Despite efforts to reduce the incidence of dengue fever in Anguilla, this painful febrile infectious disease still has the potential to affect residents of the island. Dengue is a disease with different clinical presentations ranging from benign conditions to severe clinical courses – and outcomes that may lead to death.
What is dengue fever
Dengue fever is a mosquito-borne disease that occurs in tropical and subtropical areas of the world. Mild dengue fever causes a high fever, rash, and muscle and joint pain. A severe form of dengue fever, also called dengue hemorrhagic fever, can cause severe bleeding, a sudden drop in blood pressure (shock) and death.
What causes dengue?
Dengue is an infectious disease caused by the dengue virus (DENV). It belongs to the genus Flavivirus of the Flaviviridae family which, in turn, belongs to the group of Arboviruses (arthropod-borne viruses).
There are 4 serotypes called DENV-1, DENV-2, DENV-3 and DENV-4. Infection with one serotype produces lifelong immunity against that serotype reinfection. Successive infection with two different serotypes is a risk factor for developing the severe forms of the disease.
All serotypes have been isolated in the Caribbean. In several countries they circulate simultaneously, creating a serious risk for an epidemic.
How is the dengue virus transmitted?
The Aedes aegypti and Aedes albopictus mosquitoes are transmitters of dengue. The Aedes aegypti female mosquitoes are the main source of dengue transmission. These species bite during the day, with the most active feeding period 2 hours before and after dawn and dusk. The mosquito bites an infected person and ingests blood with the dengue virus, which incubates in the mosquito for a period of 8 to 12 days, after which the mosquito begins to transmit the virus biting others. The newly infected person may have symptoms after 5-7 days of infection.
What are some symptoms of dengue?
In some individuals, especially, children, there might be no signs or symptoms during a mild case of dengue fever.
Dengue fever causes a high fever — 104 F degrees — and at least two of the following symptoms:
• Headache
• Muscle, bone and joint pain
• Nausea
• Vomiting
• Pain behind the eyes
• Swollen glands
• Rash
Most people recover within a week or so. In some cases, symptoms worsen and can become life-threatening. Blood vessels often become damaged and leaky. The number of clot-forming cells (platelets) in your bloodstream drops. This can cause a severe form of dengue fever called dengue haemorrhagic fever, severe dengue or dengue shock syndrome.
Signs and symptoms of dengue haemorrhagic fever or severe dengue — a life-threatening emergency — include:
• Severe abdominal pain
• Persistent vomiting
• Bleeding from your gum or nose
• Blood in your urine, stools or vomit
• Bleeding under the skin, which might look like bruising
• Difficult or rapid breathing
• Cold or clammy skin (shock)
• Fatigue
• Irritability or restlessness
What to do if you have symptoms of dengue?
If you are someone you know have signs and symptoms suggestive of dengue seek medical advice and you should do the following:
• Watch for signs of serious illness.
• Do not self-treat. Do not use aspirin because it can cause bleeding effect.
• Do not use antibiotics because a virus causes dengue and antibiotics only attack bacteria.
• Get lots of rest.
• Use fluids to keep you hydrated.
• If symptoms worsen in 24 hours seek urgent medical attention.
Diagnosis
Diagnosing dengue fever can be difficult because its signs and symptoms can be easily confused with those of other diseases. Certain laboratory tests can detect evidence of the dengue viruses, but test results usually come back too late to help direct treatment decisions.
Treatment
No specific treatment for dengue fever exists. Your doctor may recommend that you drink plenty of fluids to avoid dehydration from vomiting and a high fever. If there are severe signs and symptoms hospitalization will be required. Supportive care would be required while in hospital. If complications develop these should be managed by a team of experienced healthcare professionals.
Dengue prevention
You can help prevent dengue by avoiding mosquito bites. This can be done be doing the following:
• Use insect repellent
• wear long-sleeved shirts and long pants
• control mosquitoes inside and outside your home.
To reduce the mosquito population, get rid of places where mosquitoes can breed. These include old tires, cans, bottles or flower pots that collect rain.
Conclusion
Dengue fever is a painful, debilitating mosquito-borne disease caused by any one of four closely related dengue viruses. Symptoms will vary from very mild to very severe. If you have symptoms suggestive of dengue fever seek medical attention as complications might develop that can be life-threatening.
Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an obstetrician/Gynaecologist and Family Doctor with over thirty-six years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5928).
