What Is Dengue?

Dengue is a virus-based infection majorly predominant in the world's tropical regions. The female Aedes mosquito is the vector that transmits dengue-causing virus cells from infected people to healthy people through blood-sucking bites. The virus then transfers from the vector and enters the host to reproduce the dengue-causing virus rapidly. Dengue is commonly classified into four serotypes: DENV 1, DENV2, DENV3, and DENV4. DENV 3 and 4 are the most occurring forms of the virus. These serotypes belong to the genus Flavivirus. Outbursts of Dengue are commonly recorded in the Indian Subcontinent, Southeast Asia, southern China, Taiwan, a few countries in Central and South America, and a few islands in the Caribbean, Mexico, and Africa.

The infestation of these disease-occurring agents is commonly found near open drains, stagnant water bodies, marshy lands, and human-inhabited locations. 2007 to 2009 witnessed significant Dengue outbreaks in various parts of the world, with an alarming mortality rate of 50% in a short period. Once the DENV serotype is introduced into a new host from a viremic source, the serotype attacks the Dendritic, Langerhans, and Skin-Dendritic cells. Dendritic cells of all the other cells are important as they form a direct route for the pathogen to access and affect the lymph nodes, thereby compromising the adaptive immune responses of the host. Researchers and doctors are constantly trying to create a vaccine for dengue.

Symptoms Of Dengue

The virus cells multiply after entering the host, and it takes 2-12 days before any dengue symptoms start appearing in the host. Depending on the type of serotype, the symptoms and severity of the condition persist.

The symptoms include:

Sudden fever
High temperature
Eye pain
Nausea
Vomiting
Bleeding
Teeth pain
Nose bleed
Skin rash

Types Of Dengue

About 40% of the population of the 100 countries where dengue is endemic are susceptible to dengue. The chances of early recovery are high if the diagnosis is made in the early stages. Depending on the severity and the symptoms observed in the host, dengue is classified into:

Mild Dengue Fever
Dengue Haemorrhagic fever
Dengue Shock Syndrome

Mild Dengue Fever:

It takes up to 7 days for Mild Dengue Fever (MDF) symptoms to appear in the host. These symptoms include muscle aches, joint pains, Vomiting, High fever, and intense and prolonged headaches. When diagnosed early, dengue in this stage can be intervened with different options depending on the severity of the condition.

Dengue Haemorrhagic fever:

Dengue Hemorrhagic fever (DHF) is a severe condition or form of dengue; when left untreated or improper medication is taken, this form of dengue can be fatal. The symptoms of DHF are often seen during or after recovering from MDF. DHF usually occurs when blood is transfused through a mosquito from a viremic person. The symptoms of DHF include but are not limited to those presented by a person infected with MDF.

The symptoms are internal bleeding, sudden fever, cold chills, cold or clammy skin, bleeding and bruising under the skin, nose bleeds, restlessness, and a significant decrease in blood pressure.

Dengue Shock Syndrome:

Dengue Shock Syndrome (DSS) is generally the following condition that patients experiencing DHF transition into. In this type of dengue, the patient experiences a sudden onset of shock and high fever and is prone to sudden collapse due to a significant drop in blood pressure. The patient showcases severe headache, sore throat, and respiratory irregularities.

DSS is majorly seen in children under ten years of age. The mortality rate of DSS is currently between 6-30%. It is a severe form of dengue, and the symptoms include blood in stool, vomit, weak pulse, and spitting up blood.

Causes Of Dengue

Viremic transfer of Dengue-causing virus from a person infected with dengue to a healthy host through mosquito bites is a major cause of dengue. When a mosquito bites an infected person, the virus enters the mosquito through the bloodstream and is later released into the host when the same mosquito bites another person.

While preventive vaccines are available for dengue, a person suffering from dengue generally becomes immune to that strain of serotype. However, when a person is infected with dengue for the second time, they are more prone to developing DSS or DHF.

Dengue commonly occurs in human-inhabited areas, and disease-causing vectors rapidly breed in stagnant waters, such as open drains, water-filled disposed tyres, unattended flower vases, open tanks, and other stagnant water sources.

The global medical community is actively researching isolating and developing vaccinations that could make people immune to dengue. As of now, there are no vaccines available to prevent dengue completely. At its core, dengue is a disease predominantly caused by the Aedes mosquito, and measures to prevent such an occurrence can go a long way in preventing a Dengue attack.

