Dengue Hemorrhagic Fever

The end of the scorching summer brings not only a much-awaited monsoon, but also a spike in the diseases that go hand in hand with it. Dengue is the most common one, affecting tens of thousands of people all over the country. Since this is a disease without a vaccine where prevention is the cure, here’s a concise guide on everything you need to know about dengue in order to steer clear of it.

While the whole world struggles on with the repercussions of the Covid-19 pandemic, a more dangerous killer may be lurking in the shadows.

Dengue fever is a common mosquito-borne disease, affecting thousands of people in India every year. With medical and administrative services already stretched too thin, 2020 can be the year when dengue numbers surge significantly.

However, before you can assess how devastating a dengue outbreak could be for India, here is a quick guide we’ve put together on the disease, what it is, what are its symptoms, treatment, costs and the numerous precautions you can take to avoid it altogether.

Dengue fever refers to a viral infection that is communicated from one person to another through the bite of a specific species of mosquitoes, named Aedes aegypti.

Upon being bitten by a mosquito carrying the virus, symptoms including the onset of dengue fever can appear up to 2 weeks later. It is characterized by sudden weakness and a steep drop in blood platelet count and can also be fatal in some cases.

Dengue is also referred to as a break-bone disease, since the dengue fever can cause severe pain and discomfort in one’s muscles and bones. The pain is so acute that affected individuals can easily mistake it as pain from fractures!

Apart from India, the condition is also extremely common in certain parts of China, Central America and Africa. The dengue virus can be divided into four primary classifications, namely DENV 1, DENV2, DENV 4 and DENV 3.

The last two strains are the commonest. However, due to the prevalence of these four strains, an individual can be affected by the disease as many times.

When are Dengue mosquitoes more likely to bite?

While you may assume mosquitoes to be a nuisance at night, Aedes aegypti is a daytime feeder. Thus, they are more common during early mornings and evenings.

Residents of regions where this infection is common should undertake proper precautions at these times.  

When you get dengue, you could experience these symptoms:

• Sudden, high fever
• Severe headaches
• Pain behind the eyes
• Severe joint and muscle pain
• Fatigue
• Nausea
• Vomiting
• Skin rash, 2-5 days after the fever starts
• Mild bleeding in the nose, gums, etc.

As you can see, these are common viral infection symptoms and you might think, “Oh, it will go away in a day or two; I just need some rest.”

But they can be dangerous. While it doesn’t help to panic, it’s better to go to a doctor if you have any of these symptoms.

Around 40% of the population in the 100 countries where dengue is common is susceptible to the viral infection. (1)

As per the severity of the fever and its symptoms, dengue can be classified into three groups:

• Mild Dengue Fever - Individuals suffering from this form of the condition may start showing symptoms around 7 days post this infection. High fever, muscle and joint aches, vomiting, nausea, headaches and high fever are characteristic of mild dengue fever.
• Dengue Shock Syndrome - Patients suffering from this form of the disease will suffer from shock, high fever, and sudden blood pressure drops. These symptoms can also cause one to collapse. Additional concerning symptoms include respiratory issues. Dengue shock syndrome is the most severe kind of this viral infection.
• Dengue Hemorrhagic Fever - If dengue is left untreated for a significant period, it can progress into this hemorrhagic state. Misdiagnosis and an incorrect treatment can also cause this stage. Symptoms of such a type of dengue fever are more commonly found in people recovering from mild dengue fever. However, one should not take this stage lightly, as it can be fatal.

Who is at risk?

A tropical country like India is a hotbed for dengue fever. People of all age groups in rural or urban areas could be affected.

Since the mosquitoes can bite during both daytime and nighttime, and both indoors and outdoors, this disease becomes all the more potent since it spares none.

Doctors often prescribe a simple blood test that detects the presence of the dengue virus can confirm whether you have the disease.

You don’t need to fast before taking this test. Here’s a list of some other tests too that your doctor may recommend to diagnose dengue:

• Immunoglobulin M Test - Immunoglobulin M refers to an antibody, which is found in a person’s body when they are infected with the dengue virus. If the first three days after infection, the chances of discovering this antibody is around 50%. By day 10, this chance goes up to 99%.
• NS1 Antigen Test - This is another blood test, which offers the fastest way to diagnose the condition. Antigen forms within the affected individual’s blood in just a day or two, whereas antibodies may take up to 4-5 days to reveal its presence. The NS1 antigen test’s accuracy depletes when conducted 5-7 days post the initial infection.
  
• Dengue RNA PCR Test - Blood drawn for this test is used by lab technicians to detect the presence of dengue virus in your body. This is one of the most accurate ways of diagnosis, delivering accelerated results within five days from experiencing the first symptoms.
  
