Dengue Fever: Causes, Symptoms, Stages, Diagnosis, &Treatment
Dengue fever is a mosquito-borne tropical disease. It is caused by four different types of dengue viruses. Dengue virus is transmitted by the bites of Aedes mosquitoes. It has a wide range of clinical manifestations. It is a painful and debilitating condition.
The fatality rate of dengue fever is 1–5%. The fatality rate of dengue fever in patients who develop significantly low blood pressure is up to 26%.
An expected 400 million dengue diseases happen worldwide every year, with around 96 million bringing about sickness. Most cases happen in tropical spaces of the world. The Indian Subcontinent, Southeast Asia, Southern China, The Pacific Islands, Taiwan, Mexico, Africa, and The Caribbean are high-risk areas of dengue fever.
The term dengue is derived from “dinga” in the Swahili phrase Ka-dinga pepo, which means that the disease is caused by an evil spirit. Dengue fever was linked with flying insects near water. That is the reason why it is labeled as “The water poison”.
Dengue is the most common vector-borne disease throughout the world. It is normal in excess of 110 nations. Rates of dengue expanded 30 overlay somewhere in the range of 1960 and 2010. A little less than half of the total populace, around 3 billion individuals, live in regions with a danger of dengue.
Dengue is endemic in Pakistan with its standard pinnacle occurrence in the post rainstorm time frame. The initially affirmed episode of dengue fever in Pakistan was in 1994.
Extreme dengue fever can cause interior bleeding and organ harm. BP can drop to risky levels, causing shock. Sometimes, extreme dengue fever can prompt passing.
Ladies who get dengue fever during pregnancy might have the option to spread the infection to the child during labor. Also, children of ladies who get dengue fever during pregnancy have a higher danger of preterm birth, low birth weight, or fetal trouble.
Causes Of Dengue Fever
Dengue fever is brought about by the Dengue fever virus (DENV). Dengue fever virus (DENV) is a single-stranded RNA virus. It has a place with the group of Flaviviridae.
It is transmitted by the nibbles of Aedes mosquitoes, for example, A. aegypti, A. albopictus, A. polynesiensis, and A. scutellaris. It reliably eats during the early morning and in the evening. Dengue can in like way be passed on through dirtied blood things and through organ donation. Vertical transmission has been addressed.
The most by and large saw pandemic vector of dengue on the planet is the Aedes aegypti mosquito. It will overall be perceived by the white social events or scale plans on its legs and chest.
The typical future of an Aedes mosquito in Nature is fourteen days. The mosquito can lay eggs near standing water around various occasions over the span of its life, and around 100 eggs are conveyed each time. The eggs can lie lethargic in dissipated conditions for around 9 months. After which they can brood at whatever point introduced to incredible conditions, for instance, water and food.
Dengue fever disease has five strains of the contamination, called serotypes, DENV-1, DENV-2, DENV-3, DENV-4, and DENV-5. These serotypes express lifetime immunity and transient cross-obstruction. All serotypes can cause outrageous and dangerous ailments.
The genetic assortment is found inside each serotype of dengue fever contamination. Some genetic varieties inside each serotype appear, apparently, to be more unsafe or have more significant pandemic potential.
Dengue fever infection is inoculated into people with mosquito salivation. The infection limits and recreates in different objective organs, for instance, neighborhood lymph nodes and the liver. Infection is then delivered from these tissues and spreads through the blood to white blood cells and other lymphatic tissues. Infection is then delivered from these tissues and circulates in the blood.
The mosquito ingests blood containing the infection. The infection imitates in the mosquito midgut, the ovaries, and the nerve tissue. It then, at that point escapes into the body cavity, and later contaminates the salivary organs. The infection duplicates in the salivary organs and when the mosquito nibbles another human, the cycle proceeds.
The mosquito becomes infective roughly 7 days after it's anything but an individual conveying the infection. This is the extraneous hatching time frame, during which time the infection duplicates in the mosquito and arrives at the salivary organs.
The incubation period ranges from 3 to 14 days, but most often it is 4 to 7 days.
Symptoms Of Dengue Fever
The signs and symptoms of dengue fever include low blood pressure, rashes, red eyes, red throat, weak-rapid pulse, swollen glands, headaches, bone or joint pain, muscular pains, rash, and leukopenia, and hepatomegaly.
There are four dengue clinical conditions: undifferentiated fever, classic dengue fever, dengue hemorrhagic fever, or DHF and dengue shock syndrome, or DSS. Dengue shock syndrome is actually a severe form of DHF.
The indications of intense fever, low platelet count, expanded hematocrit, low degree of albumin, and pleural or other effusions are reported during undifferentiated fever.
The symptoms of skin hemorrhages, gingival bleeding, hematuria, increased menstrual flow, nasal bleeding, hematochezia, gastrointestinal bleeding, hematemesis, and melena are accounted for during dengue hemorrhagic fever or DHF.
The symptoms of rapid and weak pulse, limited pulse pressure, hypotension, circulatory failure, frank shock, and chilly, damp skin, and altered mental status are reported during dengue shock syndrome, or DSS.
