Dengue is not a word which is heard in every walk of western life but indeed it is a giant killer in developing nations. I come from New Delhi where I am working as Physician (Internal Medicine) . Over last couple of years ,I have noticed a surge of dengue and chikungunya( both mosquito related diseases) and more number of people or dying or developing debilitating joint problems later on in their lives.
So what is Dengue fever?
The dengue virus complex comprises four antigenically related but distinct viruses, designated dengue virus serotypes 1 through 4.
All dengue viruses are mosquito-borne human pathogens that exclusively cause acute infection.
Yes,this guy with white stripes, kills! Watch out!this critter is bad...bad........real bad.
Its like Al- Qaida of mosquitos.
Day biting – normally catches us unaware
Loves / lives in fresh water in homes
Lays eggs preferentially in jars, discarded containers, coconut shells, old tires etc.
Year round breeding
Tropical regions like our mother India are its favorite zones.
It is an urban mosquito
So What happens when you do get dengue infection?
2–7 days after the mosquito had its dinner on us we may develop
Sudden onset of fever, chills, headache.
Back pain with severe muscle and joint pains
Pain behind the eyes and on moving the eyes
Nick name - Break bone fever- pains so severe
Red patches or spots on the skin ,mild nose bleeds.
This is the ordinary classical ,Non dangerous form!
Petechiae
Sub-conjunctival Hemorrhage.
The Blood tests need to be done:-
Routine blood test(CBC,Liver function,kidney function)
Tests to check the clotting process(PT/APTT/INR)
Special tests to identify the Dengue or its foot marks in our blood(Dengue NS1 Antigen,IgM Dengue)
Urine to check protein leak
How do we treat this monster?
Supportive measures – Acetaminophen for fever,fluids plenty of.
Avoid NSAIDS( say no no to Ibuprofen)
Steroids should not be used
Plenty of water and salt are required
Children below 12 require careful watch
No antibiotics are of proven value
Monitor Platelets on regular interval.
If someone develop low blood pressure or bleeding from nostrils,oral cavities or from any other source ,should be admitted and may need Platelet transfusion.
unfortunately due to lack of resources many people die in India.
There are some misconception about dengue.
Severe Dengue is only a childhood illness – No, All ages may be involved
Sever form is a problem of poor families – No, The effluent do get very sick
What we can do to control it?
Mosquito control is the answer.
Do not allow empty vessels, coconut shells, plastic containers, flower pots, tires etc to collect rain water in them.
Frequently (once in 2-3 days) empty all water storage containers.
Cover your over tanks to prevent mosquitoes breeding in fresh water.
Screen your homes with mosquito screens like Netlon -
Wear full clothing – long sleeves
Apply mosquito repellents like Odomos
Keep Dengue fever patient under mosquito net
True community participation is key
I often get baffled when my patients ask me that why we are not able to find a cure for it like how we have a cure for malaria. Unlike Malaria, Dengue is a viral disease and we all know that we do not have a definitive cure for viral conditions.
So what can be done? Should we just ignore the general health of 1.5 billion peoples of South asia?
I am driving a movement for dengue/ chikungunya awareness in rural part of northern India and opened a community clinic where i offer my services with a nominal cost( I charge 1.5 $ ). With help of government and International community We can find a solution of Dengue and other mosquito borne diseases.
