Overview

Dengue is a mosquito-borne viral disease spread by a particular species of female mosquitoes. Dengue is widespread, with risk influenced by rain, temperature, corresponding humidity, and unplanned accelerated urbanisation in India.

Dengue fever is a painful, debilitating disease caused by four closely related dengue viruses. These are closely connected to the viruses that are the reason behind West Nile infection and yellow fever.

Close to 400 million dengue infections occur across the globe every year, with nearly 96 million resulting in illness. Most cases occur in tropical areas of the world, with the most significant risk occurring in the Indian subcontinent, Southeast Asia, Southern China, Taiwan, The Pacific Islands, The Caribbean, Mexico, Africa and Central and South America. 

Dengue fever is transmitted by biting an Aedes mosquito infected with a dengue virus. The mosquito gets infected as it bites a person with the dengue virus in their blood. It can't be easily spread directly from one individual to another.

There are four different but closely associated serotypes of the dengue-causing virus - DENV-1, DENV-2, DENV-3, and DENV-4. These can co-circulate within a range and can have an alarming impact on human health and national economies.

Infected travellers frequently spread the virus from one place to another. Therefore, when susceptible conditions are present in areas, there is a high potential for local transmission to be established.

Symptoms

Dengue causes a broad spectrum of illnesses ranging from no noticeable symptoms to severe flu-like symptoms among those infected. Though rare, some people develop severe dengue, which can cause severe complications associated with critical bleeding, organ impairment, and plasma leakage. In addition, severe dengue can lead to death when not managed appropriately. 

The most common symptoms may include:

• Sudden, high fever
• Severe headaches
• Pain behind the eyes
• Severe joint and muscle pain
• Fatigue
• Nausea
• Vomiting
• Skin rash post 2-5 days of the commencement of fever.
• Benign bleeding (maybe a nose bleed, bleeding gums, or easy bruising)

Younger children and people who have never had the infection before have milder cases than older children and adults. However, serious problems can evolve. These complications comprise dengue hemorrhagic fever. This is a rare complication distinguished by high fever, damage to lymph and blood vessels, bleeding from the nose and gums, enlargement of the liver, and overall circulatory system failure. The symptoms may progress to tremendous bleeding, shock, and even demise. This is termed as Dengue Shock Syndrome, a.k.a DSS.

People with weakened immune systems, and those who are infected with dengue the second time or subsequently, are believed to be at greater risk for developing dengue hemorrhagic fever.

Diagnosis

 If sickness persists after travelling to a tropical area, it is best to consult a healthcare provider. Healthcare providers can diagnose the dengue infection with a blood test to check for the virus or antibodies. This will enable us to evaluate whether your symptoms were caused by a dengue infection.

Treatment

There is no particular treatment for dengue. However, one can take fever reducers and pain killers to control muscle aches, pains and fever. Acetaminophen or paracetamol are the best options available to treat these symptoms.

One should avoid non-steroidal anti-inflammatory drugs as they thin the blood and risk haemorrhage; they could worsen the diagnosis.

Experienced healthcare providers can save lives by decreasing mortality rates for severe dengue. Patients with dengue should seek medical advice upon the occurrence of warning signs. Sustenance of the body fluid of the patient is essential for dengue care.

Prevention

The best way to prevent the disease is to prevent bites by infected mosquitoes, mainly if you live in or travel to a tropical area. This means protecting yourself and making efforts to keep the mosquito population down. There is currently no vaccination to prevent the general population from contracting it.

To protect yourselves:

• Utilise mosquito repellents, even if indoors.
• When outdoors, cover the whole skin area. Wear long-sleeved shirts and long pants tucking into socks.
• When indoors, utilise air conditioning if available.
• Ensure no mosquitoes enter from window and door screens. If sleeping sites are not screened or air-conditioned, utilise nets.
• If you have symptoms of dengue, consult a healthcare provider.

Get rid of places where mosquitoes can breed. This is the best way to reduce mosquito population. Regularly change the water in pets water dishes. These include containers that collect rain.

If someone at home is infected by dengue, be especially observant about efforts to protect yourself and other family members from mosquitoes. Mosquitoes that bite the infected family member could spread the infection to others at home.

Fact Check

• Dengue is endemic in India. Transmission occurs the entire year in southerly areas and from April - to November in northerly lands of India.
• Dengue is also known as breakbone fever.
• 40% of the world's population is now at risk from dengue
• An individual can get dengue fever more than once
• Hydration with intravenous fluids is the mainstay of treatment of dengue.
• Aedes Aegypti mosquitoes are daytime biters that thrive in stagnant waters.

PGC Resolution: To support India in the confirmation, guidance and management of outbreaks through a collaborating network of laboratories.