Dengue-, Causes, Symptoms Diagnosis, & Treatment[2024]

What is Dengue?

Dengue fever is a virus-borne infection that is primarily found in tropical regions around the world. The female Aedes mosquito transmits dengue-causing virus cells from infected to healthy people via blood-sucking bites. The virus then spreads from the vector to the host, rapidly reproducing the dengue-causing virus.

Dengue is typically divided into four serotypes: DENV 1, DENV 2, DENV 3, and DENV 4. DENV 3 and 4 are the most common forms of the virus. These serotypes belong to the Flavivirus genus. Dengue fever outbreaks are frequently reported in the Indian Subcontinent, Southeast Asia, southern China, Taiwan, a few Central and South American countries, and Caribbean, Mexican, and African islands.

These disease-causing agents are frequently found near open drains, stagnant water bodies, marshy lands, and human-populated areas. From 2007 to 2009, there were significant Dengue outbreaks worldwide, with a 50% mortality rate in a short period.

When the  is introduced into a new host via a viremic source, it attacks Dendritic, Langerhans, and Skin-Dendritic cells. Dendritic cells of all other cells are important because they provide a direct route for the pathogen to enter and affect the lymph nodes, compromising the host’s adaptive immune responses. Researchers and doctors are constantly working to develop a dengue vaccine.

Symptoms of Dengue

After entering the host, the virus cells multiply, and dengue symptoms appear 2-12 days later. Symptoms and severity of the condition vary according to serotype.

Symptoms include:

• A sudden fever

• High temperatures.

• Nausea

• Vomiting

• Bleeding

• Teeth pain

• Nose bleed

• Skin rash

Types of Dengue

Dengue infects approximately 40% of the population in the 100 countries where it is endemic. If the diagnosis is made early, there is a good chance of recovery. Depending on the severity and symptoms observed in the host, dengue is classified as:

• Mild dengue fever.

• Dengue hemorrhagic fever.

• Dengue-Shock Syndrome

Mild Dengue Fever:

Mild Dengue Fever (MDF) symptoms can take up to 7 days to appear in the host. These symptoms include muscle aches, joint pains, vomiting, a high fever, and severe and prolonged headaches. When diagnosed early, dengue can be treated with various options depending on the severity of the condition.

Dengue Hemorrhagic Fever.

(DHF) is a severe dengue infection that can be fatal if left untreated or treated incorrectly. DHF symptoms are frequently observed during or after the recovery from MDF. DHF is typically caused by the transfusion of blood from a viremic person via a mosquito. DHF symptoms include, but are not limited to, those experienced by people infected with MDF.

Internal bleeding, sudden fever, cold chills, cold or clammy skin, bleeding and bruising under the skin, nose bleeds, restlessness, and a significant drop in blood pressure are some of the symptoms.

Dengue-Shock Syndrome:

(DSS) is the condition that patients with DHF typically develop. This type of dengue causes the patient to experience a sudden onset of shock and high fever, as well as a significant drop in blood pressure, which can lead to sudden collapse. The patient exhibits severe headache, sore throat, and respiratory irregularities.

The majority of DSS cases occur in children under the age of ten. The mortality rate for DSS is currently between 6-30%. It is a severe form of dengue, with symptoms including blood in the stool, vomiting, a weak pulse, and spitting up blood.

Causes Of Dengue

Dengue is primarily caused by the viral transmission of the dengue-causing virus from a dengue-infected person to a healthy host via mosquito bites. When a mosquito bites an infected person, the virus enters the mosquito’s bloodstream and is then released into the host when the mosquito bites another person.

While there are preventive vaccines for dengue, a person who has been infected with the virus will usually develop immunity to that strain of the virus. However, when a person is infected with dengue for the second time, they are more likely to contract DSS or DHF.

Dengue fever is common in human-populated areas, and disease-carrying vectors breed quickly in stagnant waters such as open drains, water-filled discarded tires, unattended flower vases, open tanks, and other stagnant water sources.

Dengue can also be transmitted intravenously and through sex. However, the reported issues with these forms are minor.

The global medical community is actively working to isolate and develop vaccines that will make people immune to dengue. There are currently no vaccines available that can completely prevent dengue fever. Dengue fever is primarily caused by the Aedes mosquito, and taking precautions to avoid such an occurrence can help prevent a Dengue attack.

Dengue fever is well-known in tropical countries, and it is always a good idea to pack mosquito repellent. Following these steps will help you successfully prevent Dengue fever.

1) Cover your body from top to toe:

When visiting mosquito-infested areas, wear long pants and long-sleeved t-shirts. Wear protective clothing such as gloves, socks, and hats to cover all of your skin. It is also recommended that you tuck your T-shirt that ends near your sleeve into your gloves and your pants into your socks near the ankle to prevent mosquitos from reaching exposed skin.

2) Apply mosquito repellents:

For direct skin application, use a mosquito repellent containing at least 10% N-Diethyl-Meta-Toluamide. It will keep mosquitoes away. This formula is widely used in the Odomos, Good Knight, and Mamaearth Natural brands.

