Dengue Fever

Dengue Fever: Causes, Symptoms, Diagnosis And Treatment

Dengue fever is a mosquito-borne disease. It means you develop the problem when you get bitten by an infected mosquito. The disease, also known as breakbone fever mostly occurs in tropical and subtropical regions around the world. It has become a common disease with millions of people getting affected by it. It is more common in people living or visiting the western Pacific islands and Southeast Asia. But, data suggests the diseases are increasing rapidly in the Caribbean and Latin American regions. The disease can have no symptoms or people can manage it at home. So, the actual number of cases remains unclear. Some cases are misdiagnosed as it mimics other symptoms.

The condition has no specific cure. You can only get supportive treatment for the condition. Right now prevention is the best method to avoid complications. Reducing the mosquito habitat is an effective method to prevent the disease. No vaccine is available to prevent the disease. But, researchers are working on developing an effective vaccination for the condition. Read ahead to know more about it.

Symptoms Of Dengue Fever

Dengue Fever

Mild cases of DENV infection causes no symptoms in children and young teens. But, some people can experience symptoms four to seven days after the bite from an infected mosquito. The common symptom of the disease is high fever. So, people suffering from the condition can experience 104 F degrees fever along with two or more symptoms:

In the majority of the cases, people suffering from the fever can recover within a week. But, in rare cases, the signs can worsen and cause life-threatening complications. The complications like the following needs immediate attention:

  • Damage and leaking of blood vessels
  • The drastic drop in the clot-forming cells (platelets) in the bloodstream

People experiencing severe symptoms need immediate medical attention. It is because they can suffer the severe form of the disease. It is known as dengue hemorrhagic fever, dengue shock syndrome or severe dengue. Due to the condition, you experience signs like:

  • Severe abdominal pain
  • Bleeding from nose or gums
  • Persistent vomiting
  • Blood in stools, urine or vomit
  • Skin looks bruised due to bleeding inside
  • Trouble breathing or rapid breathing
  • Restlessness or irritability
  • Shock (cold or clammy skin)
  • Fatigue

Consulting Doctor For Dengue Fever

You need to consult a doctor when you suffer from symptoms triggered due to DENV. It is especially needed when you suffer from the signs after visiting a region experiencing the outbreak of the disease. You need to go to the emergency room when you experience the following signs like:

  • Vomiting
  • Severe abdominal pain
  • Blood in nose
  • Difficulty breathing
  • Blood in gums
  • See blood in stools or vomit

Causes Of Dengue Fever

Causes Of Dengue Fever

Breakbone fever is caused by any of the four different kinds of DENV (dengue virus). Female mosquitoes bite a person infected with the DENV. It enters the mosquito’s body and replicates it. When the infected mosquito bites another person, the virus enters the bloodstream and infects the person. Once you recover from breakbone fever, you develop immunity to the specific type of virus that caused infection in you. But, you have no protection against the other three types of the virus. When you suffer from the infection once, the chances of developing a severe form of the infection increases. The condition, also known as dengue hemorrhagic fever increases with your second, third, or fourth infection.

Transmission Of Dengue Virus

You know that breakbone fever develops due to infection from a virus. How does the virus infect humans? To understand more about it, you need to know its transmission cycle. Here are the ways of transmission of DENV.

Mosquito-To-Human Transmission

Mosquito-To-Human Transmission

In the majority of the cases, the virus is transmitted to humans through the infected female mosquito bites. The primary source of transmission is the Aedes aegypti mosquito. Other species of the Aedes type can act as the vectors of the disease. But, Aedes aegypti acts as the primary contributor and others are secondary to it. The transmission occurs when the mosquito feeds on a DENV infected person. The virus causing the disease replicated in the midgut of the mosquito. Then, it spreads to secondary tissues of the mosquito, including the salivary glands. The time taken for the mosquito to ingest the virus and transmit it to a new host is referred to as EIP (Extrinsic incubation period). The EIP for DENV can range from eight to twelve days with an ideal temperature (25-28 degrees Celsius). Other factors affecting the EIP of DENV are:

  • Virus genotype
  • Daily temperature fluctuation
  • The initial virus concentration

Once the mosquito becomes infectious, it can transmit the disease to humans for the rest of its life.

Human-To-Mosquito Transmission

Mosquitoes get infected when they bite people suffering from DENV virema. It can occur in people of the following type:

  • Individuals who suffer from suggestive breakbone fever infection
  • People who are yet to exhibit the signs associated with the infection (mostly pre-symptomatic)
  • Individuals showing no signs of infection (the asymptomatic person)

The human-to-mosquito transmission can occur two days before the infected person exhibits symptoms of the illness. It can also occur two days after the fever resolve. The high risk of the particular mode of transmission is linked with patients suffering from high fever and viremia.

