Dengue Fever and Dengue Haemorrhagic Fever

General

Causative organism - Dengue is an acute fever caused by a virus. It occurs in two forms:

• Dengue Fever
• Dengue Haemorrhagic Fever

Dengue fever is characterized bythe onset of sudden high fever, severe headache and pain behind the eyes, muscles and joints. Dengue Haemorrhagic fever (DHF) is a more severe form, in which bleeding and leading to death probably secondary to shock. It is most serious in children. Symptoms of bleeding usually occur after 3-5 days of fever. The high fever continues for five to six days (103 – 105⁰ F or 39- 40⁰ C). It comes down on the third or the fourth day but rises again. The patient feels much discomfort and is very weak after the illness. Dengue spreads rapidly and may affect large number of people during an epidemic resulting in reduced work productivity, but most importantly causing the loss of lives.

Symptoms of Dengue Fever

• Sudden onset of high fever
• Severe headache (mostly in the forehead)
• Pain behind the eyes which worsens with eye movement
• Body aches and joint pains
• Nausea or vomiting

Symptoms of Dengue Haemorrhagic Fever and ShockSymptoms similar to dengue fever plus, any one of the following:

• Severe and continuous pain in abdomen;
• Bleeding from the nose, mouth and gums or skin bruising;
• Frequent vomiting with or without blood;
• Black stools, like coal tar;
• Excessive thirst (dry mouth)
• Pale, cold skin
• Restlessness or sleepiness

Treatment

There is no specific medicine for the treatment of the disease. However proper and early treatment can relieve the symptoms and prevent complications and death. Aspirin and ibuprofen should be avoided in dengue fever, as it is known to increase the bleeding tendency and also it increases the stomach pain. Paracetamol can be given on medical advice. If one or more signs of Dengue Haemorrhagic fever are seen, take the patient to the hospital immediately. Give fluids to drink while transferring the patient to the hospital.

Basic Facts on Dengue to be considered

• Spreading of dengue - Dengue is spread by the bite of an infected mosquito Aedes aegypti. The mosquito gets the virus by biting the infected persons. The first symptoms of the disease occur about 5-7 days after an infected bite.
  There is no way to tell if a mosquito is carrying the dengue virus. Therefore, people must protect themselves from all mosquito bites.
• The mosquitoes live in -The mosquito rests indoors, in closets and other dark places. Outside, they rest where it is cool and shaded. The female mosquito lays her eggs in water containers in and around homes, schools and other areas in towns or villages. These eggs become adult in about 10 days.
• Breeding ground for mosquitoes - Dengue mosquitoes breed in stored exposed water collections. breeding places are Barrels, drums, jars, pots, buckets, flower vases, plant saucers, tanks, discarded bottles, tins, tyres water cooler, etc. and a lot more places where rain-water collects or is stored.

Prevention of Dengue

All efforts of control should be directed against the mosquitoes. It is important to take control measures to eliminate the mosquitoes and their breeding places. However, the efforts should be intensified before the transmission season (during and after the rainy season) and at the time of the epidemic.

Prevent Mosquito Bites

Dengue mosquitoes bite during the daytime. The bites from mosquitoes can be prevented by. 

• Wearing full sleeve clothes and long dresses to cover the hands and legs
• Repellent – care should be taken in using repellents on small children and the elderly
• Use mosquito coils and electric vapour mats during the daytime to prevent mosquito bite which can lead to dengue
• Use mosquito nets – to protect babies, old people and others, who may rest during the day. The effectiveness of such nets can be improved by treating them with permethrin (pyrethroid insecticide). Curtains (cloth or bamboo) can also be treated with insecticide and hung at windows or doorways, to repel or kill mosquitoes.
• Protection of people sick with dengue – Mosquitoes become infected when they bite people who are sick with dengue. Mosquito nets and mosquito nets and mosquito coils will effectively prevent mosquitoes from biting sick people and help stop the spread of dengue.

Prevention Multiplication of Mosquitoes

Mosquitoes which spread dengue live and breed in and around houses.

• Drain water from coolers, tanks, barrels, drums and buckets, etc.
• There should be no water in coolers when not in use;
• Remove from the house all objects, e.g. plant saucers, etc. which have water collected in them;
• Remove water from refrigerator drip pans every other day;
• All stored water containers should be kept covered all the time;
• Discard solid waste and objects where water collects, e.g. bottles, tins, etc.

Always Remember

• Dengue is a serious viral disease transmitted by the bite of the mosquito.
• Dengue mosquitoes bite during the day.
• Dengue infection occurs in two forms: Dengue fever and Dengue Haemorrhagic Fever.
• Dengue fever is a severe flu like illness that affects older children and adults but rarely causes death.
• Dengue haemorrhagic fever (DHF) is a more severe form, in which bleeding and occasionally shock occur, leading to death, mostly in children.
• Persons suspected of having dengue fever or DHF must see a doctor at once. Dengue haemorrhagic fever is a deadly disease and early recognition and treatment can save lives. Unless proper treatment is given promptly, the patient may go into shock and die.
• Severe abdominal pains (black stools), bleeding on the skin or from the nose or gums, sweating, cold skin are danger signs. If any one of them is noticed, take the patient to a hospital immediately. Give fluids to drink during transfer to the hospital.
• Give nutritious food and fluids to drink to the patients. 
• The patient should be kept under a mosquito net or in a screened room during the period of illness. 
• Screen your rooms against mosquitoes or use mosquito nets or use mosquito repellent.
• Discard objects in which water collects, e.g. tins, cans, coconut shells, etc.
• Do not allow water to collect in pits around your houses. All stored water containers should be covered all the time. This will prevent breeding of Dengue mosquitoes, and
• Doctors and health workers treating cases of dengue fever should also notify the health authorities.