Dengue Fever

What is Dengue Fever?

Dengue fever kills millions of infected people around the world every year. Although the disease is the most common in countries in Southeast Asia and the western Pacific islands, it has been rapidly spreading in Latin America and the Caribbean.

The mosquito-borne disease is spreading to people by the bites of female mosquitoes. It causes a high fever and rash for those patients with mild dengue fever. In addition, muscle and joint pain are the symptoms that are shown for those patients with the mild dengue fever. Severe bleeding and a sudden drop in blood pressure as well as death can occur due to a severe form of dengue fever, which is called dengue hemorrhagic.    

Dengue fever is caused by four types of dengue virus, namely DENV-1, -2, -3 and -4. The viruses are dangerous and harmful. Until now, there are no vaccines to fight them. While researchers are currently working on the vaccines, the best prevention of the dengue viruses is to lower the number of mosquitoes that are the carriers.

Situation in Thailand

Dengue infection has been reported in Thailand for over 50 years. Currently, the infection has spread throughout the country. By 2020 there will be around 140,000 dengue cases, which are close to the pandemic in 2015, with the DENV-1 and DENV-2 viruses being the dominant species and with a constant trend. The risk group for dengue fever remains among school-age children (5-14 years), but the risk of death is an adult (aged 35 years and older), especially in adults and the elderly with chronic diseases.

What are the dengue Fever symptoms?

With the mild case, no signs of dengue fever or symptoms are shown in children and teens. After being bitten for four to seven days however, Warning signs of dengue could show through body temperature that can increase up to 104 F degree, which is so serious and dangerous that you may need remedies. In addition, some dengue fever symptoms may also show as follows:

• Having headache
• Experiencing nausea    
• Vomiting
• Having swollen glands
• Having rashes
• Experiencing muscle, bone and joint pain
• Experiencing pain behind the eyes

Most patients may get recovered within a week or longer. In terms of dengue fever symptoms,  some patients may be worse and can be life-threatening, while blood vessels are damaged and leaky. As a result, the number of clot-forming cells, which are known as platelets in the bloodstream decreases. When it comes to this condition, it can cause a severe form of dengue fever, which is sometimes called dengue hemorrhagic fever or dengue shock syndrome. Dengue hemorrhagic fever’s signs and conditions are as follow:

• Experiencing fatigue
• Excessive vomiting
• Having serious abdominal pain
• Having bleeding gums and nose
• Experiencing breathing difficulty
• Being in shock with clod and clammy skin
• Having blood in stools, vomit or urine
• Having bruises that may be caused by bleeding under the skin
• Experiencing frustration and fidgetiness
  
  

When to see a doctor

If you have been to a region where dengue fever is common, and you experience such as severe abdominal pain, excessive vomiting, breathing difficulty, or bleeding gums or nose, you are advised to call 1669 or go to an emergency room near you immediately.  

What are the causes?

When a mosquito bites someone with a dengue virus, the mosquito is infected. And then it bites another human, he or she is infected with the virus.

Human can develop immunity to prevent the reoccurrence of the disease. However, you can have immunity to the only type of dengue virus that once transmitted to you, but not other types of virus. Moreover, the chance you can be sick with severe dengue fever or dengue hemorrhagic fever could be higher if you are infected with it again and again.

What are the risk factors?

Two factors that put you at risks of developing the disease or possibly with more severe form of the fever include:

• Living or travelling in the risk areas where the disease is common such as in a country that is tropical or subtropical. This increases your chance to get infected with a dengue virus.
• You have a high chance to have more severe symptoms if you get infected with the dengue virus again.  

How do doctors diagnose the disease?

It is not easy to diagnose the disease. You can have the same signs and symptoms of the dengue fever but still you can be diagnosed with other diseases such as malaria, leptospirosis, typhoid fever, etc.  

Once signs and symptoms are shown, doctors will likely need to investigate a little more about your medical and travel history. When it comes to this circumstance, you are advised to reveal your international trips in detail as well as the countries you have been to and dates in the locations you were in to see if you have any chance to get infected.

As sign of dengue and symptoms can cause confusion, doctors may advise you to have some certain laboratory tests to detect evidence of the dengue viruses.  

What are the dengue fever treatments?

There are no specific treatments for dengue fever. You may be recommended to drink plenty of fluid as you don’t want to get dehydrated from excessive vomiting and a high fever.

Despite of getting better from the fever, you are advised to watch your signs and symptoms of dehydration. Meet your doctor immediately once you develop some certain signs and symptoms as follows:

• Your urine output is low.
• You have few or no tears.
• You have dry mouth or lips.
• You experience lethargy or confusion.
• You experience cold or clammy extremities.

As for the initial dengue fever treatment, Acetaminophen including Tylenol and others can help ease pain and alleviate your fever. Pain relievers such as aspirin, ibuprofen and naproxen sodium are not recommended as they may increase risks of excessive bleeding conditions. With severe dengue fever, you are advised to:

• Request supportive care in a hospital
• Get intravenous (IV) fluid and electrolyte replacement
• Take blood pressure as advised by the doctor
• Consider blood transfusion to replace blood loss

How do we prevent dengue infection?

Measures to prevent and control dengue fever should, therefore, focus on disease prevention in advance. By controlling mosquito breeding sites both inside the house, community, and important places especially in schools and hospitals, the mosquito larval index should be equal to zero. The most important time to take action is from January – April because it is the time when the disease is spread the least and affects the number of patients that may occur during the rainy season (May-August).

Currently, 65% of dengue vaccines registered are effective in preventing all dengue strains. The dengue fever treatment in Thailand has been using the vaccine since 2017. Data from public and private hospitals have found side effects after received only 0.22 percent of the vaccines, all of which were mild. The World Health Organization recommends the use of vaccines in people aged 9-45 years and who have previously been infected with dengue fever. Doctors are to consider the vaccination individually.