Overview Dengue

Dengue is a mosquito-borne viral disease that is prevalent in tropical and subtropical regions around the world, primarily in urban and semi-urban areas.

The disease is transmitted through the bite of an infected Aedes mosquito, primarily Aedes aegypti. These mosquitoes typically bite during the day, particularly in the morning and the evening. Once the mosquito bites a person infected with dengue virus, the virus incubates in the mosquito for a period of 8-12 days, after which it can be transmitted to other humans during subsequent bites.

Dengue can manifest in various forms. Dengue Fever is a severe, flu-like illness that affects older children and adults, but rarely causes death. However, Dengue Severe Dengue (also known as Dengue Hemorrhagic Fever) is a potentially deadly complication due to plasma leaking, fluid accumulation, respiratory distress, severe bleeding, or organ impairment.

Both Dengue Fever and Severe Dengue are characterized by sudden onset of high fever, severe headache, joint/muscle pain, nausea/vomiting, swollen glands, or rash. Symptoms tend to last about a week. In more severe cases, the disease can lead to circulatory system failure, shock, and death.

Currently, there is no specific treatment for dengue, but supportive care with analgesics, fluid replacement, rest and anti-viral medication can help with symptoms. Preventative measures are focused on avoiding mosquitos and eradicating their breeding grounds. Vaccination is also available in some countries for high-risk individuals.

Symptoms of Dengue

Dengue fever is a mosquito-borne illness that often exhibits the following symptoms:

1. Sudden, high fever.
2. Severe headaches.
3. Pain behind the eyes.
4. Severe joint and muscle pain.
5. Fatigue.
6. Nausea.
7. Vomiting.
8. Skin rash, which appears two to five days after the onset of fever.
9. Mild bleeding (such a nose bleed, bleeding gums, or easy bruising).

In severe cases of dengue, symptoms may progress to severe abdominal pain, persistent vomiting, rapid breathing, bleeding gums, fatigue, restlessness, and blood in your vomit. The next critical phase of dengue can also cause organ damage, severe bleeding, and even death. It is crucial to seek medical attention immediately if any of these symptoms are observed.

Causes of Dengue

Dengue is a viral infection caused by four types of viruses (DENV-1, DENV-2, DENV-3, DENV-4) belonging to the Flaviviridae family. The viruses are transmitted to humans through the bites of infected female mosquitoes, primarily the Aedes aegypti mosquito and to a lesser extent, the Aedes albopictus mosquito.

The primary cause of dengue is:

1. Mosquito Bites: The Aedes mosquito is a vector that transmits the dengue virus. It bites during the day, particularly early morning and in the evening before dusk. When the mosquito bites a person who has been infected with the dengue virus, the mosquito can pick up the virus along with the blood meal. When this mosquito bites another person, the virus gets injected into that person, thereby spreading the infection.

Secondary causes include:

2. Rapid Urbanization: Rapid and unplanned urbanization leads to inadequate housing and waste management facilities and a lack of reliable piped water, which provide breeding grounds for mosquitoes.

3. Climate Change: Changes in climate such as increased rainfall, temperature and humidity also increase the number of breeding sites for mosquitoes, leading to an increase in the number of mosquitoes that can transmit the dengue virus.

4. Increased Travel: Due to increased global travel, dengue has spread to new areas where such mosquitoes are present.

5. Lack of Effective Mosquito Control Methods: Ineffective vector control can also contribute to the spread of dengue fever. Factors such as resistance to insecticides can make it more difficult to control the mosquito population effectively.

It’s important to note that dengue cannot be spread directly from person-to-person. A mosquito is required as a vector to transmit the virus.

Risks of Dengue

Dengue is a mosquito-borne viral infection that can cause severe health problems. Below are some risks associated with it.

1. Severe Illness: The most dangerous risk of dengue is dengue hemorrhagic fever or dengue shock syndrome, both can be fatal. They may cause bleeding, blood plasma leakage, and low platelet count.

2. Organ Damage: Severe cases of dengue can damage the liver and heart. It added strain to these organs can cause long-term issues.

3. Mortality: In serious cases, dengue can lead to death especially if not promptly treated.

4. Recurring Infection: If you’ve had dengue once, you are at increased risk for a more severe version if you get infected a second time as there are four different strains of the virus.

5. Other Complications: Dengue can also cause damage to the eyes, brain and other parts of the body.

6. Pregnancy: Dengue can cause complications in pregnancy, including preterm birth, low birth weight, and even maternal death.

Preventative measures such as reducing mosquito habitats, using repellants, and wearing clothing that covers the skin can help in reducing the risk of incidence. If symptoms of dengue are experienced, it’s crucial to seek medical help immediately.

Diagnosis of Dengue

Diagnosis of dengue fever usually revolves around the patient’s symptoms, physical examination, and medical history, especially the history of travel to tropical or subtropical regions where the disease is endemic. Following that, various lab tests are used to confirm the diagnosis, including:

1. **Antibody Test:** This blood test detects the antibodies produced by the immune system in response to the dengue virus. It may not be positive if the test is done in the early stages of the disease.

