Across the world, 390 million people over the year are affected by Dengue, says the the World Health Organization. With a huge share of victims, India has been a country burdened with both medical and enconomic repercussions of the disease. First epidemic of clinical dengue like illness in India was recorded in Chennai in 1780, The first evidence of occurrence of first virologically proven dengue fever in the country was reported in 1956 from Vellore district in Tamil Nadu, while first epidemic of dengue fever was reported in Kolkata and Eastern coast of India in 1963.
After adjustment for underreporting from a case study in Madurai and an expert Delphi panel yielded an annual average of 58 lakhs clinically diagnosed dengue cases between 2006 and 2012. The total direct annual medical cost was US$548 million or around Rs 3500 crores per year. About 80% of this huge expenses was made at hospital level. If we consider the indirect cost incurred due to loss of work days of people affected with dengue it raises the economic cost to $1.11 billion per year.
The only way to stay safe from dengue is to be equipped with information and act on the information. The viral infection of dengue is spread by the infected female Aedes mosquito, which is also responsible for spreadingchikungunya. It takes around 3 to 14 days for the infected to be identified with the symptoms after being bitten by the mosquito.
Symptoms of dengue –
- Sudden fever with high temperatures. This is NOT like the usual common cold with fever that increases gradually with cough and running nose
- Severe headache
- Pain behind the eyes
- Feeling of fatigue and exhaustion
- Skin rashes
- Nausea and vomiting
- Sudden drop in Blood Pressure
- Pain in the joints and muscles
- A few may present in advanced stage of dengue fever with bleeding gums, nose bleeding, excessive menstruation, or blood in urine.
Patients of dengue are at risk for development of dengue hemorrhagic fever and then to dengue shock syndrome. Abdominal pain in conjunction with restlessness, change in mental status, sudden fall in body temperature are the signs of the development of dengue hemorrhagic fever. In such unfortunate patients, dengue hemorrhagic fever may start in 24 hrs of fever onset.
Following are the recommended tests for Dengue diagnosis
- NS1 antigen
- Dengue IgM and IgG by ELISA
- Dengue virus PCR
Treatment of Dengue
Dengue fever is usually a self-limited illness, meaning patients recover on his or her own. There is no specific antiviral treatment currently available for dengue fever. Supportive care with analgesics, fluid replacement, and bed rest is usually sufficient. Blood will be tested a number of times to check if the platelet level is falling and platelet transfusion is required.
Paracetamol may be used to treat fever and relieve other symptoms. Aspirin, Voveran®, ibuprofen etc should be avoided as such drugs can decrease platelet count further. To check Management of severe dengue requires careful attention to fluid management and proactive treatment of hemorrhage.
Recovery from Dengue
Recovery is complete but slow, with fatigue and exhaustion often persisting after the fever has subsided. The convalescent phase may last for 2-4 weeks.
How to Prevent Dengue?
Dengue is not a contagious disease which spreads from one person to another. It is transmitted by mosquitos. So the first step to prevent dengue is to stop the breeding of mosquitoes. This means the surroundings should be kept clean. Do not allow water to be stagnant. Do not store water in a container for long without attending to it, as Aedes mosquitoes lay eggs mainly in clean water. Use mosquito repellant at home as well well as for children going to school. You can also use natural options like lavender oil, eucalyptus oil, and neem oil. Garlic, lemongrass, and rosemary are helpful too. Use mosquito nets while sleeping. If you are close to a water body, protect your home using nets. And whenever you or any of your family member think that a fever can be dengue rush immediately to the doctor.
In summary, here are the WHO recommended Prevention and Control measures for Dengue.
- Prevent mosquitoes from accessing egg-laying habitats by environmental management and modification;
- Dispose of solid waste properly and remove artificial man-made habitats;
- Cover, empty and clean domestic water storage containers on a weekly basis;
- Apply appropriate insecticides to water stored for non drinking purpose in outdoor containers;
- Use personal household protection such as window screens, long-sleeved clothes, insecticide materials, coils and vaporizers;
- Improve community participation and mobilization for sustained vector control;
- Community elevl active monitoring and surveillance of vectors should be carried out to determine effectiveness of control interventions.