Other Transmission Modes

While mosquitoes are the primary modes of transmission of DENV in humans, studies suggest other transmission modes. Evidence suggests the possibility of transmission of DENV from a pregnant mother to her newborn baby (maternal transmission). The transmission from pregnant women to their babies (vertical transmission) appears low. But, it depends on the timing of the infection during pregnancy. Unfortunately, pregnant women with DENV suffer from the following complications:

  • Low birthweight
  • Pre-term birth
  • Fetal distress

Risk Factors Associated With Dengue Fever

Some factors increase your risk of developing a fever or a more severe form of the disease. The different factors leading to the condition are:

Tropical Area

If you live or travel to tropical or subtropical areas, it increases the risk of exposure to DENV, which causes fever. The high-risk area prone to outbreak of the disease are:

  • Latin America
  • West Pacific Islands
  • Southeast Asia
  • Caribbean Islands
  • Prior DENV Infection

When you have suffered by a prior infection due to DENV, it increases the risk of getting infected again. People who get the infection again can suffer from severe symptoms.

Complications Linked To Dengue Fever

When you suffer from dengue fever, without any supportive care, it can lead to complications. The condition can trigger the following issues:

A small percentage of people suffering from fever due to DENV can suffer from a severe form of the disease. It is known as dengue hemorrhagic fever.

Dengue Hemorrhagic Fever

DHF or dengue hemorrhagic fever is a life-threatening condition. It is a fatal complication linked to the disease. The condition affects your vital organs like heart and liver. In severe cases, you can go into shock due to the sudden drop in blood pressure. So, the condition needs immediate medical intervention to avoid any complications. Not all people who get infected by DENV develop severe conditions. But, certain factor puts you at risk of the life-threatening condition. The risk factors include:

  • Have antibodies to DENV due to prior infection
  • The affected person is a female
  • Children below twelve years
  • A weak immune system (due to a medical condition, taking medication or old age)

The rare form of the disease can create havoc in your body. It leads to severe problems with different parts of your body like:

  • Damage to the lymphatic system
  • Problems to blood vessels
  • Liver enlargement
  • Failure of the circulatory system

Diagnosing Dengue Fever

Diagnosing breakbone fever can prove difficult as the signs and symptoms mimic several other diseases. A definitive diagnostic test is not available and your doctor can make the diagnosis only by eliminating the presence of other diseases with similar signs. The diseases with similar symptoms are:

  • Typhoid fever
  • Leptospirosis
  • Malaria
  • Chikungunya

Therefore, you need to see a doctor for further analysis and tests to determine the exact issue triggering the symptoms. Your doctor performs the following diagnostic tests to detect the problem conclusively:

Physical Assessment

You need to inform your doctor about medical and travel history. It will help the doctor while examining your signs. Make sure to inform the doctor about your international trip along with the countries you have visited. The dates of the travel can shed light on whether you have visited the place during an outbreak. You must also inform about contact with mosquitoes.

Blood Tests

Certain lab tests are suggested by your doctor to find evidence of the virus causing breakbone fever. But, some tests can take a longer time to come back. The test suggested are:

Total White Blood Cells Count

You need to provide a blood sample to detect the total white blood cell count. When you suffer from breakbone fever, the test reveals leukopenia. It is the low white blood count caused due to a decrease in leukocytes (the disease-fighting cells).

Thrombocytopenia

It means you have low platelets count. Thrombocytes (platelets) allows the blood to clot. When the blood test reveals less than the normal count (<100.000/mm3), it means you have low platelets. But, other diseases like septicemia, measles, rubella, leptospirosis, and meningococcemia can also cause low platelet levels.

Other tests like monitoring hematocrit levels (measuring more than 20% means danger) is necessary when you suffer from severe dengue hemorrhagic fever.

Treatment For Dengue Fever

Dengue fever occurs due to a virus. So, no specific treatment or cure is available. But, with early medical intervention, you can manage the condition and prevent any complications. The assistance and care from your doctor aids in overcoming the problem depending on the severity. Therefore, the supportive treatment options available are:

Milder Forms Of Dengue Fever

For milder forms of the fever, you can try the steps at home as per recommendations from your doctor. Never self-medicate as it can worsen the condition. The steps to follow are:

Prevent Dehydration

Breakbone fever can trigger severe vomiting and fever. So, the condition can lead to dehydration. The affected person has to drink clean water. It is ideal to opt for bottled drinking water instead of tap water. Also, use rehydration salts to replace the lost fluids and minerals.

Use Painkillers

You suffer from fever and pain as a result of the disease. So, your doctor suggests using painkillers to ease the symptoms. Paracetamol and Tylenol can ease the symptoms.

It is not advisable to use NSAIDs (Non-steroidal anti-inflammatory drugs) like aspirin or ibuprofen. It enhances the risk of internal bleeding.

Severe Dengue Fever

The severe forms of breakbone fever need immediate medical intervention. So, you need to seek assistance from your doctor. Your doctor suggests the following:

Deal With Dehydration

To deal with severe dehydration cause due to vomiting, the doctor suggests IV (intravenous) fluid supplementation. Patients who cannot fluids by mouth can get the necessary nutrition through IV.