2. **Molecular Testing:** This primarily includes Polymerase Chain Reaction (PCR) test that identifies the virus’s genetic material. This test is more precise and can be used to determine the type of dengue virus causing the infection.

3. **Virus Isolation:** In this test, the virus is isolated from the patient’s serum collected within the first five days of the symptom onset.

4. **Antigen Tests:** This includes tests detecting the NS1 protein (non-structural protein 1), a dengue virus protein produced in the initial phase of infection.

The clinical diagnosis can be complicated because dengue fever can present similar symptoms to other illnesses such as chikungunya, yellow fever, and Zika virus. Therefore, laboratory confirmation is necessary for an accurate diagnosis.

Please note that depending upon the disease’s phase and the timing of the patient’s presentation, the tests used or their results may vary. Medical attention should be sought whenever dengue is suspected.

Treatment of Dengue

Dengue is a viral disease transmitted through the bite of an Aedes mosquito. When infected with dengue, a person may experience flu-like symptoms such as high fever, severe headache, pain behind the eyes, joint and muscle pain, rash, mild bleeding (e.g., nose or gum bleed, easy bruising).

As of now, there isn’t a specific medication for the treatment of dengue. The treatment is mostly symptomatic which means easing the symptoms.

Here are the common ways to manage dengue:

1. Hydration: One common side effect of dengue fever is dehydration which can worsen the condition. Therefore, it’s crucial for a dengue patient to drink plenty of fluids such as water, fresh fruit juices, or oral rehydration solutions.

2. Rest: Make sure to get adequate rest. The body goes into overdrive to fight off the illness and needs all the energy it can get.

3. Fever and Pain relief: Over-the-counter medicine such as acetaminophen (Tylenol) can be taken to relieve pain and reduce fever. However, drugs such as aspirin and ibuprofen should be avoided as they can increase the risk of bleeding.

4. Regular monitoring: Regular blood tests are needed to monitor the disease progression, primarily your platelet count and hematocrit.

5. Hospitalization: Severe cases may require hospitalization where healthcare professionals can manage the symptoms and provide supportive treatments such as fluid replacement therapy, blood transfusions, etc. In critical cases, a condition known as “severe dengue” may occur which needs emergency treatment.

6. Balanced Diet: Eating a balanced diet can help strengthen your immune system and quicken the recovery process.

Prevention is the most effective treatment, ensure to eliminate mosquito breeding sites and protect yourself from mosquito bites. Also, a dengue vaccine (Dengvaxia) is available in some countries for people ages 9-45 who have already had dengue.

Keep in mind that it is crucial to get medical attention if you’re experiencing symptoms of dengue, especially if they worsen or persist after a few days. Always follow the advice of a healthcare professional when dealing with illnesses such as dengue.

Complications of Dengue

Dengue is a viral disease transmitted by mosquitoes. While many people infected with dengue don’t exhibit symptoms or have only mild ones, severe dengue can arise and present serious health complications, including:

1. Dengue Hemorrhagic Fever: This is a severe form of dengue, which can cause bleeding, blood plasma leakage, and low platelet count.

2. Dengue Shock Syndrome: Another severe form of dengue that causes a drastic drop in blood pressure that can lead to shock, organ failure, or even death.

3. Organ Damage: Severe dengue can also damage the heart and liver, and can cause problems in the circulatory system.

4. Neurologic Disorders: In some cases, dengue might cause neurological complications such as encephalopathy, encephalitis, or neuropathies.

5. Other Complications: These could include damage to the linings of the blood vessels, causing them to become leaky.

It is important to seek medical attention if the symptoms of dengue fever do not improve after a week or if they suddenly get worse, as this could indicate a progression to a more severe form of the disease.

Support and Resources of Dengue

To manage and fight against diseases like Dengue, various types of support and resources are required which can be categorized as follows:

1. Medical Support: This includes healthcare professionals who can diagnose and treat dengue fever. These professionals are equipped with knowledge on the symptomatic treatment of Dengue, as there’s currently no specific antiviral drug available for it. They provide care and monitor the patient’s health, manage the symptoms, and prevent complications.

2. Laboratory Facilities: Dengue is confirmed through laboratory tests, hence laboratories with the capacity to diagnose dengue are critical.

3. Information and Education: There are numerous health organizations and online resources providing information on Dengue prevention, symptoms, treatment, and management. These resources are important for educating the public and spreading awareness.

4. Vaccines: WHO recommends the Dengvaxia vaccine as a preventive measure against dengue in certain cases. Vaccination is a critical resource in preventing dengue.

5. Research Institutes: Dengue research is being carried out worldwide to discover more about the disease, its treatments, and preventive measures. Institutions like The Centers for Disease Control and Prevention, World Health Organization, and various universities and pharmaceutical companies play an important role in conducting Dengue-related research.

6. Governmental Support: Government initiatives for vector control and public health awareness campaigns are critical in dengue prevention.

7. NGOs and Non-Profit Organizations: These entities also contribute by spreading awareness, providing medical aid and supporting research related to dengue.

