Though diagnosis of dengue causes fear and panic in patients, it is important to understand that not all dengue cases are fatal, and many are simple fevers that can be treated at home. Experts state that 90 per cent of the disease is just mild fever which won’t kill people. For that reason, doctors are working with their team of counsellors to guide patients to understand the disease, which requires simple treatment procedures like good intake of fluids, healthy home food and complete bed rest. These three factors are very important for cure, and if followed religiously, there is no need for hospitalisation.
Also, those who are seeking treatment at home need to follow up every alternate day, and repeat the blood counts to ensure that platelets are in good condition. Experts state that hospitalisation is required only for severe symptoms like a drop in the platelets, severe bleeding episodes and very high fever.
Complications begin post fever
It is not difficult for a trained doctor to identify the symptoms of mild from severe dengue. They are able to diagnose it, but many fail to understand that infections, especially viral fevers, take time to respond to treatment. Dr Hari Kishan Boorugu, consultant physician, Apollo Hospitals, explains, “At times, patients insist that they must be admitted and treated. We try and explain that they can come for a review as their condition is mild and does not require hospitalisation. Dengue patients have high fever for five to six days. Platelet count may drop after the fever ceases. Most complications occur towards the end of the first week and not during the first three days of fever. It must be understood that complications can’t be avoided even in hospitals despite continuous treatment.”
Special attention to immune compromised patients
Plasma leaking, fluid accumulation, respiratory distress, severe bleeding and organ impairment are severe symptoms in patients of extreme cases. Warning signs usually occur after three to seven days after the first symptoms of the disease.
Dr A. Kamalesh, senior general physician of the department of Internal Medicine, Yashoda Hospitals, says, “Dengue is suspected when the fever is 1040C and is accompanied by either of two symptoms like severe headache, pain behind the eyes, muscle and joint pains, nausea, vomiting, swollen glands or rash.”
“Extra care should be ensured for pregnant ladies, obese people, diabetics, alcoholics, patients with malignancies and heart diseases. It is important for the doctors to identify them and counsel them,” adds Dr Kamalesh.
Steps to follow
1. Dengue fever can also be mild and self-limiting in most patients.
2. Dengue fever diagnosis is not possible only on symptoms. Hence the fever is characterised by high fever, rash, severe headache and backache. Dengue fever is also called breakbone fever.
3. Blood test is required to confirm the fever. Dengue PCR should be done to detect viral RNA. Another blood test called Dengue NS 1 antigen and Dengue IgM test which is an antibody test. Tests have pitfalls and can be falsely positive or negative at times.
4. When dengue fever is suspected, patients must avoid aspirin and pain killers and also drugs like ibuprofen and diclofenac as they affect the platelet function.
5. All dengue patients do not require hospitalisation. Complications in dengue patients and blood transfusion are only in extreme cases. Only 10 per cent of the patients develop complications while 90 per cent respond well to the treatment.
- To control or prevent the transmission of dengue virus, a good mosquito control programme is required:
- Preventing mosquitoes from accessing egg-laying habitats by ensuring no water is accumulated.
- Emptying and drying of water storage utensils on a weekly basis is important.
- Government must declare a particular day as dry day to control the spread of mosquitoes.
- Insecticides must be sprayed on outdoor containers and water puddles in and around your home.
- Mosquito repellents must be used at home even during the daytime. People must wear full sleeves so they are protected from mosquitoes.
- Keeping surroundings clean and dry is very important so that there are no mosquito breeding grounds.
- Disposing of plastic, coconut shells and empty tins and cans must be done properly.