As the COVID-19 pandemic winds its way, it has left a sense of unease and concerns among the general population and medical fraternity alike. More and more doctors are reporting flu-like symptoms in their clinics or OPDs but there is confusion about the diagnosis.
While the symptoms indicate a flu-like/viral illness, it is not caused by a single cause. Influenza A and C, H1N1 (swine flu), common tropical infections, monsoon diseases and dengue are all presenting similarly. Of these, dengue is of particular concern as the number of cases reported across the country has been significant in recent years. About 2 lakh dengue cases were seen in 2021, which is 4 times more than the number of 2012. Dengue is a viral disease that is spread by the bite of the Aedes mosquito. These mosquitoes bite during the day so simple protective measures like using mosquito nets at night are of little importance in prevention. When a mosquito bites a patient and then bites a normal person, the infection spreads.
There are 4 types of dengue virus serotypes. In most cases, dengue is a self-limiting disease, but if a person is bitten a second time and becomes infected with a different viral serotype, the disease can have severe morbidity and mortality (up to 20%). Is. In such cases, dengue hemorrhagic fever and dengue shock syndrome may occur, which manifest as haemorrhage, severe plasma leakage from the blood, liver failure and altered sensorium.
Therefore, it is important to understand how dengue can be suspected and detected early. After the bite of an infected mosquito, it can take 4-10 days for the first symptoms to appear. High-grade fever (up to 104o F), chills, skin rash, flushing of the face, retro-orbital (behind the eyes) headache, joint pain, nausea, vomiting, easy skin rash, etc. All dengue may be indicators. infection. Dengue hemorrhagic fever can cause bleeding gums and gastrointestinal tract and can be fatal if not diagnosed and treated in time.
A thorough clinical history of travel to a dengue endemic area guides clinical suspicion that can be confirmed by serological blood tests. The results are likely to show a 4-fold increase in plasma proteins called immunoglobulins. Dengue antigen determination is confirmatory. As with serology, the complete blood count is important, especially the platelet estimation. Dengue can cause a drop in the number of platelets and this is the drop that results in easy bruising and bleeding of the skin, as platelets control blood clotting. Platelet levels below 100,000 are considered abnormal and about 20% of patients will have counts as low as 30,000. Platelet assessment should be repeated daily from the third day of illness and continued until platelet levels return to normal levels, as well as complete recovery.
There is no specific antiviral drug available to treat dengue. Supportive treatments like oral rehydration, antipyretics to control fever, etc. are important. Patients showing more aggressive symptoms, including those with suspected hemorrhagic fever, are best treated in hospital. Elderly dengue patients may present unusually and are at higher risk of hemorrhagic fever and shock. In addition to the severity of dengue, age and the presence of co-morbid conditions are associated with prolonged hospitalization.
Recovery is gradual. It is essential that patients do not resume all activities immediately and do so only for a short period of time. This could have implications for employees and employers as the increase in extended leave requests could lead to restrictions on e. A thorough workplace assessment of common and currently prevalent infectious diseases can guide infection prevention, control and management strategies.
A vaccine for dengue has been developed but is not universally available for general use. Its use is restricted to people who are at high risk for reinfection. Individuals, organizations, vector-control agencies and health officials must work in coordination to ensure prevention of dengue. What is needed on a war footing:
• Increased surveillance and increased public awareness
• Regular spraying/fogging of mosquito breeding areas and avoiding stagnation of water
• Use of protective/blocking clothing with repellent
• Avoid outdoor exposure during the day as much as possible
In fact the only way to prevent dengue is to avoid being bitten by mosquitoes carrying the virus. Staying alert and updated with reliable information is the cornerstone of conquering dengue and other viral diseases.
Contents By: Dr. Vikram Vora, Medical Director, India Subcontinent, International SOS
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