Dengue alert

With the onset of monsoon, Delhi and surrounds are vulnerable to dengue.  SHAlINI SASKSENA speaks to doctors to bring you a lowdown on tackling this virus

Who are vulnerable

Vulnerable areas are stagnant water and newly developing colonies or societies. Fatality seen in  children and young adults.

— Dr Parashar

What is DengueIJ

It is a disease caused by a virus transmitted by a mosquito bite. It is a viral infection which causes flu-like illness sometimes triggering a fatal complication called severe Dengue.

— Dr Sunil Dutt Parashar, General & laparoscopic Surgeon, Shankar Hospital, Faridabad

To fight Dengue

To fight the virus, the immune system needs to be optimum. Dengue patients need to consume lots of fluids. The trick is to eat foods that contain lots of vitamins and nutrients, like orange, coconut water and fruit juice.

— Dr Aggarwal

The virus

The dengue virus includes four serotypes (DEN-1, DEN-2, DEN-3 and DEN-4) which belong to the genus Flavivirus. The virus gets transmitted from an infected mosquito to a human. A mosquito bites a person who is infected with the dengue virus — the virus is then passed on to another person when bitten by the infected mosquito.

— Dr Aggarwal

To do

There is no specific treatment for dengue fever but few advisories are: Plenty of intake of liquid, rest, symptomatic treatment of fever such as paracetamol. Medicines like aspirin should be avoided.

— Dr Parashar

Symptoms

Mild dengue fever

Symptoms: Appear up to seven days after the mosquito carrying the virus bites and generally go away after a week. High fever, headache, aching muscles and joints, body rashes that disappear and reappear, pain behind the eyes, vomiting and nausea.

Dengue Hemorrhagic Fever

Mild in the beginning but worsens after some days. DHF can cause death if not treated in time.

Symptoms: Clammy skin, bleeding from mouth/gums, nose bleeds, considerably damaged lymph and blood vessels, internal bleeding which can result in black vomit and faeces, lower number of platelets in the blood, small blood spots under the skin, a weak pulse.

— Dr Jeevan Aggarwal, Consultant, Internal Medicine, Fortis Hospital Shalimar BaghAyurveda says

Dengue fever reflects strong vitiation of vata and pitta doshas. The pathogenesis begins with the weakening of gastric fire and production of ama (toxins). This leads to vitiation of vata and pitta dosha as a result of which various symptoms appear. While muscle and joint pains indicate aggravation of vata, the hemorrhage reflects aggravation of pitta.

• Treatment includes complete bed rest. The aggravated vata requires avoidance of all activities that aggravate vata.
• The patient’s body should be covered with a blanket to prevent exposure to cold and spread of the infection by mosquito bites.
• Since gastric fire is generally weak and toxins dominate the digestive system, the patient is advised light meals and digestible foods. Soups prepared from pulses or vegetables, rice and porridge are recommended.
• Fried, spicy, sour foods and items made from white flour should be avoided as they generate toxins in body and create conducive environment for fever.
• Sufficient water should be drunk to avoid dehydration. Papaya leaf juice should be consumed as it increases platelet count which can be taken on regular basis.
• Medicines are given for digesting toxins, stimulate gastric fire, pacify vata and pitta and bring down the fever. Herbs like guduchi, musta, parpatak, khus, sandal, dhanwayas, tulsi and patha are useful as they meet all the above purposes. To pacify pitta and arrest haemorrhages, cooling medicines like khus, sandal, kamadudha ras, Chandrakala ras are useful.
• Patient should be given warm water to drink and body sponging should be done instead of taking a full-fledged bath.

— Ayurvedacharya Dr Partap Chauhan, director, Jiva Ayurveda

  Warning

In a majority of cases, its just a simple viral fever which can be treated symptomatically. But severe cases need hospitalisation due to low platelet count, poor intake, sever pain in the abdomen,  bleeding gums, respiratory distress and internal bleeding leading to multi-organ failure and death.                                 — Dr Parashar

Treatment

Dengue has no cure. Platelet transfusion may be needed if the count falls below 20,000 platelets per microlitre of blood. There are currently no vaccines for dengue fever in India. The only countries where the vaccine is available are Indonesia, Mexico and Brazil. The best way to prevent the disease is to avoid being bitten by mosquitoes. Although there is no precise treatment for dengue, it is treatable if caught before developing into Dengue Shock Syndrome or Dengue Hemorrhagic Fever.

For typical Dengue, the treatment is purely symptomatic. Dengue patients must take rest and lots of fluid intake for adequate hydration.

Close monitoring of vital signs in the critical period (between day 2 to day 7 of fever) is critical.

— Dr Aggarwal

Precautions

Since the Dengue mosquito breeds in fresh water, every household must keep surrounding clean. Weekly cleaning of cooler, and buckets, A/c trays, indoor plants and nearby stagnant water bodies is a must. It’s important to remove trash and standing water. Use mosquito repellents, wear full sleeve clothes, spray insecticide to prevent Dengue.                     — Dr Aggarwal

Danger

The Dengue Shock Syndrome is the worst form of Dengue which can result in death. Symptoms are:

• Intense stomach pain, disorientation, sudden hypotension (fast drop in blood pressure), heavy bleeding, regular vomiting, blood vessels leaking fluid and eventual death
• The symptoms begin after three to 14 days of the infection. This may include  high fever, headache, vomiting, muscle and joint pains and a characteristic skin rash. Patient usually takes two to seven days. In some cases, the disease grows into the life-threatening dengue hemorrhagic fever.
• This results in bleeding, low levels of blood platelets and blood plasma leakage, or into dengue shock syndrome, where dangerously low blood pressure occur.
• Patients with the most serious forms of dengue fever need hospitalisation. If you have suffered from dengue fever previously it is possible to contract it again. If you get infected again and get ill, there is a greater risk of developing a severe form of the disease.

— Dr Aggarwal