blood clotting cells) is low.
Bleeding becomes a concern if a patient starts to vomit blood or notices blood in the stools (or jet black tarry stools), indicating bleeding in the gut.
Individuals who start to bleed profusely might have developed a more severe form of dengue fever called dengue hemorrhagic fever. This is a serious condition that could be life-threatening in up to 50% of patients. However, it tends to be seen in children, including infants under the age of 1 year.
Swollen Lymph Glands
In some patients, lymph nodes may be swollen in the groin and the neck. This may not be present in some patients though.
A diffuse rash can develop all over the body, affecting even the hands, feet and the face. This rash may or may not be itchy.
It is usually seen around the 4th day of illness. Medication is rarely needed, and the rash tends to disappear in 1 or 2 days.
Nausea And Vomiting
Patients with Dengue fever may experience abdominal discomfort along with nausea and vomiting.
I have listed the common symptoms above, but not every patient has them all. Some have a milder form of the condition, while in some it starts off in a lot more serious manner.
A diagnosis of dengue fever can be made clinically by a doctor to some extent. However, it does require tests to confirm the diagnosis.
A dengue NS-1 test is a slide test where a drop of blood is placed on a slide. If the virus is present in the blood, then a ‘red bar’ appears on the slide.
The more definite test is a dengue serology test, that looks for antibodies called IgG and IgM. They tend to appear a little later in the disease, so the NS-1 test is useful for early diagnosis.
Blood counts to check the level of platelets in the bloodstream is an important test. Dengue fever can suppress the bone marrow, leading to low platelet counts.
Given that the normal platelets we produce in our body only have a life span of 12 hours, new platelets are not formed to replace these old ones.
Some patients require daily platelet count testing to guide dengue fever treatment. If the values drop to extremely low numbers, patients may need admission for observation.
Dengue Fever Treatment
Most patients with dengue fever only need observation. Hospitalization is generally not indicated, provided they can be watched in the outpatient department closely by their doctor.
Daily blood tests to assess platelet count, and examination by the doctor to look for any signs of bleeding and complications is often all that is needed.
High fever is treated with paracetamol, usually given 4 times daily. Under caution, doctors may prescribe stronger medications such as Ibuprofen and other non-steroidal anti-inflammatory drugs, as these may worsen bleeding in patients with low platelet counts.
Never self medicate yourself with over the counter medications without the approval of your doctor.
Papaya leaf extracts has been found in clinical trials to be helpful in preventing platelet count from reducing drastically. While it might taste bitter, it has its benefits.
For those who cannot tolerate papaya leaf extract juice, oral medication containing the same is now available.
Dengue Fever Prevention
The image below gives you all the steps of preventing dengue fever.
As you can see, there are many simple steps depicted in the above image that can help dengue fever prevention.
Bottom line – Do your best to avoid getting bitten by mosquitoes!
Is Dengue Fatal?
Most patients with dengue fever recover fully. It can take around 3 to 4 weeks to see full recovery though.
It is estimated that only 1 – 2% of people with dengue die from the condition. Around 2.5 – 3% of patients with dengue hemorrhagic fever succumb to the illness.
In A Nutshell
Here is a video I made that talks about dengue fever treatment and what to expect.
Dengue fever is rising again, and it is time to take steps now. If you are experiencing any of the symptoms discussed above, you may have dengue fever. Get yourself checked out as soon as you can and get the right dengue fever treatment on time.