8. Community Support: Efforts like keeping surroundings clean, destroying mosquito breeding sites, etc., are a crucial part of community-level support.

9. International Support: Many international organizations and developed countries often provide financial and logistical support via programs aimed at controlling and eliminating Dengue.

All these resources and support systems work collaboratively to help treat, control, prevent, and ultimately eradicate Dengue. It’s important, however, that individuals take their part seriously, such as seeking medical care when needed, taking preventive measures against mosquito bites, and keeping their surroundings clean to prevent mosquito breeding.

Who will treat Dengue

Dengue is a viral infection transmitted by the bite of an infected mosquito. It should be treated by a healthcare professional, typically a General Practitioner, Infectious Disease Specialist, or a Pediatrician in case of children. Management involves hydration, pain control, and monitoring for severe complications. In severe cases, hospitalization may be necessary for close observation and treatment. There isn’t a specific treatment for dengue; most care involves treating symptoms. Always remember that self-diagnosis and treatment without professional guidance can lead to complications.

Latest research on Dengue

1. A New Vaccine Trial: The World Health Organisation highlighted that the dengue vaccine pipelines are advancing with clinical trial phases. One of the most promising candidates is the TAK-003 vaccine, that is safe and also registered a overall efficacy of around 80.2%

2. Understanding Dengue Strains: Researchers across the globe are strategizing to manage the effects of the four distinct but related strains of the dengue virus, given that infection with one strain could leave people more vulnerable to severe illness if they’re later infected by another strain.

3. Antibody-Dependent Enhancement (ADE): Continuous research is being done to fully comprehend ADE and its role in dengue, particularly severe dengue. ADE is thought to play a role in why secondary infections with a different dengue serotype are often much worse than primary infections.

4. Genomic Research: Studies are being done to understand genomic aspects of the virus to not only predict outbreaks but also develop more effective treatments and preventive measures.

5. Drug Development: A lot of research is being conducted to develop antiviral drugs for treating dengue fever, even though no drug has specifically been approved for this purpose yet.

For the most recent developments, please consult peer-reviewed scientific articles or respected global health resources like the WHO or CDC.

Frequently asked questions for Dengue

1. What is Dengue?
– Dengue is a viral disease spread by mosquitoes, primarily the Aedes aegypti and Aedes albopictus mosquitoes. World Health Organization identifies it as one of the world’s leading mosquito-borne illnesses.

2. What are the symptoms of Dengue?
– Symptoms typically start 4-6 days after infection and can last up to 10 days. They can include: high fever, severe headache, pain behind the eyes, muscle and joint pains, nausea, vomiting, swollen glands, or rash.

3. How is Dengue transmitted?
– Dengue is transmitted through the bite of a mosquito infected with one of the four dengue virus serotypes. It is not contagious and cannot be spread directly from person to person.

4. How is Dengue diagnosed?
– Diagnosis of dengue is confirmed by detecting the presence of the virus in the blood of a patient. This can be done through virus isolation in cell cultures, nucleic acid detection by PCR (Polymerase chain reaction), viral antigen detection and serological tests.

5. Is there a vaccine for Dengue?
– Yes, there is a vaccine for dengue fever called Dengvaxia. However, it is only recommended for individuals aged 9-45, who have previously had dengue infection.

6. Can you get Dengue more than once?
– Yes, there are four serotypes of the dengue virus, so it is possible to get dengue fever multiple times. However, an individual can only be infected by each serotype once. Subsequent infections by other serotypes increase the risk of severe complications.

7. Can Dengue be fatal?
– Yes, if not managed properly. A severe form of the disease called dengue hemorrhagic fever can cause bleeding, blood plasma leakage, and low platelet count which can be fatal.

8. How can Dengue be prevented?
– The best preventative measure is to avoid mosquito bites. This can be done by staying in air-conditioned or well-screened housing, wearing protective clothing, and using mosquito repellent. Also, limiting mosquito habitats such as stagnant water helps control their population which in turn reduces the risk of dengue.

9. What is the treatment for Dengue?
– There is no specific treatment or antiviral drug for dengue. Patients should seek medical advice, rest and drink plenty of fluids. Paracetamol can be taken to bring down fever and reduce joint pains. Hospitalization may be necessary in severe cases.

Conclusion

Dengue is a mosquito-borne viral disease prevalent in many tropical and subtropical regions. It is primarily transmitted through the bite of the Aedes aegypti mosquito. Common symptoms include high fever, severe headaches, pain behind the eyes, severe joint and muscle pain, fatigue, nausea, vomiting, and skin rash.

1. Preventing or reducing dengue virus transmission depends heavily on controlling the mosquito vectors or interruption of human–vector contact.
2. There is no specific treatment for dengue, but early detection and access to proper medical care can lower the risks of complications and severe forms of the disease.
3. Vaccination could be integrated into a comprehensive dengue control strategy in areas where the disease is endemic. Dengvaxia is the first dengue vaccine to be licensed. However, its use is limited and needs to be carefully considered based on specific and evolving recommendations.

 

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Last Update: December 6, 2023