Manage Bleeding

In severe cases, the patient suffers from bleeding. It can lead to low platelets count. So, blood transfusion is suggested when the platelet count is less than 10,000.

Hospitalization

In severe cases, your doctor suggests hospitalization. It is to allow proper monitoring. Hospitalization is needed when you exhibit the following signs:

  • You suffer from severe abdominal pain
  • The patient suffers from persistent lethargy, persistent vomiting, and restlessness
  • When the affected person suffers from the abrupt change in the body temperature. The body temperature can drop to low levels or it can change from fever to hypothermia.
  • The patient suffers from bleeding and/or looks pale.
  • Your limbs tend to become cold and clammy.
  • During the physical examination, the liver looks enlarged.

In such cases, you need medical attention and constant monitoring to avoid the worsening of the symptoms.

Preventing Dengue Fever

You can take steps to prevent the disease. You need to reduce the proximity of the mosquito breeding site. The breeding sites near human habitation increase the risk of dengue fever as well as other diseases transmitted by mosquitoes. So, to effectively control or prevent transmission of the virus causing breakbone fever, you need to combat the mosquitoes triggering the problem. People living or traveling to the area with the outbreak of the disease need to avoid getting bitten by the infected mosquitoes carrying the disease. So, you can follow some steps suggested below:

Stay In Air Conditioned Room

You can stay in an air-conditioned room to avoid mosquitoes from biting. Mosquitoes thrive on hot and humid temperatures. So, air conditioning prevents the mosquitoes to thrive.

Well-Screened House

When you sleep at night, try to avoid mosquitoes from biting you. The mosquitoes carrying the virus causing breakbone fever are active from morning to dusk. But, they can also bite people at night. So, try to sleep in a well-screened house.

Wear Protective Clothing

When you go outside, you need to wear protective clothing, which covers your body. Wearing a long-sleeved shirt and long pants cover your hands and legs from mosquito attacks. Also wears socks and shoes when you go to a mosquito-infested area.

Use Mosquito Repellent

Mosquito Repellent
Source: Amazon.com

When you are going out, use mosquito repellent like permethrin on your clothes, bed netting, shoes, and camping gear. You also have the option to buy clothing made out of permethrin. If you have exposed areas of your skin, then use a mosque repellent containing 10% of DEET concentration.

Reduce Mosquito Habitat

The mosquito carrying dengue virus live and breed in and around your house. Standing water in and around your home can act as the breeding ground for the mosquitoes. Non-dangerous things like used automobile tires, tin buckets or empty flower pots can increase the mosquito population. Eliminating the habitats where the mosquitoes lay eggs can help control their population. So, you need to empty and clean the containers holding standing water, flower vases, animal dishes, and planting containers. You need to cover the containers between your cleanings. It is also essential to undertake emergency mosquito control measures during an outbreak. So, you need to space spray the insecticides like health authorities for good results.

Community Engagement

It is important to educate others in the community on the risks of mosquito-borne disease. You need to engage the community to improve participation in vector eradication. It will help sustain the control of the mosquito population and prevent the problem.

Active Surveillance

Even after taking all the steps, you need to monitor actively the species composition. The surveillance will determine the effectiveness of the steps you take to eradicate the mosquito population. You can also monitor the prevalence of the virus in the mosquitoes. The active screenings will help decide if you are taking the right steps or you need a new strategy to manage the mosquito population.

Vaccination

The WHO (World Health Organization) feels the use of the vaccine is not as effective as other tools. The vaccination alone cannot reduce the disease in areas that experience the outbreak commonly. The effective method to avoid the condition is to control the mosquito population and human exposure. If you are traveling abroad to areas experiencing the outbreak, then you can consider getting the vaccination.

The vaccine (Dengvaxia) is approved for use in people aged between nine and forty-five. It is only recommended for people living in areas with a high incidence of breakbone fever. The vaccination is provided in three doses over a period of twelve months. It is effective in preventing the infection more than half the time. The vaccination is approved only for older children (nine years and more) as young children are more at risk of developing complications. They suffer from severe dengue fever and need medical attention two years after receiving the vaccination.

Other Tools

Several types of research among different international collaborators give hope of finding new tools and innovative strategies to prevent the disease. It aids the global efforts to prevent the transmission of the disease as well as the other mosquito-borne diseases. These approaches are supported by WHO for achieving an effective and sustainable

Conclusion

Dengue fever can cause death without proper supportive care. You need to see the doctor to get advice on the best steps to beat the virus. With the best care, you can overcome the condition effectively and return to your normal routine. The worst symptoms of the disease occur within the first two weeks of developing the disease. In most cases, people affected by the disease can recover fully within a few weeks. The disease causes fatal complications in a small percentage of cases. It is important to avoid the disease from developing into a hemorrhagic fever as it can lead to severe issues. Without treatment, infected people can face death. Therefore, get the necessary supportive treatment to prevent any severe complications.

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