Stages Of Dengue Fever
Dengue fever infection progresses through distinct stages, each characterized by specific symptoms and clinical features:Incubation Period
After an individual is bitten by a mosquito carrying the dengue virus (usually the Aedes aegypti mosquito), there is an incubation period during which the virus replicates in the body without causing symptoms. This incubation period typically lasts 4-10 days, with an average of 7 days.
Febrile Phase
The febrile phase marks the onset of dengue symptoms and usually lasts around 2-7 days. Symptoms during this phase can be flu-like and may include:- High fever, often spiking to 104°F (40°C) or higher.
- Severe headache, often described as "behind the eyes''
- Pain in muscles and joints, leading to the colloquial term "breakbone fever.''
- Pain and tenderness in lymph nodes.
- Skin rash, which may manifest as a mild red rash or petechiae (small red or purple spots).
Critical Phase (Severe Dengue)
- Severe abdominal pain, often accompanied by tenderness.
- Persistent vomiting, sometimes with blood.
- Rapid and shallow breathing.
- Bleeding tendencies, such as nosebleeds, gum bleeding, or easy bruising.
- A significant drop in platelet count (thrombocytopenia) and an increase in hematocrit levels (indicating plasma leakage).
Recovery Phase
Diagnosis Of Dengue Fever
Clinical Assessment
- Symptoms Evaluation: Assessing symptoms such as high fever, severe headache, joint and muscle pain, skin rash, and eye pain.
- Medical History: Gathering information on recent travel to dengue-endemic areas, mosquito exposure, and underlying health conditions.
- Physical Examination: Looking for specific signs like petechiae (small red or purple spots), hepatomegaly (enlarged liver), and signs of plasma leakage.
Physical Examination
Healthcare providers perform a physical examination to look for specific clinical signs associated with dengue fever, such as petechiae (small red or purple spots), hepatomegaly (enlarged liver), and other signs of plasma leakage.Laboratory Tests
- Complete Blood Count (CBC): This test estimates different parts of blood, including the quantity of platelets. A huge drop in platelet count (thrombocytopenia) is a common feature of dengue fever.
- NS1 Antigen Test: This test identifies the presence of the dengue infection NS1 antigen in the blood. It is generally reliable during the beginning phases of the disease, commonly within the first week.
- Polymerase Chain Response (PCR) Test: PCR can straightforwardly identify the hereditary material of the dengue infection in the blood. It is especially helpful in the beginning phases of disease when viral RNA is available.
- IgM and IgG Antibody Tests: These tests distinguish specific antibodies produced by the immune system. IgM antibodies appear in the early phase of the disease, while IgG antibodies grow later, diagnosing and distinguishing between acute and past dengue infections.
Imaging: In severe cases, imaging studies like ultrasound or chest X-rays may be used to assess organ involvement and fluid accumulation.
Clinical Criteria: In some cases, healthcare providers may use clinical criteria, such as the WHO criteria for dengue diagnosis, to classify and diagnose dengue fever based on the presence of specific symptoms and clinical signs.
Monitoring: Continuous monitoring of the patient's condition, including vital signs and laboratory parameters, is crucial, especially during the critical phase, to identify any worsening of symptoms or complications.
Treatment Of Dengue Fever
No effective treatment is available for dengue fever. Supportive and symptomatic treatment is the backbone of treatment in dengue fever. Your doctor will recommend you take paracetamol for fever and muscle pain. Quick substitution of body liquids is suggested by persistent utilization of oral rehydration solution.
You should take complete bed rest during bleeding episodes. You ought to keep a raised trunk position for nose bleeding. You should keep yourself well hydrated by drinking plenty of fluids.
You can put an ice bag on your forehead for the purpose of promoting vasoconstriction in the nasal mucosa. Moreover, you can put an ice bag over your midsection for the treatment of melena. Dietary considerations likewise assume a significant part in the recuperation of dengue fever.
Dengue Vaccination
The primary dengue vaccine, Dengvaxia (CYD-TDV) by Sanofi Pasteur, was first enrolled in Mexico in December 2015. CYD-TDV is a live recombinant tetravalent dengue antibody that has been assessed as a 3-shots series on a 0/6/year plan for Phase III clinical investigations. It has been enlisted for use in people 9-45 years old living in endemic regions.
WHO prescribes that utilization be restricted to regions where the sickness is normal since immunization may really build the danger of dengue fever in individuals who have not been recently contaminated with the dengue infection on account of the phenomenon of immunizer subordinate upgrade. In 2016 a part of the way compelling immunization for dengue fever (Dengvaxia) opened up in 11 nations.
Historical Proactive Measures in Controlling Dengue Outbreaks
Proactive measures have played a significant role in controlling dengue outbreaks in various historical instances. Here are a few notable examples:Cuba's Dengue Control Program (1981)
Singapore's "Do the Mozzie Wipeout" Campaign (2014)
Thailand's Community-Based Programs
Australia's Northern Queensland Program
These historical examples demonstrate that proactive measures, including community involvement, education, and effective mosquito control, can be highly effective in controlling and preventing dengue outbreaks. Dengue control often requires a multi-faceted, sustained approach involving both government and community efforts.