Dengue
Dengue fever has become a critical public health concern in Bangladesh. Dengue outbreak of 2024 is one of the deadliest outbreaks in the history of Bangladesh. This mosquito-borne disease spread relentlessly and overwhelmed the healthcare system. The situation claimed thousands of lives and leaves countless others severe symptoms. Climate change, urbanization, and inadequate mosquito control system have exacerbated the situation as serious. This polluted environment created the perfect breeding ground for the primary carriers of the virus Aedes mosquito. Raising awareness and implementing effective prevention strategies can help the nation to combat the threat of the epidemic. In this article we’re going to discuss causes, symptoms, diagnostic methods, treatment and preventive methods.
What is Dengue?
Dengue is a mosquito-borne viral disease. It is caused by a virus which is primarily transmitted by the bite of infected Aedes aegypti and Aedes albopictus mosquitoes. It is a significant public health concern in tropical and subtropical regions worldwide. The disease ranges from mild to severe flu like symptoms. These mosquitoes are most active during the day and especially they bite early in the morning and before dusk. And this mosquito-borne viral illness is called Dengue fever.
Causes and types of Dengue Virus
Flavivirus is the main cause of the situation Dengue Fever. The virus belongs to the Genus: Flavivirus and Family: Flaviviridae. It has four types including:
- DENV-1
- DENV-2
- DENV-3
- DENV-4
Infections with one of these serotype provides lifetime immunity to an individual. But increases the risk of severe disease upon subsequent infections with a different serotype due to antibody-dependent enhancement (ADE). [1]
Symptoms of Dengue Fever
Symptoms of dengue fever appear within 4–10 days after bitten by an infected Aedes mosquito. The fever normally last for 2–7 days. The symptoms can be range from mild to severe including:
Mild Symptoms:
- High fever (≥40°C or 104°F)
- Severe headaches
- Muscle, joint, and bone pain (known as ‘breakbone fever’)
- Nausea and vomiting
- Rash in the skin
- bleeding in the nose, gum, brain, lever etc. organ
Severe Symptoms (known as DHF or DSS):
- Continuous vomiting
- Severe abdominal pain
- Bleeding in different organ
- Organ dysfunction
- Difficulty in breathing
- Severe fatigue and restlessness
- Presence of blood in vomit and stool
- Dengue Shock Syndrome (cold, clammy skin)
Severe dengue can be life-threatening and can cause death. This situation requires immediate medical attention. [3]
Diagnostic Tests for Dengue
Diagnosis of dengue is very important for effective management. The following tests are used:
1. NS1 Antigen Test: The test detects the non-structural protein 1 (NS1) of the virus. It is very effective during the early stage of the fever (1–7 days of the symptom). It is very reliable for confirming the infection.
2. RT-PCR Test: Detects viral RNA. This test is highly sensitive and best for identifying the specific serotype of Dengue.
3. IgM/IgG Antibody Tests: IgM antibody detect dengue from 4–5 days after starting of the symptom and IgG antibody Indicates past exposure or secondary infection.
4. Complete Blood Count (CBC) Test: Identifies warning signs, such as thrombocytopenia and hemconcentration. [3]
Which Diagnostic Test is better?
For early diagnosis of Dengue NS1 antigen test or RT-PCR test is most effective. Combination of NS1 antigen and antibody tests will increases the diagnostic accuracy. For late stage diagnosis IgM/IgG antibody tests are preferable.
Treatments of Dengue
There is no specific antiviral treatment for dengue. Management can helps to treat the disease. It should focuses on:
- Take pain relievers, such as acetaminophen
- Avoid anti-inflammatory drugs, such as aspirin for reducing the risk of bleeding
- Maintaining hydration by taking oral rehydration salts or intravenous fluids
- Keep monitoring severe symptoms, especially internal bleeding
Severe cases may require hospitalization for more supportive care, which may include blood transfusions. [4]
Prevention of Dengue
Best way to prevent dengue is to avoid mosquito bites. Prevention involves keep ownself safe and making efforts to mosquito population down. To protect people:
1. Prevent Mosquito Bites: Use mosquito repellents even in indoor, which may contain DEET or picaridin. Use bed nets before sleep, especially in areas with high mosquito populations.
2. Mosquito Breeding Control: Eliminate stagnant water in containers, tires, and flower pots. Clean water tanks and cover them tightly. Introduce mosquito eating fish in water bodies.
3. Community Level Measures: Fogging and spraying insecticides in high-risk areas can destroy effectively. Public awareness is more important for dengue prevention.
4. Vaccination: Dengvaxia vaccine can help prevent Dengue for who previously had positive or lives in the dengue spreading area. It is about 80% effective. [5]
Dengue remains a great health challenge, particularly in the densely populated country like Bangladesh. Proper treatment, early diagnosis and preventive measures are important to reduce morbidity and mortality.
References:
[1] CDC. (2024, May 21). About. Dengue. https://www.cdc.gov/dengue/about/index.html
[2] Dengue fever. (n.d.). Mayo Clinic. Retrieved December 2, 2024, from https://www.mayoclinic.org/diseases-conditions/dengue-fever/symptoms-causes/syc-20353078
[3] CDC. (2024b, August 26). Clinical testing guidance for. Dengue. https://www.cdc.gov/dengue/hcp/diagnosis-testing/index.html
[4] Kay, B. H., Barker‐Hudson, P., Marks, E. N., Gorman, B. M., Stallman, N. D., Wiemers, M. A., Holt, P. J., & Muscio, M. (1984). Dengue fever. Medical Journal of Australia, 140. https://doi.org/10.5694/j.1326-5377.1984.tb104033.x
[5] CDC. (2024b, May 21). Preventing. Dengue. https://www.cdc.gov/dengue/prevention/index.html