[ Hindi version ]
Dengue fever or breakbone fever is an infectious disease caused by dengue virus. This fatal viral ailment is transmitted by several species of Aedes mosquitoes in the tropics and subtropics regions. Sofar, there has been no specific clinical remedy such as vaccine to cure it completely. However, thecommonly practiced medical treatments can minimize the symptoms. A sudden onset of heavy headache,fever,nose and gum bleeding, vomiting, skin rashes,muscles and joint ache and lymphadenopathy indicate the symptoms of dengue. People with weak immunity system are most likely to get infected by the virus. Children below 10 years of age are prone to dengue hemorrhagic fever (DHF) which is a more serious form of this illness. It can lead to even death if not detected and treated on time.
Dengue fever is also known by the term breakbone fever due to the muscle contortions, tremendous muscle and joint pain it causes. Thesymptoms of fever begin to appear from 3 to 7 days after getting exposed to the virus. The breakout of this epidemic is noticed mainly during the rainy season in the tropical regions of West Indies, Puerto Rico Island and Asia (India,Singapore,and Thailand). The other geographical areas which have been identified as high risk areas are U.S, Cuba, Latin America, South pacific, Brazil,Bolivia,Paraguay, Venezuela and Middle Easterncountries. More than 100 million cases of dengue fever are reported worldwide each year, among which nearly 23 thousands are of minors.
The history of dengue in a nutshell
“Dengue” the word has been came from theSwahili phrase called “ka-dinga-pepo” which means “severe cramp and seizure produced by an unknown evil power”. The word “dinga” owes its origin to one Spanish term “dengue” which is used for describing a being suffering from acute bone pain (hence, the name breakbone fever). InWestIndies, dengue is known as dandy fever since the patients develop the posture of a dandy. The first ever report of this disease was recorded in Chinese medical encyclopedia between 265-420 AD). In the late seventies, the disease slowly spread in the different regions of Asia and Africa. Benjamin Rush, just a year before it, coined the term “breakbone fever”. Theactual fact that it is a mosquito-borne viral disease was discovered in the 20thcentury after the post-world war II.
About the dengue virus
The chief culprit of dengue fever and dengue hemorrhagic fever is DENV (Dengue Virus). It is a type of flavivirus borne by Aedes mosquitoes. It is a notorious member of the Flaviriadae.this genus has a single stranded RNA positive strand. The four general serotypes of this virus is DENV-1, DENV-2, DENV-3 and DENV-4. Each serotype indicates a group of antigenically similar viruses. Infection by any of these subtypes forms a life-long immunity against the infecting type along with a short-lasting cross protection against the other types. The second infection causes more damage than the first infection in most cases.
How does it spread?
In order to protect yourself from the clutches of this fall disease, one needs to amass a good deal of knowledge on how the infection spreads. Dengue is transmitted from one person to another by Aedes aegypti mosquito, commonly found in the western hemisphere. Thereare other transmitters of the virus as well but Aedes is considered as the most important among all. The mosquito bites a person who already has the virus in his blood, theperson may or may not show the symptoms of it by then. After a week or so, when the same mosquito bites a non-infected person, the virus is transmitted to his body. In the non-tropical areas, the virus is said to be transmitted by tourists returning from the affected places. Thedisease, howeverthe virus is not contagious and does not spread by human to human.
Factors promoting the disease include:
- Overpopulation in the unplanned urban areas. Due to overpopulation, giving proper attention to the public health security becomes tough. It leads to the poor maintenance of the sewage and drainage system.
- Humidclimate increases viral transmission.
- Presence of stagnant pools promotes mosquito breeding.
Symptoms and signs
Dengue hemorrhagic fever or DHF lasts for about a week. The general signs and symptoms includes nausea, constantvomiting, intense abdominal pain, breathingproblem, muscle pain etc.in the first two days of the exposure, the capillaries or blood vessels become leaky to a great extent. It allows the fluid component to run out of the capillaries into the peritoneum. It leads to severe ascites and pleural effusions. This sudden shock heavily affects the circulatory system of the body, often resulting in the failure of the system and ultimately death if left untreated. Patients of DHF are characterized by low platelet count which makes them prone to hemorrhagic symptoms like easy bruising, internalbleeding, nose and gum bleeding.
In case of general dengue fever, theincubation period lasts for 2-15 days with signs and symptoms consistent with those of dengue hemorrhagic fever. Different symptoms appear in different stages of the ailment. It usually begins with red rashes (Petechiae) develop all over the skin, followed by high temperature (104o F) with bradycardia or low heart rate and low blood pressure, intenseheadache, vomiting,poor appetite and muscle contortions.in the next stage, the eyes are reddened and lymphadenopathy or swollen lymph nodesoccur. Fever and other symptoms remain for 3-5 days.
Then a sudden drop in the body temperature with heavy sweating is noticed. This is followed by a period of normal temperature which might give an implication of recovery. But a rapid rise in the temperature occurs the very next day with characteristic pale pink rashes appearing under the skin. The blister covers the palm, soles, back, chest leaving only the face area. Approximately 40-50 percent cases of dengue results in death. Being infected by any one of the five serotypes of virus builds immunity for a lifetime to that particular strain but does not protect the patient from the other types. Itis possible to get affected by dengue fever multiple times. Youngchildren, who have been contracted by a serotype, develop less intense sickness than the adults. According to the reports of the U.S centres for disease control prevention (CDC), more than 40% of the world’s population lives in the risk prone areas.
