Fight the bite

MALADY With National Dengue Day on May 16, Dr Amitabha Ghosh suggests ways to tackle the endemic disease

With the onset of summer, a serious health threat rears its head in India every year. Cases of vector-borne disease dengue start trickling in as the summer season sets in and typically peaks during the monsoon when environmental conditions are most suited for the breeding of mosquitoes.

Alarmingly, India has witnessed a more than 300% hike in dengue cases in recent years with the total number of dengue deaths in 2017 being the highest in the last decade. According to a National Vector Borne Disease Control Programme (NVBDCP) report, dengue cases increased to 188,401 in 2017, from less than 60,000 in 2009. Interestingly, dengue has seen a dramatic rise not just in India but across the world. Prior to 1970, only nine countries had experienced severe dengue epidemics, but the disease is now endemic in more than 100 countries.

Dengue virus is transmitted by female mosquitoes, mainly of the species Aedes aegypti and, to a lesser extent, Ae albopictus. These mosquitoes also transmit other potentially serious vector-borne diseases including chikungunya, yellow fever and zika infection.

With the absence of any credible vaccine against the disease yet, prevention from mosquito bites remains the most important course. Unlike other mosquitoes, the dengue virus carrier is mostly a day biter, and is believed to be most active during dawn and dusk. Symptoms of the disease usually begin within seven days of the bite.

Signs & symptoms

Dengue fever, also known as breakbone fever, is a severe flu-like illness that affects all age groups. In most people, the fever passes off at its own course. However, in some patients it can cause serious complications like hemorrhagic fever, which can damage the lymph and blood vessels and can cause high fever, bleeding from nose and gums, liver enlargement and circulatory system failure.

It is therefore very important to stay under medical supervision during the course of the disease. If the platelet count dips too low, it may also increase the chances of internal bleeding, and platelet transmission becomes important.

Apart from high fever, cold and cough, other symptoms that accompany this viral infection include:

1. Pain in muscles and joints
2. Rashes in the body
3. Severe headache
4. Discomfort behind the eyes
5. Vomiting and feeling nauseous

Curative measures for dengue

Like most viral infections, we don’t have any specific treatment or cure for dengue. It’s a self-restricted disease because maximum dengue cases are simple dengue fever.

However, timely medical attention and supervision can prevent the risk of complications like persisting vomiting, pain in the abdomen, low urine volume, bleeding and mental confusion arising from the disease.

For milder forms of dengue, basic care includes keeping the fever under control and consuming a lot of fluids to re-hydrate the body’s lost hydration.

For controlling the fever, just take Paracetamol tablets and avoid using any painkillers. At the same time, keep a check on the patient’s platelet count and don’t panic if the platelet count dips because it’s normal to have it on the lower side. The platelet count will get back in order in seven to nine days only by consuming Paracetamol tablets and loads of fluid. Please consult doctors for proper guidance.

Keep dengue at bay

The only way to control or prevent the transmission of dengue is to stop the breeding of mosquitoes as much as possible through a series of measures:

1. Domestic water storage containers should be kept covered and water tanks must be filled with clean water and coolers or flower pots should also be cleaned on a weekly basis. Don’t let water stagnate in any place.
2. Kitchen and garden residue must be cleared on a daily basis. Don’t let even solid waste stand at a place for a long time.
3. Avoid using strong perfumes and soaps as they attract mosquitoes.
4. Mosquito nets must be used while sleeping to avoid mosquito bites.
5. Wearing long-sleeved clothes, repellents and vaporisers, and keeping window shields down prevent mosquitoes from entering homes.
6. Make sure children apply mosquito repellents when they step out to play in the evening.

(The author is physician, Columbia Asia Hospital)