Dengue is having a free run this autumn, thanks
to the abundant rains, ramapant water logging and unrestricted breeding of
mosquitoes. Almost every household has either had a bout of fever in the last
month or is likely to in the next one.
Recognizing Dengue Fever (DF): It is a viral
infection transmitted by mosquitoes and presents as a sudden febrile illness of
2-7 days’ duration, with 2 or more of the following:
- Headache
- Pain behind the eye balls
- Severe body aches
- Pain in the joints
- Rash
One of the main concerns in Dengue is the fall in
platelet counts from its normal range of above 150,000. Platelets play a vital
role in preventing or stopping bleeding from small blood vessels. Infusion of
platelets is required only if they drop to below 20,000 or when there is active
bleeding. Remember transfusions have their own risk of transmitting other
infections, of allergic reactions, and their effect lasts barely a few hours.
The other concern is shock. Dengue sometimes causes
fall in blood pressure due to leakage of plasma from capillaries with loss of
blood volume. The Hemoglobin level paradoxically rises and urination may become
less. Some patients show liver involvement (Serum ALT/AST, Bilirubin) or kidney
dysfunction (increase in serum creatinine). These usually settle down with good
intake of fluids and calories.
Tests for
Fever: It is important to remember that all fevers may not be due to Dengue and
Enteric Fever (Typhoid), malaria, and common flu are equally ramapant these
days. Further, while Dengue is a viral illness with no specific medicines,
typhoid and malaria need specific medications and can be far more dangerous to
life than Dengue.
If fever persists for more than 2 days and is
severe, tests should include Hemoglobin, white blood cell and platelet
estimations, a peripheral smear for malaria, and a serological test for Dengue.
The serological test for typhoid often does not show up in the first few days
of this infection and hence can be misleading if done too early.
When to worry: If you have contracted Dengue, lie
in bed and take rest for atleast a week, drink lots of liquids (water, juices,
soups, nimboo paani or ORS), take paracetamol tablets ( upto 3 a day), avoid aspirin
and brufen as they may trigger bleeding,
apply balms on your head and listen to soothing music. Consult your
family physician but do not panic. Remember that there is no specific
medication for Dengue and yet recovery is the rule.
Critical phase: Contrary to popular belief, the
danger phase in dengue is not the 1st 2-3 days of high fever, but around the 5th
to 7th day, when the fever begins to settle. Many people who are in a hurry to
get back to their normal lives often crash during this phase with low BP and
shock. It is therefore crucial to relax at home for a couple of days more.
I hope employers and school principals do not sue
me for this advice!
As published in HT City ( Hindustan Times) dated 8th September, 2012.
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