Clinical diagnosis
The medical treatment usually begins when the patient develops more than two to three typical signs of dengue. People with complaints of consistent muscle ache, difficulty in moving the pupil, redblisters, rise and drop of temperature within short intervals during the rainy season must visit the nearest hospital immediately. It’s quite tough to detect the dengue as the symptoms coincide with those of other viral diseases, mostly with chikungunya fever. The Food and Drug Administration (FDA) has approved a blood test called DENV Detect IgM Capture ELISAto diagnose the dengue patients.
Since it is a mosquito-borne viral disease, there is no specific antibiotic for it invented so farther general dengue treatment focuses on providing relief from the symptoms by reducing the intensity of it. The patient needs to be given a constant supply of fluid combined with adequate rest. Some doctors recommend nonsteroidical painkillers like aspirin to reduce the inflammation. Suchmedicines should be used with discretion as it increases the risk of bleeding complication. Acetaminophenand codeine can effectively reduce the headache, joint and muscle pain. Fullconvalescence takes more than a month.
The death cases are more common in DHF rather than typical dengue fever. Patients with DHF must be observed closely for the first few days of the onset of fever for the dengue shock syndrome may occur and recur within a certain interval. Cyanotic patients who develop a bluish tint require oxygen supply from an external source. Fluid replacement is given in case of vascular collapse. The treatment also concerns with blood transfusion to control the excessivebleeding. The mortality of typical dengue fever is 1% whereas it shoots up to 2.5% with DHF. Lack of proper treatment on time can extend the rate up to a massive 20%.
Ongoing vaccine research
The scientific researches for developing a proper dengue vaccine are going on full swing. The main obstacle is the four different serotypes of dengue virus. Itis challenging to create a single vaccine that can fight against all the types. A successful vaccination against one subtype can cause DHS when the injected person is infected by another type, becauseof the antibody-dependent enhancement factor. A vaccine that protects against all the dengue serotypes need to be a tetravalent vaccine.
Prevention tips
Since dengue is a mosquito-borne illness, the breeding of mosquitoes must be restricted so as to eradicate the transmission of the virus. People in the plagued nations are advised to sleep under mosquito netting during the night. The stagnant water bodies should be closed, garbage and trash cans should be cleaned on a regular basis as an integral part of mosquito control. Below is mentioned a number of useful dengue prevention tips:
- Mosquito control: Although mosquitoes can bite at any time of the day, the peak biting activity hour of Aedes aegypti is during the daytime. If you are going to be exposed to outside in the day time, make sure to use a skin-friendly mosquito repellent cream. The ideal breeding ground for mosquitoes is stagnant water pools and open drains. Clear all the stagnant water surrounding your home. Always keep the flower pots at your home well-covered,do not fill the containers, buckets with excess water.
- Prevent transmission: Be extra careful if you already have an infected person at home. If the same serotype that has infected the person previously bites anyone else, the virus will be transmitted to that person.
- Always use under the mosquito net to keep mosquitoes at bay when you are sleeping.
- Keep mosquito-killer sprays and coils handy.
- Clear the water tray of the cooler regularly. Dirty water tray is another very common breeding ground for the mosquitoes.
- Planting tulsi plants is a natural method for restricting the breeding of mosquitoes. Lightcamphor in your room in the evening, close all the doors and windows to block the entry of mosquitoes.
Popular home remedies for preventing dengue
The outbreak of dengue fever can be eliminated with the help of adequate awareness and effective precautions. In the obscure rural areas, where clinical treatment and scientific prevention methods are yet to be accessible by the majority, traditional home remedies for dengue prevention are being used and acknowledged by generations after generations. Theaim of these herbal aids is to detoxify the body, reduce the intensity of the symptoms and boost the power for recovery. The most extensively followed natural remedies are:
- Papaya leaf juice is a natural medicine for raising the platelet count in the blood. Dengue hemorrhagic fever results in serious platelet deficiency. The most fatal form this can lead excessive bleeding and delayed blood coagulation, ultimately causing the death of a patient. Papaya leaf juice can be supplemented with standard clinical therapy. 50 gm. of freshly extracted juice from Sekaki papaya should be given to the patient during the sickness period.
- Tawa-tawaherb is a native to land of Philippines and is known to possess amazing anti-viral properties. The botanical term of tawa tawa is Euphorbia Hirta. Like papaya juice, it also helps to elevate the platelet count in the blood by blocking the leakage of the blood vessels.
- Paste of neem leaves and neem oil are used for the purification of blood and healing of the ailment. Use a damp cloth to apply 20-50 gm. of neem oil daily
Initiative of WHO
WHO (World Health Organization) has issued dengue guidelines, resources and documents for the control and prevention of the outbreak in the high risk areas. In the southeastern Asia, emphasis has been placed upon public health awareness campaigns, active involvement of ministry and student community, garbage cleaning and vector surveillance. An audio-visual guide has also been provided to health centres for the early detection and proper diagnosis of the ailment. Manuals describing the isolation guidelines for viral hemorrhagic fever for the purpose of controlling virus transmission have been published. Aguideline, with the help of the leading physicians around the globe has been created to help the doctors provide essential treatment and deduce the intensity of the epidemic.
[ Hindi version ]
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