Dengue, pronounced as Deng-gey is a fever that is caused by the virus from the Flaviviridaefamily. Dengue fever is a mosquito-borne disease and is carried by the AedesAegyptiand theAedesAlbopictus mosquitoes that usually bite during the day. Once a mosquito gets infected with the dengue virus, it remains infected all through its life cycle and human-to-human transmission does not occur.
The virus has an RNA strand genetic make-up and there are 4 serotypes that are very closely related. However, they are antigenically different enough that if an individual is immune to one strain, the individual can get infected by the other serotypes.
Dengue occurs mainly as an endemic disease in the tropical and subtropical regions of the world like Southeast Asia, the Caribbean and Latin America and the western Pacific Islands. The World Health Organization (WHO) reports that dengue infects about 50 to 100 million individuals worldwide, every year.
In Myanmar, there are about 200 to 250 cases reported on a daily basis, with about 40 fatalities reported. In the year 2014 the country reported 13,086 cases of dengue and 20255 in 2013. The Mon State reports the highest number of cases (2182), followed by Ayeyawady and Yangon.
Dengue is also known as “Dandy fever” or “Break-bone fever” due to the awkward, distorted positions and walking efforts afflicted individuals take to reduce the pain of joints.
Usually, the symptoms of dengue start showing about five to ten days after a person is bitten by an infected mosquito. In children and teenagers, there might be no visible symptoms in mild cases of dengue.
The typical symptoms of Dengue fever range from mild to severe haemorrhaging fever ranging between 104 to 106 degree Fahrenheit, headaches, severe muscle and joint pain, pain in the back of the eyes, loss of appetite, and nausea. These symptoms usually reduce in four to five days and re-occur with skin rashes all over the body.
In certain severe cases, there is severe drop in platelet count and infected individuals experience bleeding from nose and mouth, continuous vomiting, under-skin bleeding and severe abdominal pain.
When should I see a doctor?
Diagnosing dengue fever is a little difficult as the symptoms are very similar to other diseases like malaria, typhoid, leptospirosis, etc. An individual that develops the symptoms of fever, rashes, headaches and muscle and joint pain after visiting a dengue affected area should immediately visit a doctor and carry out test for dengue fever.
A complete blood test with a platelet count is advised. However, the MAC-ELISA test which is an immunoglobulin M-based test is the most common test used to detect dengue.
Any individual that has had dengue earlier and gets the symptoms again should immediately visit a doctor as they are more easily susceptible to the other three strains of dengue.
Dengue fever is a self-limited virus and usually doctors recommend increasing intake of fluids to keep the body hydrated and prescribe medicines such as acetaminophens (Tylenol), codine and other medicines that are not Nonsteroidal anti-inflammatory agents (NSAID’s). Doctors usually avoid prescribing pain killer NSAID’s like aspirins and ibuprofen as they may create bleeding complications.
Severe cases could require hospitalization, with IV hydration, blood and platelet transfusions and intensive care.
Doctors advice patients to avoid home remedies as improper treatment could increase the severity of the fever causing complications and death.
The prognosis of dengue fever is very good with proper care; however, patients could experience weakness in the first month after recovery. Severe cases and complicated cases have a 50% fatality rate if left untreated, but only a 3% fatality rate with proper care and medication.
Prevention of dengue firstly includes protection for getting bitten by mosquitoes. In areas affected with dengue, one should wear protective clothing and use mosquito repellents. Avoid dark, damp places after dark. Also concerted efforts should be taken to prevent the breeding and spread of mosquitoes.
There are vaccinations that being developed for dengue, however, they are not completely effective.