Dengue: Understanding the Disease

Posted Aug. 01, 2024 by Dr. Aniruddha Dharmadhikari

Introduction
Dengue fever, commonly known simply as dengue, is a mosquito-borne viral infection that has become a significant global health concern. The disease is prevalent in tropical and subtropical regions around the world, particularly in urban and semi-urban areas. Dengue is caused by the dengue virus (DENV), of which there are four distinct serotypes (DENV-1, DENV-2, DENV-3, and DENV-4). A person can be infected by each serotype independently, leading to the potential for multiple dengue infections over a lifetime.

Transmission

Dengue is mainly spread by the bites of female mosquitoes from the Aedes aegypti species, and to a lesser extent by Aedes albopictus. These mosquitoes prefer laying their eggs in stagnant water found in places like containers, discarded tires, and blocked gutters. They are most active during daylight, especially in the early morning and late afternoon.

Diagnosis

Diagnosis of dengue is primarily based on symptoms and the patient's history, especially if they have traveled to or live in areas where dengue is endemic. Laboratory tests are able to verify the presence of the virus or detect antibodies that indicate an infection. These tests include:
● Polymerase chain reaction (PCR) tests
● Dengue NS1 antigen tests
● Serological tests to detect antibodies (IgM and IgG)

Complication

The symptoms of dengue can range from mild to severe and typically appear 4-10 days after being bitten by an infected mosquito. Common symptoms include:
● High fever
● Severe headache
● Pain behind the eyes
● Joint and muscle pain
● Nausea and vomiting
● Skin rash
● Mild bleeding (such as nose or gum bleeding, or easy bruising)
In certain instances, the illness can escalate into severe dengue, which is also referred to as dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS). Severe dengue is a potentially fatal complication characterized by plasma leakage, fluid accumulation, respiratory distress, severe bleeding, or organ impairment.

Treatment

There is no specific antiviral treatment for dengue. Management of the disease focuses on relieving symptoms and supporting the patient's immune response. Key aspects of treatment include:
● Rest and hydration: Patients should drink plenty of fluids to prevent dehydration.
● Pain relief: Acetaminophen (paracetamol) can be used to reduce fever and relieve pain. Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided due to the risk of bleeding.
● Hospitalization: Severe dengue cases require hospitalization for careful monitoring and supportive care, including intravenous fluids and blood transfusions if necessary.

Prevention

Dengue prevention mainly focuses on managing mosquito populations and safeguarding people against mosquito bites. Effective prevention strategies include:
● Eliminating mosquito breeding sites: Regularly empty and clean containers that hold water, cover water storage containers, and use insecticides to treat stagnant water.
● Using mosquito repellents: Apply repellents on exposed skin and clothing, and use mosquito nets, screens, and coils.
● Wearing protective clothing: Long-sleeved shirts and long pants can help reduce skin exposure to mosquito bites.
● Community efforts: Public health campaigns and community participation are crucial in reducing mosquito habitats and raising awareness about dengue prevention.

Conclusion

Dengue fever poses a significant health risk in many parts of the world, but with proper prevention and management, its impact can be mitigated. Efforts to control mosquito populations, coupled with public education and health infrastructure improvements, are essential in the fight against dengue. Ongoing research into vaccines and treatments also holds promise for better prevention and management of the disease in the future.