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Description of Dengue

Definition of DengueAccording to dictionary definition  Dengue is a viral infection transmitted by a mosquito called Aedes aegypti (A. aegypti). It occurs as dengue fever and dengue hemorrhagic fever (DHF). Dengue is also called break-bone fever because of the severe pain it causes in the joints and muscles.  Causes and Risk Factors of DengueAccording to dictionary definition  Four kinds of virus, DENV-1, DENV-2, DENV-3, and DENV-4, can cause dengue. These viruses are transmitted by the bite of the mosquito A. aegypti. However, in certain circumstances, it can also be transmitted by other mosquitoes Aedes albopictus and Aedes polynesiensis.  A. aegypti is common in warm and wet areas and is easily distinguishable with its white markings on legs and a lyre-shaped marking on its top. It breeds in the uncovered water around our homes, as well as indoors.  Discarded objects that collect rainwater provide easy breeding ground for A. aegypti. These include:1. Broken vases2. Old tires3. Buckets4. Plastic containers5. Flower pots  It takes about a week to produce an adult mosquito from an egg. The eggs can even survive in dry conditions for a long time.A. aegypti prefers dark corners of our homes such as under the bed or table or behind the curtains. They usually bite in the daytime, especially early morning and late afternoons. However, they can bite at other times of the day too, particularly the ones that live indoors. The female mosquito needs human blood to produce eggs. Once it bites an infected person, the virus starts replicating inside the mosquito. This may take about 1 to 2 weeks. The virus can only be transmitted to another person after this period.A person with dengue infection can infect it to mosquitoes 6 to 12 hours before the onset of the disease and remains so up to 3 to 5 days. Dengue does not spread from person to person. It can only be transmitted by the bite of the mosquito. Outbreaks of dengue usually occur in the rainy season.  Signs and Symptoms of DengueAccording to dictionary definition  The symptoms of dengue and the severity of illness may vary with the age of the infected person and the type of virus. The illness is more severe in infants and elderly people.Dengue fever symptoms usually appear 4 to 7 days after infection. Symptoms include:1. High fever with shivering2. Headache, especially behind the eyes3. Severe pain in the muscles and joints4. Nausea and vomiting5. Cough6. Sore throat7. Rashes  Symptoms of DHF include:1. Fever2. Headache3. Pain in the muscles and joints4. Vomiting5. Small red or purplish patches of blood under the skin6. Tiny spots of blood on the skin7. Rashes all over the body  Loss of blood and fluids due to hemorrhage may cause dengue shock syndrome (DSS). It may cause:1. Very low blood pressure2. Organ failure3. Loss of life  The duration of illness ranges from 7 days to 10 days in most cases.  InvestigationsAccording to dictionary definition  Dengue diagnosis requires following investigations:1. Complete blood count (CBC): Dengue causes a drop in the number of white blood cells and platelets.2. Liver function tests: Dengue is characterized by elevated aspartate aminotransferase (AST) levels.3. Antibody titer or polymerase chain reaction (PCR) test for dengue virus types  Treatments of DengueAccording to dictionary definition  Being a viral illness, there is no specific treatment for dengue. Treatment is symptomatic and supportive. The doctor will record the body temperature and check for rashes on the body and bleeding under the skin.Most people with dengue recover within 2 weeks. Until then one is advised to:1. Drink lots of fluids: Oral rehydration with fluids (ORS) for vomiting and diarrhea.2. Get adequate rest.3. Take paracetamol to reduce fever and pain  Note: NSAIDS (nonsteroidal anti-inflammatory drugs) must NOT be taken during a dengue infection,  for example, aspirin and ibuprofen.  People with the more severe forms of dengue need hospitalization. Treatment may include:1. Replacement of plasma losses2. Normal saline to maintain circulation3. Blood transfusion: In cases of hemorrhage, whole blood, platelet, or plasma transfusions may be carried out.  Complications and When Should You See a DoctorAccording to dictionary definition  Dengue can be life-threatening in its DHS and DSS form. When dengue turns into DHF it causes bleeding from the nose, gums, or under the skin. Massive bleeding and shock occur in DSS.  Delayed treatment can also threaten life. In rare cases, dengue may cause liver or kidney failure and brain damage. Conditions that can aggravate dengue include:1. High blood pressure2. Diabetes3. Lung diseases4. Heart diseases5. Hepatitis  See a doctor if you have:1. Fever with rashes on the body2. Pain behind the eyes3. Any other dengue symptom  Prognosis and PreventionAccording to dictionary definition  Dengue has a good prognosis if the treatment is taken in time. However, recovery may be followedby:1. Lethargy2. Tiredness3. Depression  There is no vaccine for preventing dengue. The prevention depends on public health and community-based programs that aim at controlling the breeding of mosquitoes and destroying their breeding sites.  1. DO NOT let water collect in any open container in and around your home.2. Eliminate the places where the mosquito lays eggs, primarily artificial containers that hold water.3. Cover the containers used for storing water.4. Remove water from coolers and other small containers such as flower vases at least once in a week.5. Fogging can be done once a week to destroy mosquitoes.6. Empty and clean water containers used for pets.7. Use air conditioning or window and door screens to prevent entry of mosquitoes indoors.  To prevent infection:1. Wear insect repellent with DEET2. Wear clothes that cover arms, legs, and feet3. Keep doors and windows closed4. Use mosquito repellants even during day time  ReferencesAccording to dictionary definition  Thomas SJ, Endy TP, Rothman AL, Barrett AD. Flaviviruses (Dengue, Yellow Fever, Japanese Encephalitis, West Nile Encephalitis, St. Louis Encephalitis, Tick-Borne Encephalitis, Kyasanur Forest Disease, Alkhurma Hemorrhagic Fever, Zika). Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. In: Bennett JE, Dolin R, Blaser MJ, eds. 8th ed. Philadelphia PA; Elsevier Saunders; 2015:chap155.  National Vector Borne Disease Control Programme. Directorate General of Health Services. Ministry of Health and Family Welfare. Government of India. http://www.nvbdcp.gov.in/DENGU1.html. Accessed June 5, 2017.  Centers for Disease Control and Prevention. National Center for Emerging and Zoonotic Infectious Diseases. Division of Vector-Borne Diseases. Dengue Branch. Dengue and the Aedes aegypti mosquito. https://www.cdc.gov/dengue/resources/30jan2012/aegyptifactsheet.pdf