Health Alert: Dengue! Everything You Need to Know
|   Aug 12, 2016
Health Alert: Dengue! Everything You Need to Know

Every year, parents usher in with dread, the ‘dengue season’ – which has been termed by experts as the world’s most rapidly spreading mosquito-borne viral disease. 

Let us understand some of the key aspects of Dengue & how to protect your kids from it!

What is dengue fever?

Dengue fever is an infection caused by 1 of the 4 type of viruses called the ‘dengue viruses’. They are related to each other, but are not exactly the same. Getting sick from one dengue virus does not protect a person from the others and hence it is possible for a person to contract dengue fever more than once.

Is it true that Dengue mosquitoes bite only during the day time?

Dengue fever is spread by mosquitoes that carry dengue viruses which bite mostly during the day time but they can bite at any time of the day, so precautions have to be taken throughout the season. The mosquito resides in dark places and breeds on the collections of water. Hence it is important that all water bodies inside the house or stagnant water be removed during the season.

What are the symptoms of dengue fever?

Symptoms usually happen 4 to 7 days after a bite from a mosquito that carries dengue virus and symptoms usually last between 5 to 7 days.

Dengue fever symptoms are different for each person. They can be mild or severe. They can include:

• Fever

• Headache

• Pain behind the eyes

• Joint and muscle pain

• Rash – This can be flat or have small bumps. It might be itchy. A rash is more common in people who have not been infected with a dengue virus before.

• Stomach problems, such as nausea, vomiting, and diarrhea

• Cough, sore throat, and stuffy nose – The throat might look red.

• Red eyes

Children and younger people often have less severe symptoms. People who had dengue fever in the past and get infected with a different dengue virus have the highest risk of severe symptoms.

A person with severe dengue fever might:

• Have bad belly pain

• Get bruises without bumping into anything –small purple spots may also appear on the skin.

• Vomit blood

• Get nosebleeds

• Have black bowel movements

• Have fits

Why should I visit a doctor since it is mostly self-resolving? 

You must visit a doctor if your child is showing any of the above symptoms beyond 2-3 days, as a physical examination by medical personnel would be able to tell if there is a progression to severe form and likelihood of developing low blood pressure and bleeding.

Do Dengue mosquitoes die in winters?

Mosquitoes are cold blooded and prefer temperature over 80 deg Fahrenheit. At temperature less than 50 deg Fahrenheit, they go into the HIBERNATION for the winter. The adult females of some species find holes where they wait for warmer weather, while others lay their eggs in freezing water and die. The eggs keep until the temperatures rise, and then they hatch.

Is there a test for dengue fever?

Yes. A doctor might be able to tell if you have dengue fever by doing an exam and learning about the symptoms but may need confirmation by the laboratory. There are two kinds of tests done to find out about the dengue virus presence in the blood. One is NS 1 antigen which could be positive on day 1-2 of the illness and antibody IgM Dengue test which becomes positive after 4-5 days of illness. However, doing a test very early in the illness is of no value as TLC count and platelets maybe low.

Once the dengue fever is confirmed, the doctor may have to repeat the tests to look for increasing hemoglobin (which indicates fluid losses) and decreasing platelet counts.

Sometimes in cases of doubt, the doctor may order an ultrasound of lung or abdomen to look for evidence of fluid collection.

How is dengue fever treated?

There is no treatment for the virus that causes dengue fever, but doctors can treat the symptoms. Most children would be managed with medications to control fever. Paracetamol is the safest! However use of Mefanamic acid or Ibuprofen should be avoided because of risk of bleeding. If fever does not come down with Paracetamol, then first try sponging the baby with tap water to reduce the fever. Vomiting or loose motions might need medications based on the symptoms. If the child is being managed on the OPD basis, then it is important to see the doctor couple of times in the next few days to look for progression and blood pressure measurement. Keep giving plenty of fluids of any kind to your child. Children with symptoms of severe dengue fever should be hospitalized and may need aggressive fluid therapy or platelet transfusions.

Can dengue fever be prevented?

Yes. The best way to prevent dengue fever is to avoid the mosquitoes that carry it.

You can

• Make kids stay inside during the day, when the mosquitoes that carry dengue fever are most active. Buildings with screens and air conditioning are safest.

• Make your children wear shoes, long-sleeved shirts and long pants especially when you send them outside to play.

• Drain any standing water near your home, such as wading pools, buckets, and potted plants with saucers. Mosquitoes breed in standing water.

• Make sure you apply some mosquito repellant on the child skin when he or she is going out.

• Mosquito repellant creams or lotions should be applied to the exposed areas when the child is going out to play. Advanced Odomos cream or other DEET containing products are ok to use for children. Products containing more than 30% DEET should not be used as they tend to cause skin allergies sometimes.

• Natural products like Odomos naturals or other citronella or eucalyptus based products are good but a little less effective than the chemical based products.

• Wrist band or mosquito patches etc. are not effective as they don't cover all parts of body e.g. face, neck.

What care should be taken especially for children, after coming out of the illness to avoid a relapse, if any?

If cured, the child generally has no long term complications but the weakness tends to persist for long and as discussed if the child has the illness the second time, it is likely to be more severe and hence the need for more stringent mosquito bite prevention.

Is there a dengue virus vaccine available?

Clinical trials are going on to test the effectiveness of the dengue vaccine in some parts of the world but at present there is no vaccine for dengue fever yet.

What is the role of papaya, goat milk etc in treatment of Dengue fever?

Most of the remedies have been propagated without evidence and hence may be dangerous if relied upon. Papaya leaves have been shown in few studies to increase platelet count but the benefit is only marginal and has not been shown to reduce the death rates. Also more children die because of the low blood pressure (shock) state rather than the platelet count, on which papaya leaves extract has no documented effect.

So, it’s in best interest to prevent yourself & your children from the dengue mosquitoes by adhering to the preventive measures. In this case, it definitely stands true – Prevention is better than cure!

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