Experts advise caution as dengue tally reaches 285 in Ludhiana district

Tribune News Service

Ludhiana, September 27

As many as 285 cases of dengue have been confirmed in the district till Wednesday. In view of the recent surge of dengue cases, The Tribune talked to medical experts to find answers to the most commonly asked questions regarding the mosquito-borne viral disease.

What is dengue?

Dengue is a viral infection that can lead to fever and even severe bleeding, known as dengue haemorrhagic fever, while some may suffer from the dengue shock syndrome.

How can one get infected by the dengue virus?

The virus is mainly transmitted by the Aedes aegypti mosquito, which bites humans during daytime. It breeds in relatively clean water stored for drinking and washing purposes or the rainwater collected/accumulated in tanks, containers, tyres, bottles, etc.

Who can get this disease?

Individuals of all ages and sexes, who are exposed to mosquito bites, can get infected with the dengue fever. However, children usually tend to have milder infections as compared to adults.

What are the various symptoms of dengue infection?

The first category of dengue patients experience mild uncharacteristic fever. Patients with more severe infection may complain of the ‘break-bone fever’, which is characterised by chills, high fever, severe headache, rash spreading from trunk to extremities, along with muscle and joint pains that may affect movements for around five days.

Patients with Dengue Haemorrhagic Fever (DHF) record abrupt onset and high continuous fever lasting for two to seven days with bleeding patches under skin, bleeding from nose and gums, blood in vomiting, black tarry stool, capillary leakage (ascites and pleural effusion), low platelet count and around 20 per cent rise in haematocrit, the ratio of the volume of red blood cells to the total volume of blood.

Patients with dengue shock syndrome show all the signs and symptoms of the DHF with cold clammy skin, weak and rapid pulse, hypotension and narrow pulse pressure.

How does one differentiate dengue fever complicated by bleeding from DHF?

In case of bleeding caused by dengue fever, a patient usually bleeds from pre-existing lesions and the liver is not enlarged. Also, capillary leak — ascites and pleural effusion — can be seen while the patient may record a fall in the haematocrit level. Such patients also report a fall in the count of white blood cells (WBCs) and a mild decline in platelet count, but it rarely falls below 1,00,000/mm3.

However, if a patient is suffering from DHF, symptoms include bleeding under skin and from all mucosal surfaces like peptic ulcer while capillary leaks are not seen in DHF patients. An enlargement in liver is usually noticed in one or two days and the haematocrit rises by 20 per cent or more. They report a rise in the WBC and platelet count (usually 1,00,000/mm3)

How is a patient with dengue fever managed?

There is no specific drug or vaccine available that acts against the dengue virus. However, the management of dengue patient involves bed rest under a mosquito net, use of sponge for high fever and paracetamol tablets for pain and fever.

However, they are recommended to avoid aspirin and other drugs that can reduce the platelet count and increase bleeding. Besides, doctors check vital signs such as haematocrit ratio, urine output for signs of dehydration and electrolyte imbalance.

The treatment further entails rapid intravenous replacement of fluids and electrolytes to sustain patient till recovery and plasma or plasma colloid preparations, if the haematocrit remains elevated.

However, care should be taken to avoid overhydration and pulmonary oedema, in which case, diuretics may be used. Doctors may also give diazepam to calm some dengue patients.

Can close contact with a dengue patient directly transmit the infection to a healthy individual?

Dengue does not spread by direct contact, but only via Aedes mosquito bite as its transmission route is ‘man-mosquito-man’.

How to contain the spread of dengue fever?

Individuals should take precautions such as sleeping under mosquito nets and using insect repellents to protect themselves from mosquito bites. Households, communities and the administration should take steps to control the population of Aedes mosquitoes.

How can the population of Aedes mosquitoes be brought under control?

Getting rid of discarded tins, tyres, empty pots, broken bottles and other containers, where water may get accumulated, is recommended as a basic precaution to eliminate breeding grounds of mosquitoes.

Adding oil to water collected in small ponds can help destroy the mosquito larvae while insecticides are sprayed to kill adult mosquitoes.

#dengue