Dengue Fever (aka Break bone fever): Causes, symptoms, Diagnosis, Treatment, and prevention

By: doctormubi180@gmail.com

 

 

Overview:

Dengue (pronounced DEEN-gey) fever is a mosquito (Aedes Aegypti) borne disease caused by Flavi virus. The dengue fever is prevalent in equatorial region. Dengue can cause a range of symptoms from mild symptoms such as High grade fever and flu like to severe life threatening symptoms such as dengue hemorrhagic fever, shock and even death.

Every year Millions of cases of dengue fever infection occurs globally. The most common affected regions are Africa, south East Asia and some regions in America. An estimated 400 million dengue infections occur globally annually with about 96 million resulting in illness.

Until Now Researchers are working on vaccine but no particular vaccine is available till now, the best possible way to avoid dengue fever is not being bitten by mosquito.

 

Causes:

Four subtypes of dengue virus are mainly responsible for Dengue fever. Dengue fever don’t spread from person to person instead it is mainly spread by bite of mosquito.

The dengue fever is mainly transmitted from one person to another, by an infected mosquito biting another healthy person with no sign and symptoms..

 

 

Symptoms:

Many infected individuals don’t confront no sign and symptoms of dengue fever.

Common presenting symptoms are High grade fever Up to 40 c (104 F) along with flu like symptoms and any of the following signs and symptoms:

 

·         Headache

·         Pain behind eyes

·         Nausea and vomiting

·         Bone, Muscles and Joint pain

·         Rash

·         Swollen glands (lymph nodes)

 

 

Majority of the people with dengue fever recovers within a week and so, In certain cases Dengue fever worsens and became Life threatening. This condition is then called, severe dengue, dengue shock syndrome and hemmorhagic dengue fever.

 

The main reason for this condition is, the Blood vessels become leaky and clot forming cells (platelets) in the blood stream drops leading to Shock, internal bleeding and eventually death.

 

The Dangerous signs of dengue fever which is a Life threatening emergency can develop within a span of a day or two after bitten by mosquito.

 

The Warning signs may include:

 

·         irritability

·         Restlessness

·         Fatigue

·         Bleeding from Gums, puncture sites( wounds)

·         Blood in urine, stool or vomit

·         Severe pain in the stomach

·         Persistent vomiting

·         Bruises under the skin

·         Difficulty in breathing

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Diagnosis:

Dengue fever can be diagnosed by with blood test and antibodies in the blood against dengue infection. If you become sick after travelling to an area with prevalence of Dengue you need to see your doctor for early and prompt treatment.

Your Health care provider may suggest few blood test and radiological investigations to rule out dengue fever. The dengue fever is difficult to diagnose initially with labortary tests and radiological tests because its symptoms may be similar to other diseases like malaria etc.

The Doctor may suggest following combination of Blood tests.

Complete Blood count:

Complete blood count is the base line investigation to check for platelets count particularly, along with that hematocrit, heamoglobin level red blood cells count are also considered to rule out malaria and anemia.

 

Dengue virus antigen detection test (NS1):  -TO CONFIRM DENGUE VIRUS INFECTION

This test can be done within 1 to 2 days following dengue virus infection and is useful to detect early dengue virus infection.

Dengue serology test (IgM and IgG):

This test is done to detect antibodies against dengue virus infection produced by an individual’s immune system. These tests are most effective when performed within first four days following both primary and secondary infection.

 

In case of severe symptoms, doctors may suggest additional blood tests and radiological investigations to rule out spread of the disease. These tests may include:

Liver function tests (LFTs):

To detect elevations in serum bilirubin levels, elevated serum transaminases, and defects caused in serum albumin by Aedes mosquito virus.

Renal Function tests (RFTs):

Renal function tests are done to check the levels of creatinine that can causes variety of renal disease such as acute renal failure, acute tubular necrosis, hemolytic uremic syndrome, glomerulopathy and Nephrotic syndrome.

Echocardiography (ECG):

To check for the heart electrical activity disturbance, many patients with dengue virus infection may experience sinus bradyarrythmias, ventricular asystole, sinus tachyarrythmias, supraventicualr tachycardia (SVT) and ST and T wave changes.

 

Ultrasound abdomen (USG):

To detect conditions like ascites, serositis, fluid in the abdomen and edema of the gall bladder.

Chest X-ray (CXR):

To check for pleural effusion, pericardial effusion caused by dengue virus infection.

D-Dimers:

To check D-dimer value in the blood, D-dimer is a protein fragment made when a blood clot dissolves in your body. Dengue fever infection can increase the D-dimer levels in the blood and that can result pain in body, sharp chest pain, high fever, trouble breathing and changes in skin color of your arm or leg.

 

Treatment:

  Treatment for dengue fever is mainly supportive, no specific treatment exists till now.

Drink plenty of fluids while recovering from the dengue fever and see your doctor if symptoms exacerbates.

The OTC (over the counter) drugs mainly used are acetaminophen (Paracetamol) for fever control and muscles pain.

However in severe dengue avoid drugs like aspirin, ibuprofen and naproxen sodium. These drugs can increase the risk of dengue fever bleeding infections.

 

If you have severe dengue fever, you may need:

·         Supportive care in a hospital

·         Intravenous (IV) fluid and electrolyte replacement

·         Blood pressure monitoring

·         Transfusion to replace blood loss

 

 

Prevention:

Dengue fever can be prevented by taking various precautions:

There are few ways to prevent dengue fever infection:

Mosquito repellent Use:

Mosquito repellents should be used all over the body to avoid being biten by mosquito especially travelling to dengue endemic areas. Use mosquito repellent in areas with high populations and overcrowded areas.

Wear protective clothes:

Always use clothes with long sleeves and pants to cover your whole body to avoid being bitten by mosquitos especially in dengue affected areas.

 

Use of Mosquito nets:

Sleeping under nets can provide a double protective layer for you and your family from being bitten by mosquitoes

Avoid stagnate water to stay openly:

Always empty flower pots, vessel that are filled with water, it is the main reason of mosquito breeding. Always check stagnate water in tanks and pipes and make sure to drain properly to avoid mosquito breeding there.

Keep Your House Airy and well Lit:

Mosquitoes are found in dark and dump places, in order to avoid mosquitoes biting keep your house filled with sunlight, you can also Use mosquito specific sprays to kill their breeding places and their population.