Dengue is a severe virus that affects the whole body and is found worldwide. Recent estimates say that almost half of the world’s population, or 3.6 billion people, live in places where they could get the infection.
Most dengue cases are found in kids between 5 and 15. The disease is common in our country, especially after the monsoon. The Aedes aegypti mosquito spreads illness from person to person. To stop mosquitoes from breeding, it is important not to collect water, keep good hygiene, and be extra careful during the day when the mosquito bites. Use a mosquito repellent or cover your arms and legs.
So far this year, there have been up to 24,967 cases of the dengue virus in Pakistan. Sindh remains the highly infected province with 7,951 cases and 33 deaths of the mosquito-borne disease. In Khyber Pakhtunkhwa, 6,412 dengue virus cases with seven deaths, followed by Punjab with 5,202 cases and 15 deaths. Delhi in India, there were 36 new dengue cases in July 2022, 75 in August, and 152 in September. This brings the total number of cases this year to 396. Just this past week, 101 new cases were reported.
The dengue virus has four known serotypes: DEN-1, DEN-2, DEN-3, and DEN-4. In the past 50 years, DEN-2 has been the most common and most severe disease in Delhi. A few cases of DEN-3 and DEN-4 were found to be the same or no worse than other cases. In 2013, people in Malaysia found a fifth serotype that causes mild disease.
Technically, a child can get sick with each of the five serotypes five times. You are immune to it for life when you get infected with one serotype. However, you could get very sick if you get a second infection with a different serotype (called secondary dengue). Children can have both primary (first time with dengue virus) and secondary (second time with dengue virus) dengue infections (second dengue virus infection with a different serotype).
Signs of Trouble:
- After five days of fever, cold hands and feet if the fever is low or not.
- Abdominal pain
- Feeling dizzy when walking or getting out of bed
- Any places that are bleeding
- Nose bleed
- Bleeding feces or urine
Going to Test:
- The NS1 test came back positive on days 1 and 2.
- On days 5 and 6, IgM tests positive.
- Incubation: 4–10 days after being bitten by a mosquito
Symptoms of infections can range from non-specific viral illness to severe dengue infection, which is marked by severe circulatory shock (fever for 5–6 days followed by cold extremities, bleeding from nose or stool or blood spots, bruises under the skin, fluid leakage due to injury to blood vessel lining, less blood flow to the brain in all areas, more fluid in the lungs and abdomen, swelling under the skin, and puffy eyes).
There could be fainting if the amount of blood in the body drops and the blood gets more concentrated because plasma is leaking (high hematocrit PCV that tends to clot and toxins break the platelets reducing the number of platelet functions that there are not functioning well).
All of this poor blood flow, which means that the liver and kidneys aren’t getting enough oxygen, causes low urine output, pain in the abdomen, an abnormal LFT (liver function test), and fluid in the belly as well as in the lungs, which is called pleural effusion and makes it hard to breathe. There could be pain behind the eyes and dizziness, leading to organ failure if fluids aren’t taken by mouth or IV if necessary.
Each year, a different serotype might be the most common. This year, people are getting swollen, their blood pressure is going down, and they are bleeding less, but the serotype is DEN-2. A few years ago, more patients had bleeding signs, meaning they needed platelets.
Most dengue cases can be treated at home by lowering the fever and drinking lots of fluids to prevent dehydration. Patients don’t have much appetite for solid food, so urine output indicates how dehydrated someone is. No matter what serotype it is, dengue with warning signs and severe dengue with shock, bleeding, and multiple organ failure are joint hospital admissions that can lead to death.
Most of the time, the fever gets better on days 5 or 6. After that, the leakage causes dehydration, low blood pressure, dizziness, stomach pain, rashes and face swelling, effusion, and the abdomen fills up with fluid that has leaked out. We have to wait until the leak starts to stop.
By day 7 or 8, the appetite returns, and by day 10, the overall condition improves. If a patient is bleeding, the platelet count must be kept on. Platelets may need to be checked on very young babies early because they can cause bleeding inside the head. Researchers have found that people with covid have a higher chance of getting severe dengue and may get sicker.
Dengue is preventable. During the time of year when mosquitoes are most likely to lay eggs, kids who go to school should wear pants or put bug spray on any exposed skin.