• Immunoglobulin G Test - Also known as IgG test, this is primarily used to detect the recurrence of dengue in individuals who have previously recovered from the same. Since the second or third case of infection of dengue can be more severe when compared to the first, such a conclusive test can help individuals seek the necessary treatment fast.

How much does the Dengue test and treatment cost?

The test can cost you anywhere between ₹250 and ₹600 depending on where you live, while the cost of the treatment can vary from ₹5000 to ₹5 lakhs, with an average of ₹30,000, according to this report.

Learn more about:

• Cataract Health Insurance
• Health Insurance for Diabetes Patients
• Health Insurance for COVID-19
• Health Insurance covering Daycare Treatment

The biggest concern when dealing with dengue fever is the total lack of treatment options. Rest and plenty of fluid intake are the two most common suggestions to patients suffering from the disease.

Physicians often prescribe medication to alleviate the condition’s common symptoms, rather than to fight the viral infection itself.

Since there is no cure, the treatment is to let the virus run its course. The dengue fever usually takes about two weeks to subside, and being hospitalized can be a suitable option since it ensures that you get an adequate amount of rest and are drinking plenty of water.

Depending on the fall in platelet count, a blood transfusion may be required.

Apart from hospitalization, fever and pain medication can be used to avoid excess discomfort. However, in the case of severe infections or fevers, patients may need to undergo the following as well:

• Periodic monitoring of the affected individual’s blood pressure
• In the case of blood loss, they may need to undergo transfusion to maintain healthy levels.
• Dehydration is a common issue for dengue patients, which is why intravenous electrolyte and fluid replacement may be necessary.
  

There is no one size fits all regarding dengue treatment. Each case is different, and doctors may need to adapt procedures accordingly.

Another important factor to remember here is that besides severe cases, dengue treatment can be completed at home, using home remedies.

Due to the absence of medical treatment, most individuals suffering from the condition also rely on home remedies for dengue. Some of the most reliable home remedies include:

• Drinking Sufficient Fluids - One of the most effective methods to prevent dengue complications is to drink enough water each day. Since the condition causes vomiting, drinking sufficient amounts of fluids should help your body fight off the infection.
• Fenugreek Seed Water - Patients can soak fenugreek seeds in a glass of warm water and drink this concoction in the mornings and evenings. Drinking this can help lower fever and increase your overall immunity. Additionally, fenugreek-soaked water is a rich source of fibre and vitamins C and K.
• Drinking Papaya Leaf Juice - Take a bunch of papaya leaves and grind them into a paste. Extract its juice and drink a small portion twice every day. Doing so should help boost platelet count and general immunity in your body.
• Neem Leaves - The benefits of neem leaves are numerous. In cases of dengue, steeping such leaves and drinking the liquid can help combat the symptoms. It is an easy way to rid your body of the viral infection, as soon as possible.

Note: Regardless of whether one seeks professional care or decides to follow home remedial methods, ensuring that the individual opts for an opinion from a physician is important.

A healthy combination of medication and home remedies will provide the best outcome when battling dengue.

• The medical community does not possess a cure for dengue fever. Depending on the severity of the condition, patients may even lose their lives.
• In the absence of a dengue vaccine, the only way to prevent it is by preventing mosquitoes from both breeding as well as biting you.
• Cover your body when stepping outside the home - If you stay in a dengue prone area, try to cover your arms, face and legs when venturing outside. Doing so will limit your exposure to the disease-carrying mosquitoes, preventing bites. Long-sleeved shirts, socks and gloves can help prevent dengue infection.
• Install a screen on your doors and windows - Mosquitoes tend to enter the house through windows and doors. Installing metallic screens on these spaces will restrict access to dengue mosquitoes. Simply installing such screens is not enough, one would need to ensure that this portion remains shuttered at all times.
  
• Use mosquito repellents and mosquito nets - Even when you are covered from head to toe, mosquitoes may gain access to your skin through small gaps in clothes. Using mosquito repellents will prevent an additional layer of security against such infections. Other preventative measures of dengue fever are the use of mosquito nets while sleeping.
  
• Using contraceptive methods can help - Dengue virus can spread from one person to another during sexual encounters. Thankfully, using a condom can prevent such transmissions easily.

Additional tips to prevent dengue

• Potential breeding grounds of mosquitoes are stagnant pools of water, commonly neglected buckets, flower pots, cooler tanks, or open drains. Ensure that these are cleaned or eradicated and maintain proper hygiene.
• In case your neighborhood has puddles of stagnant water, get in touch with your local authority for fumigation or other chemical intervention.
  
• In case you have a bird feeder or a pet drinking bowl or the like, ensure that the water is changed regularly.
  
• You can also opt for herbal options like neem oils or creams instead of coils to avoid any adverse side effects. 

Despite all our precautions, dengue can still strike any time. Hence, being foresighted and planning for such emergency expenditures can be helpful.