Tropical countries are infamous for dengue, and it is often advised to be prepared to protect your body from mosquito bites. You can be successful in Dengue fever prevention by following these steps.

Cover your body from top to toe: When visiting mosquito-infested areas, wear long pants and long-sleeved T-shirts. Wear protective clothing like gloves, socks, and hats to leave no area of your skin exposed. It is also recommended to tuck your T-shirt ending near your sleeve into the gloves and the pants in your socks near the ankle to leave no openings for a mosquito to reach exposed skin.

Use mosquito repellants: A mosquito repellant with at least 10% N-Diethyl-Meta-Toluamide is recommended for direct skin. It will keep mosquitos away. This formula is commonly used in Odomos, Good Knight, and Mamaearth Natural brands.

If you are camping or are in a mosquito-infested area, you are advised to spray Permethrin on your clothes, tent, and other accessories. Permethrin is a substance that kills any mosquito that comes in direct contact with the substance. Sometimes, trekkers are advised to buy gear (clothes) lined with Permethrin to reduce any chance of dengue.

Install a door/window screen: Door or window screens are specially crafted to allow the free flow of air and sunlight but prevent other tiny insects from entering the house. Installing screens on doors, windows, and other inlets can go a long way in preventing dengue.

Things you can do at home: The male Aedes mosquito often breeds in still-standing stagnant waters. Ensuring no water is stagnating in flower pots, tyres, buckets, old utensils, Air-conditioning water exhausts, open buckets, and leaky pipes can prevent this. While camping, it is also advised to stay away from ponds and lakes as these water bodies can be a breeding ground for disease-causing mosquitoes.

Diagnosis Of Dengue

Complete blood work is generally required to diagnose dengue. The medical team treating the condition looks for the NS1 antigen, Immunoglobulin M, and Immunoglobulin G.

Depending on the severity of the condition, dengue can be treated at home or a medical facility. If the patient suffers from mild fever and body aches, they can be treated at home with oral hydration and Tylenol.

However, in conditions where the patient is showing symptoms of haemorrhage, internal bleeding, shock, or high fevers, it is advised to prescribe saline-based electrolytes to restore fluid content in the body. It is also recommended to steer away from steroids and aspirins.

Dengue Fever Complications

The complications of Dengue Haemorrhagic Fever include:

Bleeding under the skin
Bleeding on the skin
Patchy skin
Bloody Stool
Bloody vomit
Bloody Spit
Weariness
Cough and sore throat
Excessive sweating
High-fever
Sudden chills
Dry eyes
Decreased urine

Outlook And Prognosis

Dengue is usually a self limited disease with mortality less than 1%, but few patients develop DHF or DSS which has higher mortality.

Diagnosing dengue is often tricky as it mimics the symptoms of Malaria and other mosquito-based illnesses. The duration of the viral fever ranges between 2-4 weeks, depending on the nature of the condition. Rehydration through oral or saline drips.

Road To Recovery And Aftercare

The recovery period for Dengue patients ranges between 1-2 weeks, depending on the condition's nature and the patient's physical fitness attributes. It is advisable to consult your treating physician about the dos and Don'ts in the recovery stage. From a diet perspective, omitting oily, junk, and other fried food is advised. Adequate water and fluids should be taken.

A doctor should be informed about the patient's vitals during recovery. The dos include regular monitoring of blood platelet count, blood pressure, and adequate bed rest. The Don'ts require patients to avoid products like coffee, alcohol, tobacco, and carbonated beverages.

Dengue FAQS: All Your Concerns Addressed

Q. What is Dengue?
A. Dengue is a virus-based infection caused when a female Aedes mosquito carrying the Dengue virus is transferred into a healthy host through a viremic process. The patient suffers from headaches, nausea, high fever, muscle aches, joint pains, bloody stools, bloody vomit, bloody spit, irritable eyes, blood scars under the skin, patchy skin, and blood scars over the skin.

