As the country welcomes the monsoons, let’s not forget what rains brings along. Accompanying the rain each year is dengue, malaria and other viral diseases. Dengue is an infectious disease caused by the dengue virus. Symptoms include fever, headache, muscle and joint pains, and a characteristic skin rash. It may also lead to the life threatening dengue hemorrhagic fever which is accompanied with bleeding, low levels of blood platelets and blood plasma leakage. Dengue fever can also lead to dengue shock syndrome which causes circulatory failure.
Although there is no vaccine or treatment for dengue, it can be prevented. While infected humans are the main carriers and multipliers of the virus, the Aedes aegypti mosquito is the primary vector of dengue. At present, the only method to control or prevent the transmission of dengue virus is to combat the vector mosquitoes. The methods include-
- Preventing mosquitoes from accessing egg-laying habitats by environmental management and modification.
- Disposing of solid waste properly and removing artificial man-made habitats, like plastic containers, drums, buckets, or used automobile tires.
- Covering, emptying and cleaning of domestic water storage containers on a weekly basis.
- Applying appropriate insecticides to water storage outdoor containers.
- Using of personal household protection such as window screens, long-sleeved clothes, insecticide treated materials, coils and vaporizers.
- Improving community participation and mobilsation for sustained vector control.
- Applying insecticides as space spraying during outbreaks as one of the emergency vector control measures,
- Active monitoring and surveillance of vectors should be carried out to determine effectiveness of control interventions.
Most patients with dengue fever can be treated at home. They should take rest, drink plenty of fluids that are available at home and eat nutritious diet. Whenever available, Oral Rehydration Salt/ORS (commonly used in treating diarrhoea) is preferable. Paracetamol is the drug of choice to bring down fever and relieve joint pain. Other medicines such as Aspirin and Ibuprofen should be avoided because of increased risk of bleeding. Antibiotics are usually not required. Sufficient fluid intake is very important and becomes more important in case dengue fever progresses into Dengue Hemorrhagic Fever (DHF) or Dengue shock syndrome (DSS), where loss of body fluid / blood is the most salient feature. It is important to look for danger signs and contact the doctor as soon as any one of these are found.
Bleeding in dengue is one of the dreaded complications and is associated with higher mortality in dengue hemorrhagic fever (DHF) or Dengue shock syndrome (DSS). The medical fraternity globally recognizes the role of platelet transfusion in the management of dengue patients. Interestingly, many cases of dengue go unreported as well. As dengue is on the rise, the requirement of blood platelets is on the rise as well. Under these circumstances, it is important that we donate blood during these times to ensure blood banks don’t run low on stocks. Let’s help the blood banking services and related organizations by donating blood voluntarily and thereby save the precious human lives.
The WHO has issued guidelines for the management of DSS.[ 1 ] Much of the evidence on therapeutic measures in dengue are from children, and evidence from adults is lacking [ Table 1 ]. Close monitoring is required as shock can develop rapidly, and transfer to an ICU is indicated. The patient should be kept under close observation. Pulse, blood pressure, and respiration should be monitored–continuously if possible or at least every 15 min. Oxygen saturation should be monitored using a pulse oximeter, and oxygen should be given by face mask. Two wide-bore cannulae should be inserted for venous access. Blood should be drawn for grouping and cross-matching, blood urea, serum electrolytes, liver function tests, full blood count, prothrombin time, and c-reactive protein. Paracetamol may be used to control the fever.
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