What is Dengue?

Dengue is one of the fastest spreading viral infections in the world that is transmitted by the bite of a female Aedes Mosquito. The first ever case of dengue is recorded to have been appeared during the 265-420AD in China however the most prominent dengue cases have been recorded during the 17th century. There has been a widespread of the infection after the Second World War. Now more than 100 countries face the endemic. The World Health Organization estimates that in a year there are around 50 to 100 million cases of dengue worldwide. The mortality rate is less than 1% in case proper treatment is provided to the patients. The symptoms start appearing only after 3 to 14 days of the mosquito bite. It affects the infants, the young and adults. Recently in India there has been a high outbreak of the infection in many states including the capital Delhi. The dengue cases have touched up to a concern raising 1,520 in Odisha, 720 in the capital and many more states facing the same scenario. With this the state governments have woken up and mosquito breeding is being checked extensively in the states along with fogging.

The carrier - mosquito

Female Aedes aegypti mosquito is the primary carrier of the infection. It transmits the virus that causes the disease and which belongs to the family Flaviviridae. There are four serotypes of the virus that causes dengue and these are called as DEN-1, DEN-2, DEN-3 and DEN-4. The virus enters the white blood cells in the body and produce a signalling proteins like interferon that are responsible for producing the symptoms of the disease like fever. In severe dengue infection the virus spreads to the liver and bone marrow of the patient. A drop in the blood pressure is seen case. The female mosquito bite leaves the virus in the blood of the person and thus infecting him. The virus is then transmitted to other Aedes mosquito through the infected person. Thus an infected human being acts as the main carrier of the dengue virus.

These mosquitoes mainly bite during the daytime. However it can bite a person throughout the day but early mornings and evenings are the peak times of the mosquito bite. It mostly breeds in the containers kept open around the human dwellings. There are others like Aedes albopictus and Aedes polynesiensis among other that have also been found to cause the infection in humans.

The infected human then acts as the carrier

A dengue infected person with the virus in his blood becomes the multipliers of the disease causing virus. If an uninfected Aedes mosquito feeds on the blood of an infected human being the virus is transmitted to the mosquito and thus increasing the carriers of the dengue virus. After 2 to 7 days of the transmission of the virus to human blood the person suffers from fever. Dengue can also be transmitted via blood and organ transplants. It has been studied that if an infected person recovers from dengue he will then develop a lifelong immunity towards the particular virus serotype. However he may or may not remain immune against the other virus serotypes.

Symptoms to look for 

The dengue infected person shows somewhat flu like symptoms. It is also known as the “break bone” fever. However it must be noted that dengue fever may not be fatal. It has been found to show a variation in the symptoms according to the age of the people. An infected person may show the following symptoms

• A very high fever up to 104o F is one of the first symptoms that may appear.
• Severe and consistent headache
• Pain in and around the eyes
• Vomiting and nausea
• Joint and muscle pain
• Rashes in the body
• Swollen glands

Symptoms appear for duration of 2 to 7 days after the infection in the body. If untreated the disease may progress to the next severe stage where in fluid accumulation, plasma leakage, respiratory problems, bleeding through nose and even organ failure may occur. These symptoms for the severe dengue case may be seen to appear after 3 to 7 days after the first symptoms mentioned above. One must look out for the following symptoms in cases when severe dengue is suspected-

• Frequent vomiting
• Blood in the vomit
• Severe pain in the abdomen
• Breathing problem
• Bleeding gums
• Restlessness feeling
• Fatigue

The severe dengue stage can be fatal if proper medication and care is not provided to the infected person. Doctors have repeatedly stated that it is not the virus that proves to be fatal but the after effects of the infection are deadly if not treated timely. It can also affect other body systems or parts. It can also damage the brain or cause acute heart or liver failure in the patient. The diagnosis of dengue is done by detecting the low white blood cell count in a person or low platelet count. For detection of dengue virus microbiological laboratory tests are conducted to isolate the virus in cell cultures or by nucleic acid detection through PCR method. At the onset of the infection detection of the virus in the blood, serum and plasma can be done. Serology can be adopted at the end of the acute phase of the infection. Serology includes tests like MAC-ELISA. Antigen detection (though the techniques like ELISA) in the blood of the patient is another detection method that is done after 5-6 days of the appearance of the dengue symptoms. Haematological tests are done in severe dengue cases to check the drop in blood platelet count. 

Treatment of dengue

At present no specific treatment is present for dengue but the symptoms are taken care of medically to fight the disease. Like many other deadly diseases like Hepatitis we do not have immunization for dengue yet. A wide research is going on presently and we may expect a well trustworthy immunization process for dengue in the future. But there is uncertainty as vaccine development for dengue has proved to be quite challenging for the researchers. A vaccine to develop immunity against the all four serotypes if the dengue virus is posing problems for the researchers.

