Dengue Fever and it's sign symptoms Diagnosis and Management and it's complications.
Dengue Fever: Comprehensive Guide for Medical and Health Professionals
An updated detailed article on 'Dengue Fever'for medical students, doctors, nurses, and all healthcare workers.
Introduction
Dengue fever is one of the most significant mosquito-borne viral infections in the world. Caused by the dengue virus (DENV), it is transmitted mainly by Aedes aegypti mosquitoes. The disease presents a wide clinical spectrum, from mild febrile illness to severe life-threatening dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS).
With rising incidence globally, particularly in tropical and subtropical regions, understanding dengue is crucial for healthcare professionals and public health workers.
Epidemiology and Global Burden
- Dengue is endemic in more than 100 countries.
- Estimated 390 million infections annually worldwide.
- Approximately 96 million show clinical symptoms.
- WHO considers dengue one of the top emerging infectious diseases.
Cause and Transmission
Dengue is caused by four serotypes of dengue virus (DENV-1, DENV-2, DENV-3, DENV-4), belonging to the Flaviviridae family.
Transmission
- Primary vector: Aedes aegypti
- Secondary vector: Aedes albopictus
- Transmission occurs through the bite of infected female mosquitoes.
- Human-to-mosquito-to-human cycle sustains outbreaks in endemic regions.
Clinical Presentation
Dengue presents with a wide range of symptoms that progress in phases:
1. Febrile Phase (2–7 days)
- Sudden high-grade fever (40°C / 104°F)
- Severe headache
- Pain behind the eyes (retro-orbital pain)
- Myalgia and arthralgia ("breakbone fever")
- Skin rash
- Nausea and vomiting
2. Critical Phase (After fever subsides)
- Plasma leakage leading to shock
- Hemorrhagic manifestations (petechiae, nosebleeds, gum bleeding)
- Organ impairment
3. Recovery Phase
- Gradual improvement in symptoms
- Rash may appear again (convalescent rash)
Diagnosis
Diagnosis of dengue is based on clinical suspicion and confirmed by laboratory tests:
| Test | Purpose |
|---|---|
| NS1 Antigen Test | Early detection of dengue virus (first 5 days of illness). |
| IgM and IgG ELISA | Serological confirmation of recent or past infection. |
| RT-PCR | Viral RNA detection, identifies specific serotype. |
| Complete Blood Count (CBC) | Thrombocytopenia and leukopenia suggest dengue infection. |
Management and Treatment
Currently, no specific antiviral treatment exists for dengue. Management is supportive:
- Maintain hydration (oral or IV fluids as needed).
- Use paracetamol (acetaminophen) for fever and pain.
- Avoid NSAIDs (e.g., ibuprofen, aspirin) due to bleeding risk.
- Monitor platelet count and hematocrit closely.
- Hospitalize in case of severe dengue (plasma leakage, bleeding, organ impairment).
Prevention and Control
Individual Prevention
- Use mosquito repellents and bed nets.
- Wear protective clothing.
- Avoid mosquito bites during peak activity (early morning, late afternoon).
Community Measures
- Eliminate stagnant water sources (breeding grounds).
- Fogging and insecticide spraying in outbreak areas.
- Public health education campaigns.
Vaccination
The Dengvaxia vaccine is available but recommended only for individuals with prior dengue infection in endemic regions due to risk of severe disease in seronegative recipients.
Conclusion
Dengue fever continues to challenge healthcare systems globally. For medical students and professionals, understanding its pathophysiology, clinical features, and management strategies is critical for timely intervention. Strengthening vector control, vaccination strategies, and patient care remains the key to reducing the burden of dengue worldwide.
References
- World Health Organization (WHO). Dengue and Severe Dengue – Fact Sheet.
- Centers for Disease Control and Prevention (CDC). Dengue Overview.
- Gubler DJ. Dengue and dengue hemorrhagic fever. Clin Microbiol Rev. 1998;11(3):480–496.
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