Dengue (pronounced DENgee) fever is a painful, debilitating mosquito-borne disease. Since the start of the rainy season, increased dengue activity above the seasonal threshold has been reported from the islands of the Caribbean. The increase in dengue cases in the last few weeks, and reported deaths, call for immediate actions to be undertaken to slow down the dengue virus transmission in affected communities, and minimise its impact on people’s lives.
What is dengue fever?
Dengue is a mosquito-borne viral disease that is common in tropical countries including Anguilla. Dengue virus is transmitted by female mosquitoes mainly of the species Aedes aegypti and, to a lesser extent, Ae. albopictus.
Dengue causes a wide spectrum of disease. This can range from subclinical disease (people may not know they are even infected) to severe flu-like symptoms in those infected. Although less common, some people develop severe dengue which can be any number of complications associated with severe bleeding, organ impairment and/or plasma leakage. Severe dengue has a higher risk of death when not managed appropriately.
What causes dengue fever?
Dengue is caused by a virus of the Flaviviridae family and there are four distinct, but closely related, serotypes of the virus that cause dengue (DENV-1, DENV-2, DENV-3 and DENV-4). Recovery from infection is believed to provide lifelong immunity against that serotype. However, cross-immunity to the other serotypes after recovery is only partial, and temporary. Subsequent infections (secondary infection) by other serotypes increase the risk of developing severe dengue. The primary mode of transmission of DENV between humans involves mosquito vectors.
Signs and symptoms of dengue fever
Dengue fever is a flu-like illness that can occur in infants, children and adults. The symptoms can vary tremendously. Symptoms usually last for 2–7 days, after an incubation period of 4–10 days after the bite from an infected mosquito.
Dengue should be suspected when a high fever (40°C/104°F) is accompanied by 2 of the following symptoms during the febrile phase:
• severe headache
• pain behind the eyes
• muscle and joint pains
• nausea
• vomiting
• swollen glands
• rash.
A patient might develop other symptoms leading to severe dengue. A patient enters what is called the critical phase normally about 3-7 days after illness onset. It is at this time, when the fever is dropping (below 38°C/100°F) in the patient, that warning signs associated with severe dengue can manifest. Severe dengue is a potentially fatal complication due to plasma leaking, fluid accumulation, respiratory distress, severe bleeding, or organ impairment. Warning signs might include the following:
• severe abdominal pain
• persistent vomiting
• rapid breathing
• bleeding gums
• fatigue
• restlessness
• blood in vomit
If patients manifest these symptoms during the critical phase, close observation for the next 24–48 hours is essential so that proper medical care can be provided to avoid complications and risk of death.
Diagnosis
Doctors can diagnose dengue infection with a blood test to check for the virus or antibodies to it. If there is a dengue outbreak a diagnosis can be suspected based on clinical findings.
Treatment for Dengue Fever
There is no specific medicine to treat dengue infection. If you think you may have dengue fever, you should use pain relievers with acetaminophen – and avoid medicines with aspirin which could worsen bleeding. You should also rest, drink plenty of fluids, and see your doctor. If you start to feel worse in the first 24 hours after your fever goes down, you should get to a hospital immediately to be checked for complications.
Prevention
The best way to prevent the dengue fever is to prevent bites by infected mosquitoes. This involves protecting yourself and making efforts to keep the mosquito population down.
To protect yourself:
• Use mosquito repellents, even indoors.
• When outdoors, wear long-sleeved shirts and long pants tucked into socks.
• When indoors, use air conditioning if available.
• Make sure window and door screens are secure and free of holes. If sleeping areas are not screened, or air conditioned, use mosquito nets.
• If you have symptoms of dengue, speak to your doctor.
If someone in your home gets dengue fever, be especially vigilant about efforts to protect yourself and other family members from mosquitoes. Mosquitoes that bite the infected family member could spread the infection to others in your home.
Reducing mosquito population
To reduce the mosquito population, individuals should get rid of places where mosquitoes can breed. These include old tires, cans, or flower pots that collect rain.
Conclusion
Dengue fever is a flu-like illness that occurs in the Caribbean mainly during the rainy months of the year. Dengue fever is transmitted mainly by the bite of The Aedes Aegypti mosquito. Human activities also contribute significantly to the spread of dengue. The storage of water in containers which are uncovered and/or incorrectly managed, and the indiscriminate dumping of unwanted receptacles such as used tyres, empty bottles, etc., provide breeding sites for the mosquitoes. Individuals and communities are asked to actively participate in reducing the spread of dengue by accessing healthcare early, through the management of water storage containers, the cleaning up of their premises and disposal of unwanted containers.
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-eight years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5828).