It is advised to have plenty of water or fluids in case of infection. Rest is advised to the patient as the infection may cause a lot of weakness. The patient is given paracetamol tablets to lower the body temperature. One must avoid aspirin and ibuprofen as they can increase the bleeding problem in the patient’s body. The WHO has described dengue to consist of two stages that is the uncomplicated stage and the severe stage.

In case of severe dengue strict medical care should be taken. The patient should be given proper medical care to save his life. After effects of dengue may cause weakness in the body of the infected person and decrease in the blood platelets in his body. In severe cases blood transfusion may be done.

Prevention of dengue

The first and foremost method of preventing dengue is preventing the breeding of the vector mosquitoes in our surroundings.

• Prevent the vector mosquitoes from breeding by not giving them favouring spaces to lay eggs that is the man-made habitats
• Proper solid and liquid waste disposal
• Water stored should be cleaned regularly and covered to prevent the mosquitoes from breeding
• Prevent water accumulation in and around your house
• Keep your houses clean by using disinfectants to wipe the floor
• Keep doors and windows shut to avoid entry of mosquitoes in the house. 
• Sleep in mosquito nets or use mosquito repellents like coils, vaporizers etc. in the house.
• Wear full sleeved clothes to prevent mosquito bite
• If using water coolers the water in them must be clean and changed on a regular basis. If cleaning regularly is not possible put some kerosene oil or a disinfectant in the water contained in the cooler. 
• Take extra care of the infants or small children in your house and if possible when they go out to play ensure that they are well covered and not exposed to mosquitoes. 
• Do not ignore or rely on self medication! In case you appear to have some symptoms immediately rush to a doctor to get yourself examined.
• The drains if any around your dwellings must be properly covered. 

The riches or the rags, the young or the old...it spares none!

The recent news that the 80 year old veteran film maker Yash Chopra popularly known as the King of Romance of the Indian Cinema died of dengue infection has brought to light the increasing risk of the disease we are at. Given birth to one of the most successful romantic movies of all times and located in the metropolitan posh city, the Yash Raj Film studios is said to have played the birth place of the life taking mosquito that might have been the cause of his death. The hospital he was admitted to has stated multiple organ failure due to dengue as the cause of death thus raising concerns all across the country and pulling up the state governments to start various dengue control measures and campaigns. The print and television media splashed pictures of the late director and producer along with the melodies from his famous movies followed by debates over the cause of death - DENGUE! over the next couple of days raising questions on the measures taken by the government to curb the dengue infections in Mumbai. The people of one of the richest cities of India are well exposed to the infection then be it the upper class or the middle. The condition is bad in the metropolitan cities but even worse in the smaller towns where the people are at a greater risk due to improper and inefficient medical services.

Prevention is the best medicine

Prevention is best in the case of dengue infection as we do not yet have the efficient immunization process for this disease. Owing sanitary and poor living conditions to the cause of dengue it was thought to be not an infection that would affect the affluent people but the case is far from what appears. Some years back even the prime minister’s two grandsons were admitted to the All India Institute of Medical Sciences (AIIMS) due to dengue infection. Thus even the upper class people are not spared by dengue infections. Poor public health services and ill managed sewage and drainage systems around the cities are acting as catalyst for the spread of dengue. The news of Yash Chopra’s death due to dengue has raised tensions among people around the country. People have been rushing to the hospitals in panic to get themselves checked if they are suffering from the dengue infection. The government has sprung into action and various dengue control measures are being fast adopted. 

But we must realize that the government alone cannot be blamed for the rise in the dengue infection. We must do our bit to keep our surroundings clean so that we do not create mosquito breeding spots or environment like stagnant pools of water and poor sanitation. Proper prevention measures can surely lower the risk of dengue infection. We all know the root cause of dengue and all the preventive measures that we must take in order to avoid the infection. Let us not continue to provide ideal breeding condition to the Aedes mosquito, the vector of the disease. Upgraded dengue surveillance systems and preparedness plans are very essential to tackle such situations in the future. Lack of awareness is also one of the reasons that may be held responsible for the recent outbreak of the dengue infection. So the next time you see a pool of water accumulating around your house do not cross it with a long jump but stop and take an action to do away with the stagnant water. Lack of proper waste and sewage management in the cities have increased the risk of spread of dengue. Raise awareness in your locality through posters or campaigns and help the government to stop the fast spreading tentacles of dengue. We must not sit dumb and wait for an awakening signal to take measures. Start now from your home and help curb the disease to be safe and live healthy.