The Complete Guide to Understanding Dengue Fever

Dengue Symptoms, Transmission, Risk Factors, Vaccination, Prevention, and Treatment are all briefly explained.

 Dengue; 

Dengue is a mosquito-borne and pandemic-prone viral infection in many parts of the world. 

Virus: Dengue is caused by a virus belonging to the Flaviviridae family, of which there are 4 distinct serotypes:

DENV 1, 

DENV 2,

 DENV 3 

and DENV 4.

Understanding these serotypes is essential since only one will offer lifetime protection following dengue infection. In addition, the likelihood of having a severe illness will rise with the following conditions from different serotypes.

 Transmission;

The virus is spread via mosquito bite, mainly by Aedes aegypti and, to a lesser extent, by Aedes albopictus. It's worth noting that these same mosquitos are involved in spreading other viral diseases, such as Chikungunya and Zika. When a mosquito bites a person who is sick, it can spread the disease.It then carries the dengue virus and injects it into another individual during its next mealDirect transmission of dengue from one patient to another is impossible. Usually, you may find these mosquitoes depositing their eggs near standing water in water-holding containers like buckets, bowls, animal dishes, etc.

The incubation period of dengue is 4–10 days once the mosquito has bitten the individual.

 Symptoms;

From a subclinical sickness, in which the patient may not be aware of the infection, to a severe disease in which the patient displays severe flu-like symptoms, dengue can produce a wide variety of symptoms in a patient. The symptoms of dengue include:

 

- High grade fever around 40°C or 104F, along with nausea

- Vomiting, which is generally non-bilious

- Rash

- The phrase "retro-orbital discomfort" refers to aches and pains that generally affect the region behind the eye.

- Severe headache

 

Generalized muscle pain and joint pains

In the case of a mild encounter, the patient will recover in about a week.

 

Severe Dengue or Dengue Hemorrhagic Fever;

 

In some cases, however, symptoms can worsen and become life-threatening. Blood vessels are negatively impacted and eventually start to leak.

The number of clot-forming platelets in the blood decreases, making the patient more prone to bleeding. Dengue hemorrhagic fever, or severe dengue, describes this disease. This is characterized by

- Severe abdominal pain

- Persistent vomiting, at least 3 times in 24 hours

- Epistaxis, or bleeding from the patient's nose

- Bleeding from gums

- Bleeding under the skin, which appears like purplish bruises

- Feeling tired and restless

- Blood in urine, also known as hematuria

- Blood is found in the patient's stool and vomit, and the patient may eventually go into shock. They may have cold, clammy skin, tachycardia, and hypotension.

Risk factors;

One's chance of contracting this virus might rise due to circumstances like living in or visiting tropical regions. Southeast Asia, the western Pacific islands, Latin America, and the Caribbean are the regions with the highest risk.

If a previous infection with the dengue fever virus is reactivated, it can cause a severe bout of the illness with a high chance of developing dengue hemorrhagic fever.

Investigation;

Detailed investigations must be carried out if the patient exhibits symptoms of dengue and has the risk factors mentioned earlier.

DENV infections can be validated by virological tests, which identify the virus or its components, or serological testing, which detects the chemicals created in human bodies during infection.

Examples of virological methods include

1) Virus isolation

The patient's blood is taken to be grown inside the mosquitoes' or their cells. After two weeks, the presence of the virus in the animal's blood indicates the virus's infection.

2) Reverse Transcriptase–Polymerase Chain Reaction or RT–PCR methodology.

The purpose is to multiply the viral RNA by using an enzyme for several cycles until it can be detected.

These tests are generally sensitive, but they require specialized equipment and technical training for implementation, which might only sometimes be available in some medical facilities.

Examples of serological methods are

 

1) NS1 detection

The cells that DENV infects produce the protein known as NS1.

2) Enzyme-Linked Immunosorbent Assay or ELISA detects the antibodies our body produces to fight viruses.

Treatment;

Diet Chart for Dengue patient

The specific treatment for dengue fever is not yet available. Still, several available treatments can be introduced to patients, such as antipyretics to reduce fever and painkillers to treat muscle or joint pain.

However,

Ibuprofen and aspirin are examples of NSAIDs, or non-steroidal anti-inflammatory medicines, which should be avoided. They thin the blood and can worsen the prognosis of diseases with a high risk of bleeding. For severe dengue, intensive medical care by physicians and nurses can decrease the progression of the disease and the mortality rates from more than 20% to less than 1%. Managing the patient's body fluid volume is critical to severe dengue care.

Vaccination against dengue;

 

The first dengue vaccine, Dengvaxia, or CYD-TDV, was licensed in December 2015 and has now been approved by regulatory authorities in around 18 – 20 countries. The vaccine targets populations are living in endemic areas, ranging from 9 to 45 years of age, with at least 1 documented dengue virus infection. The vaccine is given in three doses over 12 months. But its efficacy is a matter of debate. The vaccine is only approved for older children because the younger ones appear to be at increased risk of severe dengue fever and hospitalization two years after being vaccinated. The World Health Organization (WHO stresses that the vaccine is not the most effective tool.

 

Prevention;

Controlling the mosquito population and human exposure is a more critical issue than treatment and vaccinations.

Therefore, our best chance of avoiding dengue is to avoid being bitten by mosquitoes carrying the disease. It is as simple as that.

If you are a resident of or traveler to any tropical area where Dengue fever is previously reported, prevention can reduce your risk of acquiring it,

which includes:

• Stay in air-conditioned or well-screened housing because the mosquitoes that carry the dengue viruses are relatively more active from dawn to dusk.
• Wear protective clothing like a long-sleeved shirt, long pants, socks, and shoes.

 

• Use mosquito repellents like Permethrin to apply to your clothing, shoes, camping gear, and bed netting. Most importantly, it reduces mosquito habitat.

 

• You can lower mosquito populations by eliminating habitats where they lay their egg at least once a week and emptying and cleaning containers that hold standing water, such as planting containers, animal dishes, and standing water containers should be covered between cleanings.

 

Foreign Aid;

 

Recently, scientists from Australia and Indonesia have been working together to fight the disease. First, they turn to another creature. a bacteria called Wolbachia. They inject the bacteria into the mosquito's eggs, breed them in the laboratory, and release them into the wild. Then, the spy mosquitos will eventually mate with the natural, disease-ridden ones of their kind.

Naturally, their babies will also carry the bacteria from the spy father. It can disrupt the mosquito's reproductive process while reducing its offspring's lifespan, preventing the next generation of mosquitoes from spreading dengue altogether. The early results are extraordinary. Adults in previously released mosquito areas have a fourfold lower risk of developing dengue disease, giving us the best chance of eradicating the dengue endemic.