Dengue is a mosquito-borne viral disease that has, in recent years, spread to many parts of the world, including India. It is transmitted by female Aedes aegypti mosquito. It has become a leading cause of hospitalization and death among children and adults in Indian subcontinent. There are 4 serotypes of Dengue viruses (DEN-1, DEN-2, DEN-3 and DEN-4). Recovery from infection by one serotype leads to lifelong immunity against that serotype of Dengue virus. However, cross-immunity (infection by one serotype and immunity against other serotype) is only partial. Earlier, the disease caused by Dengue virus was usually uncomplicated Dengue fever, which has a good prognosis. But, in recent times, severe complications of Dengue fever like Dengue haemorrhagic fever, Guillain-Barre syndrome, Myocarditis, Thyroiditis, Pancreatitis have become common. These complications prolong the duration of the disease, sometimes to many months.
Signs & Symptoms of Dengue:
Symptoms of Dengue fever are:
High grade fever accompanied by severe headache
Pain behind the eyes
Upper abdominal pain
Infection with Dengue virus can be uncomplicated Dengue fever, Dengue haemorrhagic fever or Dengue shock syndrome.
Laboratory findings show decreased platelet count, raised liver enzymes (SGOT/SGPT), decreased TLC and raised hematocrit.
Duration of Illness in Dengue:
Symptoms usually last 2 to 7 days.
Fever subsides in 4-5 days.
Low platelet count usually persists for 5-7 days after fever subsides. Thereafter, platelet count usually starts recovering gradually. Patients suffering from Dengue haemorrhagic fever (bleeding tendencies) and Dengue shock syndrome (hemodynamically unstable patients) usually take longer time to recover or in very severe cases, may not recover.
Management of Dengue:
There is no specific treatment for Dengue fever. Patient needs to be adequately hydrated and patient has to avoid NSAIDS. Only paracetamol has to be taken for fever.Patients with uncomplicated Dengue fever usually recover completely in 10-15 days. But generalized weakness may persist for few days to weeks.Patients with Dengue haemorrhagic fever and Dengue shock syndrome take a longer time to recover and they may need intensive care. Proper hemodynamic monitoring is needed and signs of any organ involvement is actively sought. Patients with other complications like Myocarditis, Pancreatitis, Guillain-Barre syndrome, Subacute thyroiditis, renal failure, encephalitis take a very long time to recover and they need specific treatment for these complications.