With the onset of the monsoon season, the impact of dengue fever is gradually increasing. Therefore, it is possible to prevent dengue through public awareness and media campaigns.
Dengue is a viral disease, and there are four types of dengue viruses: DENV-1, DENV-2, DENV-3, and DENV-4. The Aedes mosquito is the carrier of this disease. Usually, symptoms of dengue fever begin 3 to 14 days after being bitten by a dengue-infected mosquito. In other words, the symptoms appear 3 to 14 days after the virus enters the human body.
Problems Associated with Dengue Fever
Blood Vessels: Dengue virus infection damages the inner lining of blood vessels, causing blood plasma to leak out. As a result, blood pressure drops, and the blood flow is disrupted, a condition medically known as shock.
Platelets and Blood Clotting: The virus damages platelets and clotting factors, increasing the risk of bleeding. The two main issues with dengue are:
Decreased blood plasma leading to low blood pressure.
Decreased platelets and clotting factors leading to bleeding.
Types of Dengue Fever Based on Severity
Classic Dengue Fever: Symptoms include fever, body aches, headaches, and pain behind the eyes.
Dengue Hemorrhagic Fever: In this condition, blood plasma leaks from the blood vessels, leading to low blood pressure along with the above symptoms.
Dengue Shock Syndrome: This is a severe form of dengue hemorrhagic fever where blood pressure drops so low that oxygen supply to body tissues is disrupted.
Expanded Dengue Syndrome: The most severe form of dengue, where the brain, heart, liver, and kidneys are affected by the virus.
Phases of Dengue Fever
Febrile Phase: Usually lasts 2 to 7 days, during which the patient may have red spots, body aches, and headaches.
Critical Phase: A dangerous phase that begins on the 4th or 5th day of fever and lasts 48 to 72 hours after the fever subsides.
Recovery Phase: Begins 2 to 3 days after the critical phase, where the patient slowly starts to recover.
Tests for Dengue Fever
Knowing which tests to perform and when is crucial for diagnosing dengue fever. Incorrect testing may lead to negative results, making diagnosis difficult. Common tests include NS1, IgM, IgG, blood count (CBC), platelet count, SGPT, and SGOT.
NS1: Typically positive from the first day of fever to the first three days, but can sometimes be positive up to 5 to 7 days.
IgM: Becomes positive from the 6th day of fever and remains so for over a month.
IgG: Indicates past dengue infection, not the current one.
If both NS1 and IgM tests are negative between the 4th and 5th days of fever, diagnosing dengue can be challenging. It’s important to note that a negative result in these tests does not 100% rule out dengue, as no test guarantees 100% accuracy.
CBC: A critical test for dengue. Clinical assessment is also done based on total count, neutrophil count, platelet count, and hematocrit levels in the CBC report. An increase in hematocrit, a decrease in WBC count, neutrophil count, and platelet count, or elevated SGPT and SGOT levels indicate the patient’s condition is worsening. Conversely, the opposite findings suggest improvement.
Clinical Assessment of Dengue Patients
Clinical assessment refers to the evaluation of a patient’s physical condition by doctors without laboratory tests. It is crucial in all diseases, but especially in dengue. Clinical assessment should consider the following:
The patient’s physical sensations and if they feel restless.
Blood pressure levels.
Presence of abdominal pain or vomiting.
Any bleeding from any part of the body.
Precautions
Remember, most dengue complications begin in the latter part of the fever or after the fever has subsided. At this stage, a sudden drop in blood pressure can lead to shock. Therefore, patients must be closely monitored in the last phase of fever or for 2-3 days after the fever has subsided.
Hospitalization
Most dengue patients do not require hospitalization. However, admission is necessary if:
A child becomes restless.
Blood pressure drops.
Severe abdominal pain or vomiting occurs.
Fluid accumulates in the abdomen or chest.
Platelet count drops rapidly.
Bleeding occurs.
Treatment for Hospitalized Patients
The primary treatment for admitted patients is to maintain blood pressure through intravenous saline and close monitoring. Therefore, if a child has dengue fever, it’s important not to panic but to seek treatment under a pediatrician’s care.
Preventive Measures for Children
Destroy Aedes Mosquito Breeding Sites: Aedes mosquitoes breed in clean, stagnant water, such as in flower pots, car tires, or coconut shells. Identify and destroy such breeding sites and keep the surroundings clean.
Use Mosquito Nets: Children should be kept under mosquito nets day and night, especially newborns. Even if a child is at the hospital for another illness, they should be kept under a net to prevent dengue transmission.
Use Mosquito Repellents: Apply mosquito repellent sprays, creams, or gels to children’s bodies during outdoor activities. Reapply every few hours.
Mosquito Repellent Accessories: If children are too young for creams or sprays, use mosquito repellent belts or patches on their clothes.
Wear Protective Clothing: Dress children in long sleeves and full-length pants to prevent mosquito bites.
Avoid Harmful Mosquito Control Methods: Aerosol sprays, coils, or fast cards can be harmful. Instead, use mosquito killer bulbs, electric lamps, or mosquito traps. Ensure these items are out of children’s reach.
Breastfeeding: If a mother has dengue, it does not affect her breast milk, so she can continue breastfeeding.
Encourage fluid intake.
Ensure complete rest.
If advised by a doctor, promptly admit the child to a hospital.
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