Q. What are the warning signs of dengue?
A. The most prominent warning sign is a high fever of 40C or 104F, accompanied by the

Following symptoms:

Headaches
Pain behind eyes
Nausea, vomiting
Swollen glands
Joint, bone or muscle pains
Rash

In the case of severe dengue, when the condition prolongs for more than 3-7 days, the signs and symptoms might turn into -

Severe abdominal pain
Persistent vomiting
Bleeding gums
Vomiting blood
Blood in the stool
Rapid breathing
Fatigue/ restlessness

Q. When should we do a dengue test?
A. Dengue fever is a viral infection that mosquitoes spread quickly from person to person. A dengue fever test is conducted to detect the infection of the dengue virus. It is mainly used for people who have symptoms of illness and have recently travelled to an infected area. It is recommended to have a dengue test if you have -

Sudden high fever (104F or higher)
Swollen glands
Rash on the face
Severe headache and pain behind the eyes
Joint and muscle pain
Nausea and vomiting
Fatigue
Severe abdominal pain
Vomiting that doesn't go away
Bleeding gums
Nose bleeds
Bleeding under the skin, which may look like bruises
Blood in urine and stools
Difficulty breathing
Cold, clammy skin
Restlessness

Some of the common tests recommended for diagnosing dengue are -

Dengue NS1 Antigen
Immunoglobulin M (IgM)

Q. Is dengue an infectious disease?
A. Generally, dengue is only caused when the virus-carrying vector bites a healthy host. There have also been occurrences when pregnant women, when affected, have seen the virus spread to the unborn child in the womb.

Q. What are the different types of dengue?
A. Dengue is majorly classified into Mild Dengue Fever, Dengue Hemorrhagic fever, and Dengue Shock syndrome. Mild Dengue Fever is the most commonly occurring form of dengue and is non-fatal. However, Dengue Hemorrhagic fever and Dengue Shock Syndrome is fatal when left untreated as the patient experiences blood loss, dehydration and a significant drop in blood pressure.

Q. Can dengue be cured at home?
A. Yes, depending on the nature of the onset condition, dengue can be treated at home. However, it is advisable to consult a medical practitioner before making a decision.

Q. Is hospitalisation required for dengue?
A. Yes, depending on the nature of the onset condition, dengue can be treated at home. However, it is advisable to consult a medical practitioner before making a decision.

Q. Is vaccination available for dengue?
A. Currently, there is no vaccination available for Dengue fever. However, the World Health Organisation and other medical communities are rigorously working towards it.

Q. Is dengue a deadly disease?
A. Dengue Fever is a deadly disease when left untreated. The mortality rate in patients affected by Dengue ranges between 20% and 50%. However, with proper medication and care, patients can recover and resume everyday lives in 2-3 weeks after the onset of the disease.

Q. What are the best foods to recover from dengue fever?
A. Here's a list of a few of the foods loaded with essential nutrients and vitamins which ensure a speedy recovery from dengue -

Papaya Leaves
A mix of herbs like tulsi, giloy, ashwagandha, ginger, and aloe vera.
Pomegranates
Coconut Water
Turmeric
Fenugreek (methi)
Orange
Broccoli
Spinach
Kiwi Fruits

Q. What should not be eaten in dengue?
A. Recovering from a dengue attack is very tough. Though there are no specific dietary restrictions, you can build an easy and fruitful recovery process by adhering to a diet -

That is less oily and spicy
Try to consume food items that are easy to digest.
Avoid non-vegetarian food
Avoid Caffeinated beverages
Up your fluid intake and
Consume warm water instead of regular water.

Q. Will Dengue spread to my baby if I'm pregnant?
A. Yes, there have been instances where the disease-causing virus was transmitted from the mother to the fetus. Pregnant women should ensure that there are no breeding grounds around their homes in the form of stagnant water in flower pots, tyres, and buckets.

Q. What is the treatment plan for a person affected by dengue?
A. no cure or treatment options are currently available in the medical community. However, there are medications that patients are introduced to deal with the symptoms, such as Tylenol, painkillers, and muscle relaxants. Along with these, the patient is asked to take adequate bed rest, including a lot of vegetables and protein-rich food like eggs, pulses, chicken, and fish, in their diet to boost blood cell count and accelerate the growth of the immune system.

Q. What do we do when a Dengue epidemic occurs?
A. When you start noticing Dengue symptoms in people around you, it is advised to alert the medical authorities and ensure that there are no breeding grounds near your residence. To ensure that you are not affected by this viral fever, installing window and door screens is a must to prevent mosquitoes from entering your home.

Q. I had dengue before. Am I immune to it now?
A. It depends on the type of serotype that you were infected with when you were first diagnosed with Dengue Fever. It is doubtful that the same patient can be affected by the same strain of virus again; however, it is more severe and fatal when the patient is concerned the second or third time.