:: Dengue Fever ::

Symptoms, Treatments, Prevention

Dengue fever, also known as breakbone fever, is a mosquito-borne infection that causes a severe flu-like illness.

There are four different viruses that can cause dengue fever, all of which spread by a certain type of mosquito.

Dengue fever can vary from mild to severe; the more severe forms include dengue shock syndrome and dengue hemorrhagic fever (DHF). Patients who develop the more serious forms of dengue fever usually need to be hospitalized.
There are currently no vaccines for dengue fever. The best way to prevent the disease is to avoid being bitten by mosquitoes altogether. Although there is no certain treatment for dengue, it can be treated as long as it is caught before developing into dengue shock syndrome or dengue hemorrhagic fever.
(There are approximately six vaccine candidates under evaluation in clinical trial. The vaccine candidate currently at the most advanced clinical development stage is a live recombinant tetravalent dengue vaccine. This has now been evaluated as a 3-dose series on a 0/6/12 month schedule in Phase III clinical studies and has been submitted for registration in several endemic countries.

Symptoms of dengue fever

A symptom is something the patient feels or reports, while a sign is something that other people, including the doctor detects. A headache may be an example of a symptom, while a rash may be an example of a sign.

As there are different severities of dengue fever, the symptoms can vary.

Mild dengue fever

Symptoms can appear up to seven days after the mosquito carrying the virus bites, and usually disappear after a week. This form of the disease hardly ever results in serious or fatal complications.

The symptoms of mild dengue fever are:

Aching muscles and joints
Body rash that can disappear and then reappear
High fever
Intense headache
Pain behind the eyes
Vomiting and feeling nauseous.
Dengue hemorrhagic fever (DHF)

Symptoms during onset may be mild, but gradually worsen after a number of days.

DHF can result in death if not treated in time. Mild dengue fever symptoms may occur in DHF, as well as the ones listed below:

Bleeding from your mouth/gums
Nosebleeds
Clammy skin
Considerably damaged lymph and blood vessels
Internal bleeding, which can result in black vomit and feces (stools)
Lower number of platelets in blood - these are the cells that help clot your blood
Sensitive stomach
Small blood spots under your skin
Weak pulse.

Dengue shock syndrome

This is the worst form of dengue which can also result in death, again mild dengue fever symptoms may appear, but others likely to appear are:

Intense stomach pain
Disorientation
Sudden hypotension (fast drop in blood pressure)
Heavy bleeding
Regular vomiting
Blood vessels leaking fluid
Death.

Causes of dengue fever

There are four dengue viruses (DENV) that cause dengue fever, all of which are spread by a species of mosquito known as the Aedes aegypti mosquito, and more rarely by the Aedes albopictus mosquito. Aedes aegypti originated in Africa, but nowadays is found in all the tropical areas around the world and prospers in and close to areas of human population.
The virus is transmitted from an infected mosquito to human. The process begins when a person who is infected with the dengue virus is bitten by a mosquito, the virus is then passed on when someone else is then bitten by the infected mosquito.
If you have suffered from dengue fever previously it is still possible to contract it again, because of the number of different types of viruses that cause the fever. If you were infected again and became ill, there is a greater risk of developing a harsher form of the disease, such as dengue hemorrhagic fever (particularly in children). This is unusual because, normally, previous exposure to a virus causes the body to carry antibodies that allow the body to fight off the virus more easily the second time.

Complications of dengue fever

The majority of people suffering from dengue fever get better within 2 weeks. However, some individuals can suffer fatigue and depression for months after the infection.

Dengue fever can develop to harsher forms of the disease i.e. dengue hemorrhagic fever and dengue shock syndrome.

Diagnosis of dengue fever

The signs and symptoms of dengue fever are similar to some other diseases, such as typhoid fever or malaria, which can sometimes complicate the chances of a prompt and accurate diagnosis. In order for a doctor to properly diagnose dengue fever they will:

1) Assess the symptoms - the doctor will take into account all your symptoms to properly diagnose whether you have dengue. Some tests may be ordered to determine whether it is a dengue infection, or some other.

2) Blood sample - this sample can be tested in a laboratory in a number of ways to find signs of the dengue virus. If the dengue virus is detected diagnosis is straightforward; if this fails there are other blood tests which can identify antibodies, antigens and nucleic acids, including:

-ELISA (enzyme-linked immunosorbent assay)
-HI assay (hemagglutination inhibition assay)
-RT-PCR (reverse transcriptase-polymerase chain reaction)

3) Assess your medical history - The doctor will need to know your travel history and medical history, especially if it involves mosquito exposure.

Treatments for dengue fever

Because dengue is a virus there is no specific treatment or cure, however there are things the patient or the doctor can do to help, depending on the severity of the disease.

For milder forms of dengue fever the treatment methods are:
Prevent dehydration - high fever and vomiting can dehydrate the body.

Make sure you drink clean (ideally bottled) water rather than tap water. Rehydration salts can also help replace fluids and minerals.

Painkillers - this can help lower fever and ease pain. As some NSAIDs (non-steroidal anti-inflammatory drugs), such as aspirin or ibuprofen can increase the risk of internal bleeding, patients are advised to use Tylenol (paracetamol) instead.

The following treatment options are designed for the more severe forms of dengue fever:

Intravenous fluid supplementation (IV drip) - in some harsher cases of dengue the patient is unable to take fluids orally (via the mouth) and will need to receive an IV drip.

Bloood transfusion - a blood transfusion may be recommended for patients with severe dehydration.

Hospital care - it is important that you be treated by medical professionals, this way you can be properly monitored (e.g. fluid levels, blood pressure) in case your symptoms worsen. If the patient is cared for by physicians and nurses experienced with the effects and complications of hemorrhagic fever, lives can be saved.

