Definition & Overview

Dengue fever is a painful and debilitating viral infection that attacks a person’s body, causing several indicative symptoms including a high fever. This is a contagious illness that can be passed on through its only carrier – a mosquito. This means that it cannot be passed from person to person, and requires a mosquito to transmit the infected blood. Dengue fever is often diagnosed by checking all the symptoms the patient is experiencing and taking a blood test to check for the virus or its antibodies. A dengue fever can affect people of all ages, including young children. In some cases, the condition is fatal.

Cause of Condition

The dengue virus, which is mosquito-borne, causes dengue fever; this means that if a mosquito bites an infected person, it becomes a carrier that can easily pass on the virus to the next person it bites. There are four different types of dengue viruses that cause the dengue infection, but they are closely related; they have also been linked to the viruses that cause West Nile and yellow fever infection. This means that the dengue virus is most common in tropical areas, such as India, Southeast Asia, southern China, Taiwan, the Pacific islands, the Caribbean islands, Mexico, Africa, and South America. Because of this, a person suspected of having dengue fever will routinely be asked if he or she had been on a recent travel to tropical areas.

Key Symptoms

The name “dengue fever” can be misleading, as a person suffering from the dengue infection will experience, not just a fever, but a set of symptoms including:

  • Skin rash
  • Severe pain in the head and muscles
  • Pain behind the eyes
  • Severe headaches
  • Severe joint and muscle pain
  • Shaking chills
  • Diarrhea
  • Vomiting
  • Extreme exhaustion
  • Mild bleeding, such as bleeding gums or a nose bleed

These symptoms usually appear four to six days after a person becomes infected, and may last up to 10 days. Once these symptoms are experienced, the patient must seek treatment immediately because this is a progressive infection. It means that it has the tendency to become serious and even fatal if left untreated. This is where dengue fever becomes quite dangerous. Since many of its symptoms are very common, the illness can easily be dismissed as flu or another viral infection. Many people are mistakenly led to believe that the illness does not require treatment, until it is too late. Thus, it is important to observe the symptoms carefully. If more than one of the above symptoms are felt together and they don’t go away, the safest course of action is to see a physician for proper diagnosis.

Severe cases of dengue infection may cause the following symptoms:

  • Bleeding under the skin
  • Red spots, particularly on the legs
  • Bleeding into the intestines
  • Significant decrease in blood pressure, which can lead to shock

In its more advanced cases, dengue fever progresses into a dengue hemorrhagic fever and dengue shock syndrome. While most cases of dengue hemorrhagic fever or shock syndrome are caused by a Type 2 dengue virus, it can also develop from the same virus that causes the initial dengue fever. Those with weakened immune systems or those who have been previously infected with dengue fever face a greater risk of developing dengue hemorrhagic fever.

On top of this, dengue fever has dangerous effects on the body if left alone. It can potentially cause the liver to become enlarged or damage the lymph nodes and blood vessels. It can also lead to a failure of the circulatory system and a risk of massive bleeding. These serious complications are what link dengue fever to death.

Who to See & Types of Treatments Available

Dengue fever. If you are experiencing a sudden high fever accompanied by other symptoms on the list above, see your family doctor or general physician immediately for a diagnosis. Once diagnosed with dengue fever, your physician will prescribe a period of watchful waiting, during which you will be given a regular pain reliever similar to ones used for treating a common fever such as an acetaminophen. Certain medications, such as aspirins, corticosteroids, and non-steroidal anti-inflammatory drugs (NSAIDs) are avoided because of their blood-thinning effects. Patients are also advised to rest, take plenty of fluids, and immediately inform the physician if any new symptoms arise or if the high fever is recurrent, causing the patient’s temperature to go down then climb back up again; the erratic nature of a patient’s temperature, in which the fever subsides then goes back again, is what most often signals patients to the possibility of the infection being caused by dengue rather than an ordinary flu.

Due to the lack of a specific anti-viral treatment that can fight the dengue virus, the treatment of dengue focuses more on relieving its symptoms, such as replacing lost fluids, and preventing other symptoms from taking effect, such as proactively treating hemorrhage even before it occurs. To do so, a patient’s platelet count and hematocrit levels should be monitored daily starting on the third day of illness until 1 to 2 days after other symptoms have subsided. If a patient’s platelet count and hematocrit levels are normal or seem to be continuously improving, the patient can be treated on an outpatient basis under close monitoring.

Dengue hemorrhagic fever. Dengue hemorrhagic fever is diagnosed if a patient’s hematocrit level continues to rise while his platelet count continues to fall. In such cases, he has to be confined to a hospital to receive continuous hydration and platelet replacement until his condition improves.

Dengue shock syndrome. Patients who are suspected of having or diagnosed with dengue shock syndrome should be admitted to an intensive care unit, where they will be given a central intravenous line to replace blood volume; this is an urgent matter especially if the patient develops internal bleeding. Blood pressure is monitored closely and blood is tested frequently. Intravascular catheters are generally avoided because of the increased risk of hemorrhage. Plasma expander, plasma transfusion, platelet transfusions, and blood transfusion may all become necessary depending on the severity of the condition.

Signs that a person is recovering from the infection and has passed the critical stage include being fever-free for 24 hours without the use of antipyretics, improved appetite, general improvement in clinical condition, normal urine levels, stable hematocrit levels, normal platelet counts, and no signs of respiratory distress. If a person experiences shock, he should have recovered from it for at least 48 hours before he will be considered well.

Nowadays, with the help of advanced medicine, experts are looking at potential preventative measures such as dengue vaccines for children in tropical areas or areas that are at risk of dengue fever.

References:

  • Malavige GN, Fernando S, Fernando DJ, Seneviratne SL. (2004). “Dengue viral infections.” Postgraduate Medical Journal.
  • Villar L, Dayan GH, Rivera DM, Cunha R., Deseda C., Rivas E., et al. (2015). “Efficacy of a tetravalent dengue vaccine in children in Latin America.” The New England Journal of Medicine.
  • Milada T. “Dengue fever.” South Sudan Medical Journal.
  • Nishiura H., Halstead S. “Natural history of dengue virus (DENV)-1 and DENV-4 infections: Reanalysis of classic studies.” The Journal of Infectious Diseases.
  • Simmons C., Farrar J. et al. (2012). “Dengue.” The New England Journal of Medicine.
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