If you’re camping or in a mosquito-infested area, you should spray Permethrin on your clothes, tent, and other gear. Permethrin is a substance that kills mosquitos that come into direct contact with it. Trekkers are sometimes advised to purchase Permethrin-treated clothing to reduce the risk of dengue.

3) Install a door or window screen:

Door or window screens are specifically designed to allow air and sunlight to flow freely while keeping other small insects out of the house. Installing screens on doors, windows, and other inlets can help prevent dengue.

4) Things to do at home:

Male Aedes mosquitoes frequently breed in stagnant water. This can be avoided by ensuring that no water remains stagnant in flower pots, tires, buckets, old utensils, air-conditioning water exhausts, open buckets, or leaky pipes. While camping, it is also recommended that you avoid ponds and lakes because they can serve as breeding grounds for disease-carrying mosquitos.

5) Use contraceptives:

Dengue is very rarely transmitted sexually, and using a condom can help prevent this. People who have been infected with dengue should avoid unprotected oral, vaginal, or anal sex.

Diagnosis of Dengue

Dengue fever is typically diagnosed through complete blood work. The medical team treating the condition looks for the NS1 antigen, Immunoglobulin M, and Immunoglobulin G, and they may also use the Dengue RNA PCR test to determine the nature and severity of the infection.

NS1 Antigen:

Looking for the NS1 antigen in blood samples can aid in the early detection of dengue. This is a faster process because antibodies take 4-5 days to reach the blood tests. Looking for the presence of the NS1 antigen is an excellent method for diagnosing dengue in its early stages, as the likelihood of false positives increases as the time frame approaches 5-7 days.

Finding the NS1 antigen is the cheapest way to diagnose dengue. However, this method of diagnosis does not reveal the nature of the virus infection or the patient’s stage.

Immunoglobulin M:

Immunoglobulin M (IgM) is an antibody that appears in the blood following the onset of the disease. Between 0 and 3 days, the chances of finding Immunoglobulin M in blood are as high as 50%, increasing to 80% by day 57 and 99% on day 10. This method can determine whether the onset condition was primary or secondary. When a patient or host becomes infected with dengue for the first time, this is referred to as primary onset. Secondary infection occurs when the virus infects someone for the second or third time.

Depending on the type of test performed, the turnaround time ranges from one to two days. However, IGM is only detectable after the fourth day of the disease’s onset.

Immunoglobulin G:

The presence of Immunoglobulin G (IgG) in small amounts in the blood indicates that the person has been infected with dengue and that the infection has occurred more than once. This aids in the classification of the viral infection, as dengue in its second or third occurrence is more severe and rapidly progresses from mild Dengue to DHF and DHS.

IgG is only detectable after the fourth day of the disease.

Dengue RNA PCR Test:

The dengue RNA PCR test is one of the most definitive and accurate tests, with results that can be used early in the disease’s onset. These findings determine the nature and stage of the infection, allowing the medical team treating the patient to prescribe medication that will keep the infection from becoming chronic and prevent multiple organ failure.

This method of diagnosing dengue is most effective when testing is conducted within 0 to 5 days of the condition’s onset. However, this type of testing is only available in a few medical centers.

Dengue fever can be treated at home or in a hospital, depending on the severity of the illness. Patients with mild fevers and body aches can be treated at home with oral hydration and Tylenol.

However, if the patient exhibits symptoms of hemorrhage, internal bleeding, shock, or high fevers, saline-based electrolytes should be prescribed to replenish fluid content in the body. It is also recommended to avoid steroids and aspirin.

Dengue Fever Complications

The complications of dengue hemorrhagic fever include:

• Blood under the skin

• Blood on the skin

• Patchy skin

• Bloody stool

• Bloody vomit

• Bloody Spit

• Weariness

• Cough, sore throat

• Excessive sweating

• High fever

• Sudden chills

• Unusual urine discharge

• Dry eyes

Outlook and Prognosis

Dengue is fatal if not treated, and DHF or DSS-causing serotypes account for only 2.5% of all reported cases. The mortality rate for patients with DHF or DSS ranges between 20% and 50%, as the majority of cases go untreated.

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Dengue fever is often difficult to diagnose because it has symptoms similar to malaria and other mosquito-borne illnesses. The viral fever lasts between 2-4 weeks, depending on the nature of the condition. Rehydration with oral or saline drips.

Road To Recovery And Aftercare

Dengue patients typically recover within 1-2 weeks, depending on the severity of the condition and the patient’s physical fitness. It is best to consult your treating physician about the dos and don’ts during the recovery period. Dietary advice suggests avoiding oily, junk, and other fried foods. Vegetables like papaya, broccoli, pomegranate, spinach, ginger-water, orange, coconut, and other boiled vegetables should be consumed because they contain Omega-3, which helps the body strengthen its immune system. These fruits and vegetables contain all of the essential vitamins, minerals, and fiber required to increase blood cell count and restore normal immunity levels.

Patients should also consume protein-rich foods such as fish, chicken, eggs, and dairy products.

During the patient’s recovery, the doctor should be kept informed of his or her vital signs. Dos include regular blood platelet count and blood pressure monitoring, as well as adequate bed rest. The Don’ts require patients to avoid caffeine, alcohol, tobacco, and carbonated beverages.