Clothing.

Your chances of being bitten are significantly reduced if you expose as little skin as possible. When in an area with mosquitoes, be sure to wear long trousers/pants, long sleeved shirts, and socks. For further protection, tuck your pant legs into your shoes or socks. Wear a hat.

Mosquito repellants

Be sure to use one with at least 10% concentration of DEET, you will need a higher concentration the longer you need the protection, avoid using DEET on young children.

Use mosquito traps and nets

Studies have shown that the risk of being bitten by mosquitoes is considerably reduced if you use a mosquito net when you go to sleep.

Untreated nets are significantly less effective because the mosquito can bite the host through the net if the person is standing next to it. Also, even tiny holes in the netting are usually enough for the mosquito to find a way in. Nets that have been treated with insecticide are much more protective. Not only does the insecticide kill the mosquito and other insects, it is also a repellent - fewer mosquitoes are likely to enter the room(s).

Smell

Avoid wearing heavily scented soaps and perfumes.
Windows

Use structural barriers, such as window screens or netting.
Certain times of day

Try to avoid being outside at dawn, dusk and early evening.
Stagnant water

The Aedes mosquito prefers to breed in clean, stagnant water. It is important to frequently check and remove stagnant water in your home/premises.

Here are some tips for this:

Turn pails (buckets) and watering cans over; store them under shelter so water cannot accumulate in them.

Remove the water from plant pot plates. To remove mosquito eggs, clean and scrub them thoroughly. Ideally, do not use plant pot plates.

Loosen soil from potted plants. This will prevent puddles from developing on the surface of hard soil.

Make sure scupper drains are not blocked; do not place potted plants and other objects over the scupper drains.

Gully traps that are rarely used should be covered; replace gully traps with non-perforated ones, and install anti-mosquito valves.

Do not place receptacles under or on top of any air-conditioning unit.

Flower vases - change the water every other day. When you do so, scrub the inside of the vase thoroughly and rinse it out.
Leaves - make sure leaves are not blocking anything which may result in the accumulation of puddles or stagnant water.

Home Remedies for Dengue Fever

The most effective form of “treatment” is actually prevention, but fending off annoying mosquitoes can be very difficult. Some of the most effective preventative strategies are avoiding or eliminating standing, stagnant water, as that is where mosquitoes reproduce. Also, if you are in a heavily wooded or tropical area, apply mosquito repellent to any exposed skin and your clothes. If possible, keep exposed skin to a minimum and ensure that wherever you sleep is fully enclosed, including tears in any mosquito netting that you may put in place to protect yourself.

Barley Grass: Barley grass has the unique ability to significantly increase the body’s blood platelet count by stimulating the production of more blood cells. You can drink barley tea or eat barley grass directly and see a rapid increase in platelet count, which is one of the more serious side effects of dengue fever that can prolong weakness and increase the susceptibility of the body to dengue hemorrhagic fever and more serious complications.

Goldenseal: Although many herbal or natural remedies aren’t directly approved or proven through research, homeopathic physicians have praised goldenseal for its ability to clear up the symptoms of dengue fever very quickly and eliminate the virus from the body. Goldenseal not only helps to ease fevers, chills, headaches, nausea, and vomiting, but its natural antiviral capacity can essentially cure dengue fever in a matter of days.

Clean Water: This may seem like common sense, but due to the excessive sweating, bodily exertion, and the internal toll that dengue fever takes on the body, extreme dehydration is common. Drink as much water as possible to keep the body hydrated, which will also help to ease symptoms like headaches and muscle cramps, both of which are exacerbated by dehydration. Furthermore, water will help to flush the body and eliminate excess toxins that can complicate the viral impact of the pathogen.

Neem Leaves: Neem leaves are commonly prescribed for a variety of ailments, and dengue fever is no exception. Steeping neem leaves and then drinking the subsequent brew has been shown to increase both blood platelet count and white blood cell count, two of the most dangerous side effects of the virus. Properly brewed neem leaves can improve the immune system and return your strength much faster than many other home remedies.

Papaya Leaves: Although the exact pathway is unclear, papaya leaves are widely known as being a natural cure for dengue fever. The complex mix of nutrients and organic compounds in papayas can cause a rise in your platelet count, the high levels of vitamin C help stimulate the immune system, and the antioxidants help to reduce oxidative stress and eliminate excess toxins in the blood. The leaves can be crushed and then strained with a cloth to drink the pure juice.

Orange Juice: The rich mixture of antioxidants and vitamins found in orange juice make it ideal for treating the secondary symptoms of dengue fever and eliminating the virus. Orange juice helps to promote antibodies of the immune system, increase urination and the release of toxins, and stimulates cellular repair due to vitamin C’s crucial role in the creation of collagen.

Fenugreek: Fenugreek leaves are known to reduce fever and act as a slight sedative to ease pain and promote more restful sleep for patients. This is a popular home remedy for dengue fever symptoms in numerous places around the world.

Basil: Chewing on basil leaves may not sound particularly appetizing, but this is known to be an important immune-boosting technique, and has long been recommended in Ayurvedic medicine for the treatment of dengue fever. Basil essential oil also has natural insecticidal properties that will make you less attractive mosquitoes, making basil a treatment and a preventative strategy!

A Final Word of Warning: Although most cases of dengue fever are not fatal, the fever can progress rapidly to more serious stages if the initial symptoms are not treated and preventative measures are not taken. If at all possible, seek professional medical attention if you think you’ve contracted dengue fever; only use these home remedies as supplemental treatments and realize that these aren’t formal “cures”.

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