What is Dengue?

August 14, 2012 at 4:59 am Leave a comment

Dengue Fever (DF) or Dengue Hemorrhagic fever (DHF), its more severe form, is an illnesses not new in our country. It is a disease that continues to scare us every time one develops fever especially during the rainy months. Although it has been known to be more common during the rainy season, it has become an all-year round disease because of the unpredictable rains we experience even during the non-rainy months. This dreaded febrile illness affects infants, young children and adults of all walks of life. Presently, there is still no specific treatment for dengue.

Epidemiology

Dengue is a mosquito-borne disease common in countries with tropical and sub-tropical climates worldwide (Southeast Asia, South Pacific, American Tropics). It occurs mostly in urban and semi-urban areas where population density is high, the water supply is inadequate (resulting to water storage hence, a good breeding place for the vector), and the solid waste collection and storage are also inadequate. All these conditions make Philippines a good candidate for dengue prevalence.

Transmission

Dengue is caused by the dengue virus (DEN) belonging to the genus Flavivirus, family Flaviviridae. There are four distinct serotypes, named DEN-1, DEN-2, DEN-3 and DEN-4. The dengue virus is transmitted to humans by the bite of a female Aedes mosquito principally Aedes aegypti, infected with any one of the four dengue viruses. Mosquitoes bite people and animals because they need the protein found in blood to help develop their eggs. The symptoms of dengue appear 3-14 days after the infective bite.

The Aedes mosquito can be identified by the black and white stripes in their body. They are known to be day-biting mosquitoes peaking at dawn and dusk. They breed in clean, stagnant water accumulated in containers which is usually found in households.

Clinical Presentation

According to WHO and expert consensus groups in Latin America and Southeast Asia, “dengue is one disease entity with different clinical presentations and often with unpredictable clinical evolution and outcome”.

Dengue has a wide spectrum of clinical manifestations from non severe to severe symptoms. Initially, patients develop sudden onset of high-grade fever for 2-7 days, often accompanied by flushing of skin (reddening), generalized body ache or weakness, muscle pain, joint pain, and headache, loss of appetite and vomiting. Some may present with sore throat, reddening of throat and eyes. These symptoms in the early stage usually make it difficult to distinguish from other non-dengue causes of fever. But since it is endemic in our country, dengue is almost always not ruled out. Hence, close monitoring of warning signs and other clinical parameters are advised.

The warning signs of dengue include abdominal pain, persistent vomiting, weakness or restlessness, signs of bleeding like rash, red or black stools and vomitus, red or tea-colored urine, and profuse vaginal bleeding in females with menses. These warning signs may progress to severe dengue after fever wanes, usually at 3-7 days of illness. This may manifest with severe bleeding, respiratory distress due to fluid accumulation in the lungs, hypotension, and other signs of organ involvement like impaired consciousness, and heart abnormalities. However, some patients recover before the critical phase sets in. As of present time, there are still no known predictive factors of who will develop severe or non-severe dengue.

Treatment

As mentioned, there is still no specific treatment against dengue virus.  Early recognition and early intervention plays a vital role in the recovery from the disease.  The keys in the treatment of dengue are fluids, both oral and intravenous, depending on the phase and severity of illness; and close monitoring of clinical symptoms and parameters such as vital signs (blood pressure, heart rate, respiratory rate, pulses) and urine output, as well as laboratory work-ups like the complete blood count (CBC).

We can protect ourselves and our families from dengue by preventive measures to avoid mosquito bites such as applying insect repellants,wearing protective clothing (long sleeves and pants), using insecticides cautiously, screening doors and windows, and using mosquito nets (kulambo).  Control measures to eradicate breeding of the Aedes mosquitoes include covering and regular emptying and cleaning of water storage containers and other sites that usually collect water after the rains (unused tires, roof gutters, flower pots etc.)  Defogging is recommended only during an epidemic and larviciding is effective under certain conditions.

There is still no vaccine available for protection against dengue.  However, a dengue vaccine is now on its way and is at the third phase of clinical trials.  It is expected to be available  two years from now.  Let us hope for its success and its availability to everyone to remove the burden of dengue on every Filipino’s shoulders.

©pinoykidsMD

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Entry filed under: Dengue Watch. Tags: , , , , , , , .

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